Causes of Respiratory Allergies

Doctors don’t know for sure why some people get allergies or allergic asthma. However, they have identified some factors that make a person more likely to develop these conditions:
• Family history-the tendency to develop allergies may be inherited
• Exposure to air pollution
• Being exposed to certain substances in the workplace
• Exposure to secondhand smoke
• Having certain health conditions, such as respiratory infections during childhood or being overweight

Diagnosing Allergies
Some allergies are easy to identify, because there is an obvious pattern of symptoms following exposure to certain substances. For example, if a person always sneezes around cats, that points to an allergy to cats. Someone who gets a runny nose and itchy, watery eyes every spring may be allergic to pollen.

A visit to the doctor’s office for a physical exam¬ination is important. When the allergy trigger is not obvious, the doctor may recommend a specialist called an allergist who will likely do a series of skin tests to identify the allergens that are causing the problem.

Treating Allergies

Avoiding the allergen is the best way to prevent an allergy attack, but this isn’t always possible. Someone who is allergic to pollen, for example, can’t hide in a closet during allergy season. However, there are some steps people can take to reduce their exposure to allergens. If pet dander is the trigger, it will help to limit the areas of the home that family pets are allowed to be in. If dust is the problem, regular cleaning will help to keep it from accumulating. Avoiding damp areas will help if mould is the culprit.

Medications can help ease the symptoms. Some can be bought over-the-counter; others require a prescription. Allergy medicines fall into several different categories:
• antihistamines
• decongestants
• corticosteroids
• bronchodilators
• mast cell stabilizers
• leukotriene modifiers

When medications don’t provide enough relief, a doctor may recommend immunotherapy (allergy shots) to reduce sensitivity to the allergy triggers.

Not every treatment is right for all allergy sufferers, so it is very important to discuss possible treatments with your doctor.

Anaphylactic Shock

Sometimes the sensitivity to an allergen is so extreme that the body goes into anaphylactic shock (also known as anaphylaxis). This is a sudden, severe allergic reaction that affects various systems in the body. The result is:

• difficulty breathing
• swelling of the face, throat, lips, and tongue
• rapid drop in blood pressure
• nausea and vomiting
• dizziness
• unconsciousness.

If it is not treated rapidly, it may lead to death. Anaphylaxis can happen within seconds of being exposed to a triggering substance, or it might happen up to two hours later. Among the most common causes of anaphylaxis are peanuts, seafood, and insect stings.

Anaphylaxis requires immediate treatment. People who know they have severe reactions should carry medication (epinephrine) with them at all times. The medication comes in a small syringe that may look like a pen, and it must be injected. Highly allergic people, their family members, and their friends should know how to give the injection in an emergency. This knowledge could save a life. Medical treatment is important even after the shot is given, because a single injection is not always enough.

Your pharmacist will be happy to answer any questions you have about allergies or allergy treatments and to help you select products to ease your family’s symptoms.

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People with allergies are super-sensitive to things that most people find harmless, including pollen from plants, mould, dust, cockroaches, pet dander (tiny skin flakes), and food.

When a super-sensitive person comes in contact with the substance that causes the allergy (called an allergen), the immune system overreacts and releases a large amount of a chemical called histamine. Large amounts of histamine cause tissue swelling (inflammation) and tightening (constriction) of muscles and other tissues, including those in the breathing passages.

Allergies can affect many different parts of the body. For example, some allergies affect only the skin; others affect more than one body system. Respiratory allergies are those that affect the organs and airways that help us breathe.

Symptoms
Not all people with respiratory allergies are allergic to the same things. One person’s allergies may be triggered by pollen, while someone else may react to dust. However, most people who suffer from respiratory allergies share the same symptoms, which may include:
•    itchiness
•    watery or red eyes
•    coughing
•    sneezing
•    stuffiness in the nose

More serious symptoms may include shortness of breath or wheezing. In severe cases, the airways may become so constricted and swollen that breathing becomes difficult or impossible. This is a serious condition called anaphylactic shock, and it requires immediate medical attention.
Common Allergies that Affect the Respiratory System

•    Hay fever (allergic rhinitis): According to The Canadian Allergy, Asthma, and Immunology Foundation, hay fever affects 20% to 25% of Canadians. It can be seasonal, if it is caused by the pollens of grasses and flowers, or chronic (long-term), if it is triggered by things such as dust, animal dander, or mould.

•    Food and drug allergies: Eating fish or shellfish may cause allergic reactions such as stomach upset or skin reactions, or it may cause severe breathing problems. Some other foods such as peanuts, milk, and eggs may also cause this type of reaction. Medications, too, can cause allergic reactions. It is important to speak to your doctor or pharmacist if you have allergies and are taking any medicines.

•    Insect allergies: Cockroaches can be a major household allergen, especially in densely populated city areas. This may be why there is a higher rate of breathing problems among children who live in inner cities. Bee stings can cause severe, life-threatening reactions in people who are allergic to them.

•    Allergic asthma: Asthma is one of the fastest growing diseases in this country, affecting between 15% and 20% of all Canadians. It is the leading cause of hospital admissions in children. Most of the cases of moderate to severe asthma are linked to allergies.

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A food allergy is a reaction by the body’s immune system. When a person is sensitive to a food, such as peanuts, the immune system overreacts when the person comes in contact with that food. True food allergies are quite rare, affecting only about 1 % of adults and about 5% of children.

Many people think they have a food allergy, but what they really have is a food intolerance, which is a problem in the digestive tract and does not involve the immune system. In someone with a food intolerance, either the food irritates the digestive tract or the body is unable to digest that food properly.

While the symptoms of food allergies and food intolerances are often similar, there are important differences between them as well. Eating even a tiny amount of a food can trigger an allergic reaction, and the reaction will happen every time the person eats that food. On the other hand, a food intolerance may not cause a reaction unless a large amount of the food is consumed. For example, in someone with lactose intolerance drinking a cup of coffee with a small amount of milk in it may not cause a problem, but that same person might become sick after drinking a whole glass of milk.
The foods that most commonly trigger allergies are:
� cow’s milk
� eggs
� fish (such as bass, cod, and flounder)
� shellfish (such as crab, lobster, shrimp)
� peanuts
� tree nuts (such as almonds, cashews, hazelnuts, pecans, and walnuts)
� wheat
� soy

Symptoms
Food allergy symptoms usually develop within an hour of eating the food, sometimes within minutes, and they can range from mild and annoying to frightening and life-threatening. People who are especially sensitive may have a reaction from simply touching the food or breathing in particles of it.

Symptoms of a food intolerance may be extremely uncomfortable, but they are typically less serious than the symptoms of a food allergy.

In severe cases of food allergy, the person may suffer from a life-threatening reaction known as anaphylaxis or anaphylactic shock. This dangerous reaction can cause:
� tightening of the airways, including a swollen
throat that causes breathing difficulties
� shock, with a severe drop in blood pressure
� rapid pulse
� dizziness, light headedness, or loss of consciousness.

These are warning signs of a serious problem and require immediate medical attention. There is a medication (epinephrine) that people with serious allergies should carry at all times. It comes in a self-injecting device, and anyone who has food allergies or knows someone who does should know how to use the device. This can, quite literally, be a life saver. Even if the reaction is controlled quickly, immediate medical attention is still necessary. A single injection is not always enough to completely control the reaction.

People with severe allergies should also wear medical identification jewelry. During a severe reaction a person may not be able to speak, and this jewelry can identify the problem for emergency medical personnel so that the proper treatment can be given quickly.

When a child has a food allergy, the parents must take special precautions. Make sure that all caregivers (including family members, teachers, babysitters, and the parents of the child’s friends) all know how to use the epinephrine injection device. Older children should learn to use the device themselves.

Parents must also impress on children how important it is not to eat the food they are allergic to. Young children should be instructed never to eat food given to them by anyone other than a family member. Older children should be instructed to ask about any food someone gives them and to make sure the person giving them the food knows about their allergy and how serious it is.

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