Southern Peninsula Paediatric Allergy strives to provide education and understanding to parents and children to enable them to better manage their medical problems.
The increasing incidence of allergy world wide especially in the developed countries, is a concern.
Allergy is all about the body’s immune system perceiving things in the environment as “threats” or foreign and producing antibodies to attack them.
True allergy (as opposed to various sensitivities) involves the OVER production of allergy antibodies called IgE (all the antibodies the body produces are given certain numbers: IgA, IgM, IgG) and these attack proteins in foods (eg: peanut, egg, milk etc.) and aeroallergens (protein particles in the air such as house dust mite, pollens and animal fur) to cause reactions by releasing histamine and other chemicals from cells around the body.
Immunotherapy or desensitization has been around a long time to try and restrict or “turn off” the body’s production of IgE.
Desensitization to house dust mite, pollens and bee stings by regular subcutaneous injections (for at least 2 years) has been available in Australia for more than 20 years.
Recently, immunotherapy or desensitization has been carried out by drops under the tongue on an every day basis or 2 – 3 times per week. This technique is being used extensively in Europe and has many advantages over the injection method. It is much safer, can be carried out at home, is less painful (most children do not like injections) and seems to be as effective as the injection method. However, the course is for 3 – 5 years so that compliance and commitment to the program is very important.
Sublingual immunotherapy (SLIT) treatment is now available for desensitising children as young as 5 or 6 years with persistent hayfever/rhinitis in particular but also for asthma. It is not available for foods or bee sting allergy. However there have recently been great strides in oral immunotherapy for foods, especially peanut and hopefully there will be a program available in the next 5-7 years.
If you wish for more information about immunotherapy, please contact us here at Peninsula Paediatrics – 0477 813 722
Rhinitis is a term used for inflammation of the nasal lining which causes symptoms such as rhinorrhoea (runny nose), itching, sneezing and blockage.
These symptoms can be a year round (perennial) problem for some people or seasonal for others. If this occurs during the spring/summer time, it is often referred to as hayfever.
It is common to have associated eye symptoms such as itching, redness of the whites of the eyes, wateriness and swelling suggestive of inflammation of the conjunctivae (the whites of the eyes.) Some people just have the eye involvement and others just the nose but the combination is common and usually called Rhinoconjunctivitis.
Allergy to airborne allergens (aeroallergens) is a common and important trigger for these areas and allergy tests (skin prick tests (SPT) and/or blood test (RAST)) can be useful in detecting the allergy antibodies.
Foods in younger children can occasionally be responsible or a trigger but never alone and always part of wider allergic reactions which involves skin reactions (hives, itching, swelling) as well as gastrointestinal reactions (vomiting, abdominal pain and possibly diarrhoea.)
Rhinitis is commonly associated with asthma and up to 80% of people (both children and adults) can have the two conditions coinciding. The rhinitis can precede the asthma or develop later. If it is present when someone has asthma, it can potentially affect asthma symptoms making it harder to control.
The nose is not only an organ used for smelling but we are meant to breathe through it so it warms, humidifies and filters the air to protect the lower airways. If the nose is blocked and you are unable to breathe through it, then the alternative is to breathe through our mouth which allows the atmosphere to directly impact on the bronchial tubes, particularly the small ones where the changes of asthma occur.
Controlling rhinitis symptoms can often lead to a reduction in asthma symptoms and improved control. There is evidence that inflammation in one area (such as the nose) can lead to inflammation in the other (the bronchial tubes leading to the lungs) so recognition and treatment of rhinitis symptoms is very important in anyone who has troublesome asthma.
If allergy factors are diagnosed as being important (on specific testing for IgE antibodies for aeroallergens) then environmental reduction measures such as trying to reduce House Dust Mite exposure especially in the bedroom,and/or reduce pollen loading by regularly washing of face and hands after being outside in the pollen season can be helpful.
Antihistamines can be useful to control symptoms of sneezing, itching, irritation of the nose and eyes and can reduce rhinorrhoea (runny nose) and watery eyes.
If there is a significant problem with blockage or obstruction, this usually indicates swelling of the lining of the nose (mucosal lining) due to inflammation. Antihistamines are of limited value and topical steroids or nasal sprays (Beconase, Rhinocort, Nasonex and Avamys) are the most helpful treatment to suppress the inflammation. There is a newer nasal spray called Dymista. which is a combination of a topical steroid and an antihistamine and has a guided response but requires a script from your doctor and is more expensive than Nasonex which can be purchased over the counter.
Nasal steroid sprays can be very effective but need to be used for some weeks often to achieve improvement. They have to be taken properly and usually once or twice a day. They can have side effects of nasal irritation and increase any tendency to nose bleeds so people with a history of nose bleeds need to be cautious in their usage.
As well as symptoms related to the nose and eyes, people who suffer from rhinitis/hayfever often experience other benefits by bringing their symptoms under control.
Perennial rhinitis often interferes with adequate sleep so people often feel tired, irritable and not refreshed the next day. It can affect children's behaviour and concentration at school as well as their appetite, energy levels and tendency to pick up infections easily. Some children are incorrectly diagnosed with ADHD because of their poor concentration and easy distractibility.
Sometimes rhinitis symptoms can gradually become worse but the children become used to their symptoms and accomodate them leading to a misdiagnosis of the effect it is having on their body.
Many parents comment on how much better and happier the children become once their rhinitis symptoms are brought under control as well as their increased ability to shake off illnesses.
Rhintis is often the "hidden" or silent partner to asthma and tis recognition and proper control can have major implications for better health.