Allergies and the Treatment of Allergy Sufferers in Singapore

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Allergies and the Treatment of Allergy Sufferers in Singapore

An allergy is an abnormal reaction to substances in the environment. They are reaching epidemic proportions, affecting up to 40 percent of the population. Allergies such as hay fever are rare in Singapore, however because of the humidity, heat, change in diet and city pollution, newcomers can be faced with allergies that they may not have experienced in the past.

Allergies are manifested in various forms and can affect different body systems concurrently. They are treated by different specialists, which can cause confusion for patients and doctors. It is therefore critical in the treatment of allergies that the patient is managed in a holistic fashion rather than by compartmentalising the symptoms.

Common terms used in the treatment of allergies

• Allergy of the nose: Allergic Rhinitis
• Allergy of the eyes: Allergic Conjunctivitis
• Allergy of the lungs: Allergic Asthma
• Allergy of the skin: Ezcema, dermatitis, contact dermatitis, hives, and urticaria
• Allergy of the gut: Manifests as colic, bloating, diarrhoea
• Middle Ear Fluid: Otitis Media
• Non-specific Symptoms: Fatigue, hyperactivity, headaches, depression

Causes of Allergies

Allergies are caused predominantly by what is breathed in (inhalant allergy) and what is consumed (food allergy).

Inhalant allergies

Inhalant allergies are easily recognised. Dust mite, pollens (hay fever) and animal danders are all common contributors.

Food allergies

A food allergy presents itself in two forms.

1. The immediate allergy: This form of allergy is generally quite easy to diagnose as a reaction (such as rash) occurs immediately during or after food consumption (examples are peanut or shellfish allergy).
2. The non-immediate allergy: The reaction appears much later and specialised tests are necessary for diagnosis. Symptoms caused by food allergies include eczema, chronic cough, nasal polyps, phlegm (in the absence of infection), chronic headaches and other symptoms. Often the symptoms are non-specific and statistics have shown that typically the sufferer has sought numerous medical opinions without relief.

Diagnosing Allergies

For allergies to be appropriately treated and controlled, it is important that the specific allergen(s) causing the allergic symptoms be identified. The first step is a detailed history and physical examination to confirm the symptoms of the allergy. The methods of assessment include using skin tests and/or blood tests. These tests will help determine the mode of treatment for the allergies.

Treating Allergies

Treatment of allergies includes avoidance, medication and immunotherapy.

1. Avoidance: In most instances, the cause of symptoms can be avoided or removed. For example, a particular food that causes the allergic reaction can be avoided, or a pet can be removed from the home or kept away from the sleeping area. Some causes of symptoms cannot be eliminated but exposure may be reduced.
2. Medication: Medication is frequently used to decrease or eliminate allergy symptoms. These include steroid nasal sprays, steroid tablets, creams and antihistamines. While they are effective in controlling symptoms, they do not provide a cure.
3. Immunotherapy (De-sensitisation): Immunotherapy is the only means of curing allergies as endorsed by the World Health Organisation. The program allows for de-sensitisation against the substance causing the allergy. For example, a person allergic to dust mites will receive immunotherapy which can prevent them from reacting to dust mites. Immunotherapy will also help reduce the development of new allergies; benefits can last up to and beyond ten years. Both adults and children from the age of three can benefit from it. It has been used successfully for allergic rhinitis and asthma with excellent results. Allergens that can be treated this way include allergies to dust mites, pollen, cats and dogs.

In the past, immunotherapy was only available in injection form. Now an oral preparation call SubLingual ImmunoTherapy (SLIT) is available. Accurate diagnosis is essential for treatment. Trained allergists and ENT doctors with a sub-specialty in allergies provide this treatment.

Allergies in Children

Children commonly have significant allergy problems, though they are often undiagnosed as the children may not complain or the allergy isn't recognised. The way a child experiences an allergy changes as the child grows, and children may "grow out" of an allergy or develop new allergies. For instance, babies are more troubled by gut problems and eczema. As the child grows, the problems of rhinitis and asthma become more prevalent and the eczema may subside. Environmental exposure to dust, pollen, pets and diet play a part in the change. There is an increasing trend of allergies in children.

Allergic rhinitis, when left untreated, leads to increased risk of asthma. A child experiencing recurrent colds, flu, runny nose, sneezing, glue ears and eczema should be evaluated for allergies as successful management of allergies will lead to a better quality of life with less frequent accompanying medical problems.

Allergies in ENT

An otolaryngologist is a doctor that specialises in ear, nose and throat (ENT) problems. Chronic nasal congestion and postnasal drip are commonly related to allergy. This may be further complicated by chronic sinus disease and middle-ear disease. An otolaryngologist who specializes in allergy will be able to provide a comprehensive diagnosis and treatment.

Information provided by Dr. Y T Pang, Senior ENT & Allergy Consultant
Centre for Ear Nose Throat Allergy & Snoring
Tel: 6738 5500 / www.ENTdoctor.com.sg
Copyright © 2008 Dr. Y T Pang All Rights Reserved