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Allergies: Stop and Smell the Roses

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Do you feel it yet? The runny nose. The itchy eyes. The sneezing. It’s allergy season!

Not everyone suffers from seasonal allergies, but as spring erupts in blossoms, plenty of people sneeze and sniffle their way through the season.

“There is a strong genetic predisposition to allergies,” explains Dr. Robert Onder, an allergist with Allergy and Asthma Consultants and on staff at Des Peres Hospital. “If you have one allergic parent, this doubles your chance of having allergies, and if you have two allergic parents, it triples your chance.”

A family history of eczema, food allergies, allergic rhinitis or asthma also increases the likelihood of reactions to environmental allergens, adds Dr. Elyra Figueroa, an allergist with SSM Sunset Hills Allergy, Asthma and Immunology and on staff at SSM St. Clare Health Center.

Fortunately, there are effective treatments to help control allergy-related discomfort. Among the most common are over-the-counter antihistamines and decongestants. Nasal steroid sprays also may be recommended by a physician for short-term symptom alleviation. Yet none of these treatments offers a true cure.

“There is a way to put allergies into a partial or sometimes complete remission, and that is with allergy immunotherapy, commonly referred to as allergy shots,” Onder says. “With immunotherapy, we treat the patient with the things she is allergic to and make her less allergic.”

Figueroa explains that immunotherapy works to suppress the body’s immune response to the allergen. “It is the only available treatment that has been proven to reduce one’s sensitivity to allergens. The long-term goal is to be able to discontinue allergy medications and potentially live a life with no allergies.”

Traditionally, patients begin by receiving weekly injections, which may continue for as long as a year while immunity to the allergen develops. “Today, we frequently begin patients on allergy shots with rapid desensitization or ‘rush immunotherapy,’ ” Onder notes. “With this procedure, in one four-hour period, a patient builds up about two-thirds of the way to the target immunotherapy dose (known as the ‘maintenance dose’). In other words, rush immunotherapy ‘jumpstarts’ the immunotherapy program, and does in four hours what would take six or more months by the traditional method.”

In Europe, immunotherapy typically is delivered by placing the allergen under the tongue. Known as ‘sublingual immunotherapy’ (SLIT), this type of treatment can be self-administered, although it doesn’t provide the advantage of combining multiple allergens into one shot, as is the case with injections.

“SLIT is gaining support among trained allergists here, but it is still considered investigational therapy,” Figueroa says. “Currently there is no FDA-approved product.” However, Onder notes that SLIT trials are underway and anticipates the treatment will become more widely available in the U.S. in the next few years.

Without the benefits of immunotherapy, preventing allergies involves determination and dedication. Frequent vacuuming with a HEPA-filtered vacuum cleaner, encasing mattresses and pillows with dust mite covers, keeping windows closed, wearing a mask when doing yard work, and quickly changing clothes and showering after being outdoors may help.

“I encounter many patients who allow themselves to merely deal and tolerate their allergy symptoms despite its effect on their quality of life,” Figueroa says. “I’m a firm believer one should be in control of their allergies and not the allergies controlling their well-being.”

Onder agrees that allergies should not control one’s activities. “Medical treatments like antihistamines are much more effective if they are begun prior to the season,” he says. “For the patient who does not get adequate relief from OTC and prescription medications, I recommend consultation with an allergist to devise a more effective treatment plan.”

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