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Dealing with Allergies

Dealing with Allergies

The article below appeared in the June 9th  issue of Health with Perdana, a regular column in The Star by Perdana University faculty members. This week’s article is contributed by

When the immune system of a child is unable to insulate itself from allergens (substances that trigger allergic reactions are referred to as allergens) in certain foods, dust, pollens, the result is an allergic reaction and the child is said to have allergies.  Allergies can impair a child’s ability to sleep, play and function in school.

Children with eczema (skin condition which is the earliest manifestation of allergy) have a predisposition to develop other allergies. The eczema is more likely to occur in young children.  Later on, the same child with eczema may develop other allergies of the nose or the lungs. This process of evolution of one form of allergy to another is known as “Atopic March”. The term “atopic” signifies that a child is allergic to various foods and environmental triggers.

Allergies seem to be more prevalent among children whose family members have a history of allergies. Since it is not feasible for the parents to control the external environment and the children’s eating habits completely, the parent’s attention should be focused on observing the symptoms. The early detection of allergies enables the parents and the consulting physician to formulate strategies to control the symptoms and enable the child to lead a normal life.

In the United States, up to 50 million people including many children, suffer from some form of allergy.

The prevalence of some of the childhood allergies in Malaysia is shown in the figure below:

Source: Malaysian Allergy Prevention (MAP):  Guidelines for Healthcare Professionals

 

Symptoms of Allergies:

Common symptoms of allergies in children are:

  • Skin rashes
  • Wheezing
  • Trouble breathing
  • Stomach ache, vomiting, diarrhea
  • Itchy and watery eyes
  • Cold, cough, sneezing

 

What causes Allergies:

Common allergens include:

  1. External environmental triggers
    • Tree pollens
    • Insect bites
  2. Indoor allergy triggers
    • Pet or animal fur
    • Dust mites
    • Cockroaches
  3. Food allergens
    • Cow’s milk
    • Eggs
    • Fish
    • Peanuts
    • Wheat
    • Many children outgrow allergies to cow’s milk and eggs as they get older. However, fish and peanut allergies generally persist. Wheat can cause a severe life threatening allergic reaction.
  4. Medicine allergies
    • Many medicines like penicillin and sulfa drugs can cause allergic reactions

 

Diagnosis:

Some allergies can be fairly easily identified. Others can have obscure symptoms.

Atopic dermatitis or eczema manifests itself by skin rash formation at the affected body parts accompanied with severe itching.

Allergic rhinitis (also called hay fever), a nasal allergy, is more common among children suffering from eczema. Most children do not start suffering from hay fever until school age. Triggers of allergies present in the environment like pets, pollen and dust can cause hay fever. In a child, if cold symptoms persist for a week or two, or symptoms always occur at a certain time of the year, hay fever should be suspected.

Asthma, a form of lung allergy, manifests itself as cough, wheezing and difficulty in breathing. Such children generally show a good response to medicine given in inhaled form.

Food allergies:  Symptoms of food allergies observed in young children include vomiting, diarhhea, runny nose and sneezing. In rare cases, children may suffer a severe reaction called anaphylaxis, which can be fatal. It is important to identify whether the reaction observed in young children is due to food allergies or food intolerance. The signs and symptoms of food intolerance and food allergy can be similar, but are generally milder in case of food intolerance. A classic example of food intolerance is lactose intolerance where the enzyme needed to digest lactose in milk is deficient. A person with lactose intolerance can drink lactose free milk without any problem.

Medicine allergies: generally manifest as skin rashes. In rare cases, may cause life threatening anaphylaxis.

Diagnostic tests to identify the allergens triggering the allergic reaction include:

1)     Skin tests

2)     Blood tests

Test findings are correlated with the observed symptoms before making a final diagnosis. In severe cases the child may need consultation with an allergist (a medical doctor who specializes in allergies).

 

Treatment:

While the allergies cannot be eliminated totally, yet their impact and symptoms can be mitigated through appropriate treatment strategies.

To insulate children from airborne allergies, the following measures can be helpful:

  • Pets to be kept out of the house
  • Stuffed toys to be kept out of the child’s bed room
  • Remove any carpets or rugs in the house
  • Keep windows closed to mitigate pollen related allergies
  • Dust mite allergies can be minimized by using encased mattresses and pillows

Children and their care givers must be educated to avoid exposure to identified allergens. However, if avoiding allergens is not feasible or not effective, doctors might prescribe anti-allergic medications

e.g. antihistamines, inhalers, eye drops and nasal sprays.

In severe cases, the child may need allergy shots which help to desensitize the child from the allergens.

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