An allergy is the body's hypersensitivity to substances in the environment. Mold, dust, pollen, pet dander, and even some foods can cause allergic reactions.

Allergy tests are used to learn which substances are causing allergic reactions. Three types of tests can be used to confirm an allergy diagnosis:

Blood tests—A small sample of blood is taken. It is tested for dozens of allergens. This test is also called Immunocap or in vitro testing.

Skin tests—Suspected allergens are applied to the skin. The area is watched to see if an allergic reaction (raised or irritated skin) occurs. It is also called skin-prick testing. This may be followed by intradermal testing (in vivo testing). In this case the allergen is placed deeper.

Patch testing—Patches containing suspected substances are placed on the skin.

Once specific allergens have been identified, steps can be taken to avoid these triggers. This will help lessen allergic symptoms. Ask your doctor to give you detailed information on ways to take control of your allergies. Adjust your activities to avoid exposure to allergens that bother you. Once you are diagnosed, pay close attention to possible triggers and discuss these with your doctor.

Treatment Options

Antihistamines and decongestants are the two main allergy medication types. Antihistamines block the action of histamine, the substance released when mast cells recognize the presence of allergens. Antihistamines relieve redness, inflammation, itchiness and watery eyes. Ophthalmic solutions (drops) for the eye can also relieve red, irritated eyes. Many older antihistamines have a sedating effect. They make you sleepy. Newer, non-sedating ones are available, most by prescription. A dry mouth is also a common side effect. It helps to have liquid antihistamines as well as those in pill/capsule form, as they are more easily swallowed during a stronger allergic reaction.

Decongestants: reduce nasal congestion by constricting blood vessels. Nasal sprays work faster than oral decongestants, but "rebound" is also common. After a few days of taking nasal decongestants, there's a "rebound effect" in which the congestion that had cleared comes back. More medication only makes the congestion worse. Discuss this side effect with your doctor to understand how to limit the amount of medication you use.

Bronchodilators: relax the muscles around the air tubes in the lungs. They decrease allergy symptoms such as coughing, wheezing and shortness of breath. Agitation and nervousness are common side effects.

Steroid medications: in oral or inhaled nasal forms are used to decrease inflammation. Nasal steroids have fewer side effects than oral forms. Long-term oral use (more than one week) must be carefully monitored by a doctor, because of potential side effects. Low-dose topical steroid medications are used for rashes.

Living with Allergies

The best way to treat allergy symptoms is to avoid allergens. This is easy to say but can be hard to do - completely eliminating microscopic allergens, such as pollen or mold spores, may be impossible. However, even reducing the amount of allergen in your environment can lead to a significant decrease in symptoms, fewer medicines and a higher quality of life. This is called environmental control. After identifying what you are allergic to, focus your attention on those places where you spend the most time. These may include your house, place of work or car.

If have additional questions or would like to speak with a allergy specialist about a specific issue, please  This e-mail address is being protected from spambots. You need JavaScript enabled to view it to learn more about your options.

Asthma

Asthma was rare in 1900, but now it has grown into an epidemic: more than 15 million are affected in the U.S. and up to 10 times that many around the world. Every year it kills 5,000 Americans, mostly older adults, and 180,000 annually worldwide, according to the World Health Organization.

Asthma is a chronic disease that affects your airways. The airways are the tubes that carry air in and out of your lungs. If you have asthma, the inside walls of your airways are swollen. The inflammation makes the airways very sensitive, and they tend to react strongly to things that you are allergic to or find irritating. When the airways react, they get narrower, and less air flows through to your lung tissue. This causes symptoms like wheezing (a whistling sound when you breathe), coughing, chest tightness, and trouble breathing, especially at night and in the early morning.

Asthma has no known cure, but in most cases people with asthma can control it so that they have few and infrequent symptoms and can live active lives. 

When asthma symptoms become worse than usual, it is called an asthma episode or attack. During an asthma attack, muscles around the airways tighten up, making the airways narrower so less air flows through. Inflammation increases, and the airways become more swollen and even narrower. Cells in the airways may also make more mucus than usual. This extra mucus also narrows the airways which restricts normal breathing.

In some parts of the world Asthma is known as Reactive Airway Disease, and is defined as a chronic lung condition with: 


• Inflammation (swelling) of the airways
• Increased sensitivity of the airways to a variety of things that make asthma worse
• Obstruction of airflow

Diagnosing Asthma

The first step in diagnosing asthma is a good evaluation. In many cases, a diagnosis of asthma is made based upon your history and symptoms at the time of evaluation. The family history should also be considered, as a positive family history increases a person's chances of developing asthma.

Kinds of Tests Used to Diagnose Asthma

Your doctor may have you perform a number of tests to evaluate breathing. These may include:

• Detailed medical history and physical exam
• Breathing tests called spirometry
• Chest and sinus X-rays

Specific tests that may be conducted in diagnosing asthma are explained in more detail:

• Bronchial Provocation Test
• Exercise-Induced Bronchoconstriction Test
• Routine Pulmonary Function Test
• Asthma Control Test

The Asthma Control Test can help you determine if your asthma is controlled as well as it could be. And it can help start a conversation with your doctor about better ways to manage your asthma.

Answer each question and write the answer number in the box to the right of each question. Please answer as honestly as possible. This will help you and your doctor discusses your asthma treatment plan and whether your asthma is controlled as well as it could be.

1. In the past 4 weeks, how much of the time did your asthma keep you from getting as much done at work, school or at home?

1. All of the time
2. Most of the time
3. Some of the time
4. A little of the time
5. None of the time

2. During the past 4 weeks, how often have you had shortness of breath?

1. All of the time
2. Most of the time
3. Some of the time
4. A little of the time
5. None of the time

3. During the past 4 weeks, how often did your asthma symptoms (wheezing, coughing, shortness of breath, chest tightness, or pain) wake you up at night or earlier than usual in the morning?

1. All of the time
2. Most of the time
3. Some of the time
4. A little of the time
5. None of the time

4. During the past 4 weeks, how often have you used your rescue inhaler or nebulizer medication (such as albuterol)?

1. All of the time
2. Most of the time
3. Some of the time
4. A little of the time
5. None of the time

5. How would your rate your asthma control during the past 4 weeks?

1. Not controlled at all
2. Poorly controlled
3. Somewhat controlled
4. Well controlled
5. Completely controlled

Add your answers and write your total score. If your score is 19 or less, your asthma may not be controlled as well as it could be. To discuss the results with an asthma specialist This e-mail address is being protected from spambots. You need JavaScript enabled to view it to schedule an appointment.