Allergy Testing & Treatment
Ear, nose and throat (ENT) allergies, like other types of allergies, are extremely common. Allergic reactions of all kinds are triggered by an abnormal response of the immune system when it mistakes an innocuous substance for a serious threat. While most allergic symptoms of this type are relatively mild, untreated ear, nose and throat allergies should not be ignored because they may lead to more significant medical problems.
Causes of ENT Allergies
ENT-allergy sufferers, although seemingly reacting to allergens, are actually being attacked by their own immune systems. When an allergic individual is exposed to an allergen, her or his body produces antibodies and releases a variety of chemicals, including histamine. Histamine is the chief precipitating cause of allergic response. In many cases, an allergic response to the allergen will not occur immediately upon exposure, but only after a certain threshold of exposure is reached. While the underlying causes of allergies are unknown, they are known to be hereditary.
Common allergens responsible for ENT allergies are present in the air, and may include dust, mold, animal dander and pollen. Allergies to plant pollens and mold can be seasonal, occurring only when certain plants or trees are in bloom, or when mold is produced by rotting leaves. Such allergies are also affected by weather conditions, particularly humidity and wind, and are commonly referred to as hay fever.
Symptoms of ENT Allergies
Most allergies of the ear, nose and throat result in mild symptoms, which may, nonetheless, interfere with normal activities. Nasal rhinitis may result in sneezing, nasal congestion or a runny nose. Individuals with ear, nose and throat allergies may also suffer from headaches, and itching and soreness in the throat and ears. More severe reactions to ear, nose and throat allergies, including anaphylaxis, are far less common but may be life-threatening.
Treatment of ENT Allergies
Allergy treatments are usually prescribed in the form of over-the-counter or prescription antihistamines. Antihistamines prevent the release of histamine and help to reduce symptoms. Decongestants and nasal sprays are also sometimes prescribed to clear nasal passages and improve breathing. Sometimes, allergy shots are recommended to gradually create a tolerance in the patient to the allergen. This is known as immunotherapy. By far, the most effective treatment for allergies of the ear, nose and throat is to avoid the offending allergens, but that is not always possible.
Limiting outdoor activities during certain seasons, avoiding contact with particular animals, wearing sunglasses and frequently washing the hands may reduce the severity of symptoms. For patients who have allergies to indoor allergens, such as dust and mold, it may be helpful to keep the indoor environment clean and to avoid the accumulation of moisture. Not using carpeting, in which mold can easily grow, may also be helpful.
Allergy Evaluation and Treatment
There are two forms of allergy treatment: drugs and immunotherapy. Most commonly, people take over-the-counter or prescribed allergy medicines like antihistamines (cetirizine, loratadine) nasal steroid sprays (fluticasone), or decongestants (sudafed). You may take several different types of allergy medicines at one time to achieve better control of symptoms. As both Otolaryngologists and Allergists, we often prescribe allergy medicines, but for many people, medicines only provide limited benefit and some cannot tolerate the side effects such as high blood pressure or fatigue. For others, their allergies directly contribute to severe and chronic illnesses such as sinus infections, bronchitis, asthma flare ups, and pneumonias, leading to multiple rounds of antibiotics, missed work days, and hospitalizations.
Patients with severe allergies should come to one of our offices for allergy evaluation and testing. Allergy testing will identify the specific allergies causing your symptoms and enable us to start allergy immunotherapy. Immunotherapy is different from medications in that medications do not eliminate allergies permanently, but only give you temporary relief as long as you continue to take them. Immunotherapy, in contrast, will provide you with significantly better control of symptoms and if continued for several years, may lead to permanent loss of allergies. You will eventually be able to quit allergy treatment and have no return of allergy symptoms. There are two forms of immunotherapy: allergy drops and allergy shots. In both forms of immunotherapy, introducing a gradually increasing dose of things that you are allergic to, leads to the down regulation of your allergic reactions, leading to decrease in symptoms and eventually complete desensitization or loss of allergies. Allergy Drops and Allergy Shots are the most effective way to treat allergies. At Florida ENT & Allergy, we have a strong commitment to providing you with outstanding allergy treatment and care.
Learn more about nasal and sinus disease treatments.
Allergy Drops (Sublingual Immunotherapy, SLIT)
Allergy Drops have become popular in the USA in the past decade. It is used throughout the world safely. It is also a highly effective way to treat environmental allergies but without needles. The drops are placed under the tongue daily. The main advantage of the allergy drops is that it is much safer than shots, therefore, patients may escalate their allergy drops at home. The main disadvantage of allergy drops is that insurances do not cover allergy drops at this time so it must be purchased by patients directly. For patients with high deductibles or no insurance, the allergy drops are much less expensive. Allergy Drops are ideal for children, people fearful of needles, medically unstable patients, or those too busy to come to doctor’s office for weekly allergy shots.
Allergy Shots (Subcutaneous Immunotherapy, SCIT)
Allergy Shots are very effective in treating nasal congestion, itchy eyes, asthma, eczema, post nasal drainage, recurring sinusitis (learn more about our sinusitis treatments), and bronchits/pneumonia. It is given once a week in the office and each week the dose is escalated. It is also very safe but there is a very small risk of anaphylaxis so patients must have an epinephrine autoinjector and wait in the office for 30 minutes after each shot. Once the patient reaches the maximum dose, or the maintenance dose, most patients choose to self-administer allergy shots at home. Insurances cover allergy shots and, therefore, it is more affordable than allergy drops for most patients with insurance. Both allergy drops and allergy shots are effective in controlling allergy symptoms. Choice between the two is often based on time, cost, and preference.
Food allergies are often under appreciated by most physicians. We have discovered over many years of practice, that food allergies are more common that previously reported and very difficult to identify because it can present in a myriad of ways. Food allergies can affect any organ in the body: nose (congestion, sinus infections, post nasal drip), ear (dizziness, ear infections, Meniere’s), skin (eczema, hives, itching), gut (reflux disease, IBS), lung (asthma), brain (fogginess fatigue), and throat (coughing, throat clearing, hoarseness). The first step is to identify the food allergy by skin testing and by food challenges. The second step is to learn how to manage your food allergies.