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Some of the key reasons that have been hypothesized to be responsible for such a rise in allergies are as follows: Hygiene Hypothesis: The theory postulated is that the cleanliness and hence the development of living conditions in developed countries results in lowered resistance to germs and infection, leading to underdeveloped immunity. The immune system might overreact to disparate and harmless environmental substances, including an allergy-inducing reaction. Environmental Changes: Pollution, urbanization, and effects of climate change will contribute to higher levels of allergens in the surrounding. Pollutants enhance the allergenicity of some common allergens, while climate change not only means the alteration of pollen seasons but also greater exposure. Diet and Lifestyle: Altered dietary habits due to modern dietary methods, which include processed foods, and a reduction in the consumption of fresh fruits and vegetables, will greatly influence gut health and immune status. The use of antibiotics and changes in our diet alter the gut microbiota, which, interestingly, lends some help in the development of the immune system. Genetic Factors: Although this cannot explain the rapid rise, there is a hereditary component. Allergic children are likely to have allergic parents. Nevertheless, the rapid rise in recent decades has pointed to environmental causative factors. Vitamin D Deficiency: Vitamin D deficiency, due to inadequate sunlight exposure, is responsible for a rise in allergies. Vitamin D is important for the regulation of the immune system, and an insufficiency of this vitamin can impair immune responses. Early Childhood Exposure: Decreased exposure to certain microbial agents in early childhood through factors such as reduced breastfeeding, more deliveries by cesarean sections, and reduced family size impacts the programming for a healthy immune system. Chemical Exposure: Growing usage of chemicals in home care, personal care products, and food production almost inevitably triggers more frequent allergic reactions. Exposure to these chemicals could sensitize the immune system. Increased Awareness and Reporting: Improved diagnostic tools and more awareness of allergies have increased the number of cases diagnosed. If one uses this argument, it does not explain the increase entirely; however, it can be assumed that just more cases are recognized and reported. These, among many others, form a dense and complicated picture of why allergies are on the rise. The interaction with genetic predisposition and changing environmental and lifestyle factors plays a significant role in this trend.
Inflammation and narrowing of the airway in any location in your lungs, can result in wheezing. The most common causes of recurrent wheezing in children is Allergy. Commonest allergen in our country is House Dust Mite. Moulds, Pollen, Pat dander and Insect are other common causes. All these can be easily detected by Skin Prick Test and appropriate measures can be advised. Children below 5 years can wheez due to viral infections. Other rare causes also exist. Everyone required detail evaluation. But those who developed persistent or repeated wheezing especially on background of strong family history of any other allergy including mild Allergic Rhinitis and has atopic dermatitis or eczema cause is usually allergy. Conditions is completely controlled with inhalation therapy and repeated episodes can be decreased or prevented once action like avoidance or environmental control is taken against causative antigen. And in those patient who remain persistent or especially in those who are likely to run a prolonged course Allergen specific Immunotherapy can be considered. Smoke, perfume , cold drinks, outside dust etc acts as an irritant and can trigger wheezing. All these need to be avoided.
Allergic rhinitis is where your nose gets irritated by something you're allergic to, such as house dust mite, Moulds, Pet dander,Pollens, etc causing sneezing and othersymptoms. Condition differs from common cold as it last more than a week and symptoms are repeatative. Allergic reaction causes sneezing, congestion, itchy nose, block nose and red eye or eye itching, throat irritation, ear fullness. Mostly in children it can cause snoring and mouth breathing especially when upper tonsil (Adenoids) blocks the airway passage by inflamation and enlargement. It also causes repeated headache when sinuses are inflammed. Overall condition is often referred as Hay fever in western world and as just “sinus” by local community. Temporary relief is obtained by allergy pills and or Intra Nasal Spray but symptom are usually chronic and lead to many complications after continuous inflammation over years often requiring surgery. 40% can develop asthma in future after decades as similar inflammatory process begins in the lung. Cause can be established by detail evaluation, examination and Skin Prick Test knowing the culprit antigen. Appropriate environmental control or avoidance of antigen can give much relief but by allergen specific immunotherapy tolerance can be developed to causative antigen giving oneself an allergy free life.
It be isolated allergy to eye but usually occurs in conjunction with nose allergy as inflammation from nose travels through nasolacrimal duct or channel which exist to drain tears into nose. Most common allergen is House Dust Mite where symptoms are seen throughout the year. Pollen allergy can be seasonal. Other allergens like pet dander, insects, moulds could be a causative factor and Skin Prick Test will detect it. Your eye doctor will prescribe drops which will give temporary relief. If symptoms are persistent Skin Test is required. And if with avoidance and environmental control of causative antigen is not possible or if symptoms remain persistent Allergen specific Immunotherapy or Allergy vaccine will be required.
Food allergy is an immune system reaction that happens soon after eating a certain food. Even a tiny amount of the allergy-causing food can trigger symptoms such as digestive problems, hives or swollen airways. In some people, a food allergy can cause severe symptoms or even a life-threatening reaction known as anaphylaxis.
The most common food allergy symptoms include:
1)Tingling or itching in the mouth.
2) Hives, itching or eczema.
3)Swelling of the eyelid,lips, face, tongue, and throat or other parts of the body.
4)Wheezing, nasal congestion or trouble breathing.
5)Belly pain, diarrhea, nausea or vomiting.
6)Dizziness, lightheadedness or fainting.
In atopic dermatitis especially in infants & small children up to 40% can have associated food allergy and can lead to increase in symptoms of eczema.
Some children outgrow their food allergies as they get older but it is not always the rule. Milk, Soy, Wheat, Egg are known to outgrow but Shellfish and nut usually do not.
Food allergy symptoms usually develop within a few minutes to two hours after eating the offending food. Rarely, symptoms may be delayed for several hours. 90% of food allergy is usually due to Shellfish (such as shrimp, lobster and crab), Milk, Soya,Wheat, Fish, Sesame, Lentils like Dal, Egg, Peanut and Tree nuts (walnuts, cashewnut, pista etc).
But any other food can be allergic to particular person.
Proteins in certain fruits, vegetables, nuts and spices cause the reaction because they're similar to allergy-causing proteins found in certain pollens. This is an example of cross-reactivity and known as Oral allergy syndrome. Here primary allergy is of particular pollen. Symptoms are typically triggered by eating these foods when they're fresh and uncooked.
Eating certain foods may cause some people to feel itchy and lightheaded soon after starting to exercise. Serious cases may even involve hives or anaphylaxis. Not eating for a couple of hours before exercising and avoiding certain foods may help prevent this problem. This condition known as Food dependent Exercise Induced Anaphylexis is increasing now a days.
DIAGNOSIS:
Detailed evaluation with history, Skin Prick Test, Prick to Prick Test, Specific IgE and CRD blood test usually help. But Gold standard of confirmation if daubt exist is Oral Challenge whereby same offending food is given in gradually increasing doses under controlled set up. Since it can trigger anaphylaxis it is usually done where severe reaction can be managed.
TREATMENT:
When you know what foods you are allergic to, the best approach is to strictly eliminate those foods from your diet. You may also need to take a nutritional supplement to replace any nutrients lost by avoiding your trigger foods. Eg. For milk avoidance one will need calcium and Vitamin D supplement.
They should have emergency medications including epinephrine autoinjectors available at all times in case of accidental ingestion and reaction.They are usually trained regarding when and how to use it. It’s important to seek emergency medical care immediately after using an epinephrine autoinjector.
Oral immunotherapy by developing tolerance of that particular offending food is successful for milk in research set up and oral immunotherapy for Peanut allergy is now approved by US FDA. Prophylactic Biologicals like Omalizumab injections are also approved above one year in recent times. These are encouraging development and future treatment guidelines will be based on this.
If your child has a food allergy, take these precautions to ensure your child's safety:
1) Notify key people that your child has a food allergy. Talk with child care providers, school personnel, parents of your child's friends and other adults who regularly interact with your child.
2) Emphasize that an allergic reaction can be life-threatening and requires immediate action.
3) Make sure that your child also knows to ask for help right away if your child reacts to food.
4) Explain food allergy symptoms.
Teach the adults who spend time with your child how to recognize signs and symptoms of an allergic reaction.
5) Write an action plan. Your plan should describe how to care for your child when your child has an allergic reaction to food. Provide a copy of the plan to your child's school nurse and others who care for and supervise your child.
6)Have your child wear a medical alert bracelet or necklace. This alert lists your child's allergy symptoms and explains how others can provide first aid in an emergency.
FOOD INTOLARANCE is often confused with Food Allergy. One may get only digestive systems such as nausea, vomiting, cramping and diarrhea.
Rash, itching, cough or difficulty in breathing which are signs of allergy are usually absent. Depending on the type of food intolerance you have, you may be able to eat small amounts of problem foods without a reaction. By contrast, if you have a true food allergy, even a tiny amount of the food may trigger an allergic reaction. Symptoms are usually stopped if particular food is avoided for 15 days. And reintroduction can trigger same symptoms again will confirm the diagnosis. These cases are usually handled by Guestroenterologist.
PREVENTION:
There is no known way to prevent food allergies in adults. In babies, breastfeeding in the first six months of life may prevent milk allergy. Early introduction of highly allergenic foods such as peanut protein and eggs into the diet may also have a preventative effect in high risk patients. Please discuss with your healthcare provider.
In India most common allergen responsible for respiratory allergy ie Wheezing in children, Allergic Rhinitis or nose allergy, Allergic conjunctivitis or Eye allergy and Asthma in adults is House Dust Mite (HDM). Being microscopic they can not be seen by naked eyes & thrive on human skin that is shed every day. They consume water from humid air and live in cotton fabrics which can not be washed and dried. They are relative of ticks and are not bed bugs. They are present in abundance in all modern houses which are full of upholstery items. Allergenic material is protein molecule. It is found abundantly in it’s feces & usually not harmful to normal individuals. But only in those people who are prone for allergy it causes inflammation in respiratory tract and give rise to clinical symptoms. House Dust Mites are deeply embedded inside cloth material and even can not be removed by vacuum cleaner. Only partial removal is possible by doing vacuum cleaning using HEPA filter. Lack of good cross ventilation, natural day light and Aircondition atmosphere facilitates it's growth. Only if all these factors responsible for its growth and survival are disturbed it's effect can be curtailed. Hence those having dust might allergy should frequently wash all upholstery fabrics ie bedding, mattresses, pillows, soft toys, cushions, cotton sofas in hot water (above 50 degree centigrade ) and then dry in open space. It is usually not possible to remove or wash all items mentioned above hence it is advisable to use good quality allergen proof bed and pillow cover which are not easily available in open market in India. Patients are advised to remove unnecessary cushions, carpet and slowly replace soft toys with some other type of toys. Sofa set can be covered with rexin which prevents dust mite proliferation. Dehumidifier can help as below 50 humidity do not favour dust mites growth. Air purifier is of not much of help as mite’s allergen consist of high molecular weight protein and do not remain suspended in air for more than 30 minutes. It usually comes up in air when fabrics material is disturbed while going on bed, seating on sofas or hugging soft toys and cushions. Blankets are usually full of dust mites antigens and should be avoided. Symptoms due to Dust Mite allergies like nose block, snoring, mouth breathing, chronic cough and wheezing are usually seen at night time and early morning. Dust mites is the highly susceptible antigen for immunotherapy. This is also called as allergy vaccines where same antigen in diluted form is given to susceptible individual and concentration is gradually increased to develop tolerance which can take up to one year. If successful it should be continued for total 3-5 years. And patient can become symptoms free and need for prolonged treatment with inhalers and intra nasal spray may not be required. It is given as drops which are administered below the tongue or by subcutanious Injections given below the skin.
If you keep your pet, you can help minimize the allergens in your home with these tips: Bathe your pet frequently. Ask a family member or friend without allergies to bathe your pet on a weekly basis. Establish a pet-free zone. Make certain rooms in your house, such as your bedroom, pet-free zones to reduce allergen levels in those rooms. Remove carpeting and dander-attracting furnishings. If possible, replace wall-to-wall carpeting with tile, wood, linoleum or vinyl flooring that won't harbor pet allergens as easily. Consider replacing other allergen-attracting furnishings, such as upholstered furniture, curtains and horizontal blinds. Enlist help. When it comes time to clean your pet's kennel, litter box or cage, ask a family member or friend who doesn't have pet allergies to do the work. Use high-efficiency filters. High-efficiency particulate air (HEPA) air purifiers and vent filters may help reduce airborne pet allergens. Keep your pet outside. If your pet can live comfortably outside, you can reduce the amount of allergens in your home. This option isn't appropriate for many pets or in certain climates.
An insect allergy means that someone has an allergic reaction to the venom of insects or the bites from specific kinds of insects. The most common insects that can cause allergic reactions are bees, wasps, hornets, yellow jackets and some ants. However, when individuals with such allergies are bitten by the above mentioned insects or stung by them, their immune system behaves abnormally to the toxins in their venoms or salivas causing histamine and other chemicals to be released resulting in symptoms of allergies. On a scale of seriousness though there may be swelling around the sting/ bite areas with redness, pain and itching involved. In its severest forms however anaphylaxis may occur which is a medical emergency situation. It may also involve breathing difficulties, swelling of face; throat tightness; increased heart rates; sudden drop in blood pressure; spinning sensation and even fainting. People who have ever experienced severe allergic reactions after being stung or bitten by insects should carry epinephrine (e.g., EpiPen) with them at all times and seek immediate medical attention if they get stung again. Allergen testing can help identify specific insect allergens and immunotherapy using allergens (allergy shots) might be recommended to desensitize the immune system over time to insect venoms. By so doing as well as wearing repellants for bugs and avoiding places where they thrive in numbers like picnic sites.
If you have a mold or Fungus allergy, your immune system overreacts when you breathe in these spores. A mold allergy can cause coughing, itchy eyes and other symptoms that make you miserable. It can also cause asthma with restricted breathing and other airway symptoms.
If you have a mold allergy, the best defense is to reduce your exposure to the types of mold that cause your reaction. Medications like antihistamines, Intra nasal Spray and lnhalers can help keep mold allergy reactions under control.
Mold allergy symptoms vary from person to person and range from mild to severe. You might have year-round symptoms or one that flare up only during certain times of the year. You might notice symptoms when the weather is damp or when you're in indoor or outdoor spaces that have high concentrations of mold.Exposure to mold spores can cause a reaction right away, or the reaction can be delayed.
Various molds are commonly found indoor areas and also at outdoors. Only certain kinds of mold cause allergies. Being allergic to one type of mold doesn't mean you'll be allergic to another. Some of the most common molds that cause allergies include alternaria, aspergillus, cladosporium and penicillium.
A number of factors can make you more likely to develop a mold allergy or worsen your mold allergy symptoms, including
1: Having a family history of allergies
2:Working in an occupation that exposes you to mold. Occupations where mold exposure which include farming, dairy work, logging, baking, millwork, carpentry, greenhouse work, winemaking and furniture repair.
3:Living in a house with high humidity usually above 50%.
Mold can grow virtually anywhere if the conditions are right — in basements, behind walls in framing, on soap-coated grout and other damp surfaces, in carpet pads, and in the carpet itself.
4: Working or living in a building that's been exposed to excess moisture. Examples include leaky pipes, water seepage during rainstorms and flood damage.
5: Living in a house with poor ventilation. Tight window and door seals can trap moisture indoors and prevent proper ventilation, creating ideal conditions for mold growth. Damp areas — such as bathrooms, kitchens and basements — are most vulnerable.
PREVENTION:
To reduce mold growth in your home, consider these tips:
1) Eliminate sources of dampness in basements, such as pipe leaks or groundwater seepage.
2: Use a dehumidifier in any area of your home that smells musty or damp. Keep your humidity levels below 50%. Remember to clean the collection bucket and condensation coils regularly.
3: Use an air conditioner and consider installing central air conditioning with a high-efficiency particulate air (HEPA) filter attachment. The HEPA filter can trap mold spores from outdoor air before they're circulated inside your home.
Change filters on your furnace and air conditioners regularly. Have forced air heating ducts inspected and, if necessary, cleaned.
4: Be sure all bathrooms are properly ventilated, and run the ventilation fan during a shower or bath and immediately after to dry the air. If you don't have a ventilation fan, open a window or door while you're showering or bathing.
Remove blackish collection in between tiles which is of mould using bleaching powder or Soda bicarb.
Paint bathroom ceiling after removing black mold patches. One with allergy should avoid this cleaning procedure or use mask or respirator and gloves.
5: Promote groundwater drainage away from your house by removing leaves and vegetation from around the foundation and cleaning out rain gutters frequently. Make sure the ground slopes away from the foundation.
Keep organic plant containers clean and dry, such as those made of straw, wicker or hemp.
6: Toss or recycle old books and newspapers. If left in damp places, such as basements, they can quickly become moldy.
7: Repair all water leaks immediately and get painted damped patches on wall or below kitchen sink or if it is existing in any other places.
8: Keep your yard free of piles of damps and decaying leaves or wood.
DIAGNOSIS:
Can be done by detailed evaluation by Allergist and through Skin Prick Test and sometimes blood test will be required.
TREATMENT:
While medical management can make you symptom free, environmental control as explained above can prevent the symptoms up to certain extent. Immunotherapy of offending mold or fungus can be considered after discussing with your Doctor.
Pollen is a powdery particle that flowering plants, trees, grass and weeds release to help fertilize other plants of the same species. It travels by floating through the air, but when it lands on surfaces it appears as a fine yellow dust. These tiny yellow particles can easily end up in your nose, eyes or lungs.
If you have a pollen allergy, your immune system thinks pollen is a dangerous intruder. It produces chemicals to fight off the pollen, and you experience an allergic reaction. Sneezing, congestion and puffy eyes and breathlessnes or asthma are just a few of the symptoms people with pollen allergies may have.
Contrary to bright insect pollinated flowers like hibiscus or rose it is wind pollinated ones are usually allergic. Most common allergenic plants of Goa are grass pollens (usually cynodon dactylin) and few weed pollen (like Amaranthus Spinosus). Although they flower perennially it is usually in abundance in post monsoon and winter season. Few other plants with pollens having allergenic potential are Azadirichta Indica (Neem), Riccinous Communisans (”Arandel”) , labernum, Acacia etc.
Pollen allergies are typically seasonal and affect people when plants pollinate and this gives clue to Allergist who evaluate and diagnose this type allergy with Skin Prick Test or by Serum specific IgE test. Medical management usually control symptoms but Immunotherapy especially of grass pollen is highly effective and once tolerance develops patient can become symptoms free and long-term medications may not be required.
How do I take care of myself?
Completely avoiding pollen and the outdoors can be tough. Some useful tips for dealing with a pollen allergy are:
1: Stay inside when pollen levels are highest or on windy days.
2: Close your windows and use air conditioning or fans to stay cool.
3: Avoid being outdoors in the morning and early afternoon when pollen levels tend to be higher.
4: Wear a dust mask when you’re outside. A hat and sunglasses can also help.
5: Use high-efficiency particulate air (HEPA) filters in your home.
6: Remove and wash any clothes that have been outside immediately.
7: If you spend time outside, shower and wash your hair before getting into bed.
8: Pollen calendar and high pollen count of the particular place is known it can help in planning outdoor activities.
Latex allergy is caused by natural rubber products like gloves, balloons, and medical equipment. It may cause itching, rash, runny nose, asthma, or even anaphylaxis in severe cases.
Urticaria, commonly known as hives, is a skin condition characterized by raised, red, itchy welts or bumps on the surface of the skin. These welts can vary in size and shape and may appear suddenly and disappear within hours or days. Urticaria can be acute (lasting less than six weeks) or chronic (lasting longer than six weeks). The condition occurs when certain cells in the skin release histamine and other chemicals in response to an allergen or other trigger. Common triggers for urticaria include certain foods, medications, insect stings or bites, pollen, pet dander, infections, physical factors (such as pressure, cold, or sun exposure), stress, and underlying medical conditions. In many cases, the cause of urticaria is unknown (idiopathic urticaria). The symptoms of urticaria can range from mild to severe and may be accompanied by swelling of the lips, tongue, or throat (angioedema) in some cases, which can be a medical emergency if it affects breathing or swallowing. Treatment for urticaria typically involves identifying and avoiding triggers when possible and using medications to relieve symptoms. Antihistamines are commonly used to reduce itching and swelling, while corticosteroids may be prescribed for more severe cases. In chronic urticaria, other medications such as leukotriene receptor antagonists, omalizumab (an anti-IgE antibody), or immunosuppressants may be recommended.
Angioedema is deep swelling of the skin, lips, eyelids, or throat due to allergic reactions. It can be dangerous if it blocks the airway and requires immediate medical attention.