Posted by Dr Joe on April 2, 2018 · Leave a Comment
We, as humans, are so prone to allergic problems that it seems to be the “human condition” helping to define who we are. Don’t get me wrong, other species can also have allergic problems and you have probably seen that at some point in your domestic cats and dogs.
But we humans are not very tolerant of these annoying symptoms and aside from cold medicines and possibly antibiotics, medications for allergies are one of the leading popular medications for allergy sufferers and pharmaceutical companies.
Not to belittle symptoms of allergies in humans but in the overall scheme of illnesses that cause substantial morbidity and mortality, allergic problems are way down on the list; this is not to include the very serious types of allergic problems leading to anaphylaxis and sometimes death- bee stings, certain drug allergies, etc.
During the springtime, the allergens (substances causing allergic reactions) tend to come out into the air sometime between April and July. We all know what these are; tree pollen usually appears first followed by residue of growing grass, and then certain weeds such as goldenrod, etc. which tend to show up in the later summer and early fall. The very things that create a beautiful, colorful springtime are bothering us. The only way to avoid some contact with these elements is to remain indoors for 4-5 months with your heat or A/C on: a totally impractical solution. So we must learn to live with these allergens.
The first thing to do is to prioritize the symptoms that you are having (runny nose, sneezing, coughing, itching, etc.) in order to decide which of these are really affecting your life style and help determine which methods of treatment are the best. The allergic symptoms one sees is the end result of a pattern of reaction.
- The allergen enters the field of attention, usually the respiratory or skin systems and attach to certain cells lining these areas.
- This causes a chemical reaction that ends in the release of many substances called mediators, of which histamine is one.
- These mediators then attach to cells disrupting them and causing the symptoms that we recognize as “allergies”.
- These cells become soft, leaky and sometimes swollen, producing mucus at the site and causing runny nose and sneezing.
This problem can be treated by attacking the process at any stage along the way.
- Initially, avoiding the allergen would be ideal but this can only happen under unusual circumstances.
- The next step would be to interfere in some way with the attachment of the allergen to the cell. There are some medications available to hinder this process but it is not very effective.
- The next process would be to interfere with the release of mediators from the cell that is damaged by the previous processes mentioned and there are medications that try to do this, but again not very efficiently.
- There are medications available that can counteract the effects of the mediators on the active cells lining the respiratory tract; the most well-known and common of these are the antihistamines that are used widely, such as Benadryl and others. The antihistamines counteract the effects of the histamines and other mediators on the cells of the respiratory tract so that the symptoms tend to occur less frequently or severely.
- Finally there are common medications available that can try to alter the function of the affected cells in the respiratory tract and diminish the effects of the mediators on these cells. These are the decongestants (such as Sudafed) that are present in just about every cold medicine. Decongestants act to, among other effects, to cause the small leaky blood vessels in the respiratory tract to constrict and “leak less”.
- Finally there are allergy shots which expose the individual to increasing amounts of the offending allergen in an attempt to “desensitize” the person to the effects of exposure to that allergen.
Now back to the symptoms and their importance. These symptoms can and do regularly interfere with normal comfortable functioning in our everyday life. These can vary from very mild to constant and very severe. It is best not to medicate the very mild end of the spectrum as each of the medications mentioned above have their own individual side effects (e.g. sleepiness, irritability, and elevated blood pressure), and these can sometimes be worse and more annoying than the symptoms of the allergy. So, choose your red line in the sand as far as reducing symptoms in your child- are they significant enough to treat at all? The unfortunate corollary to this is that your child’s teacher may interpret any sneezing coughing or runny nose as a “cold” worthy of separating from the other children in the class.
The bottom line is to work closely with your child’s doctor to establish a plan of action as the severe symptoms can interfere with school, sleeping and eating.
