Who is an allergist?
An allergist is a physician who specializes in the diagnosis and treatment of asthma and other hypersensitive diseases associated with the immune system. The allergist is specially trained to identify allergy and asthma triggers. Allergist help people treat or prevent their hypersensitivity issues. After earning a medical degree, the allergist completes a three-year residency-training program in either internal medicine or paediatrics. Next the allergist completes two or three more years of study in the field of hypersensitivity and immunology. You can be certain that your doctor has met these requirements if he or she is certified by the American Board of Allergy and Immunology.
What is the immune system and how it is linked with hypersensitivity?
The immune system is involved in defending the body from infection. One of the marvels of the human body is that it can defend itself against harmful invaders such as viruses or bacteria. But sometimes the defences are too aggressive and harmless substances such as dust, molds or pollen are mistakenly identified as dangerous. The immune system then rallies its defenses, which incorporate several chemicals to assault and destroy the supposed enemy. In the process, some unpleasant and, in extreme cases, life-threatening manifestations may be experienced in the hypersensitivity-prone individual.
The reasons for hypersensitive responses:
There are hundreds of ordinary substances that can trigger hypersensitive responses. Among the most common are plant pollens, molds, household dust (dust mites), cockroaches, pets, industrial chemicals, foods, medicines, feathers and insect stings. These triggers are called as “allergens.”
Who develops asthma or hypersensitivities?
Asthma and hypersensitivities can affect anyone, regardless of age, gender, race or socioeconomic factors. While it’s true that asthma and hypersensitivities are more common in children, they can occur for the first time at any age. Sometimes allergy symptoms start in childhood, disappear for many years and then start up again during adult life.
Although the exact genetic factors are not yet understood, there is a hereditary tendency to asthma and hypersensitivities. In susceptible people, factors such as hormones, stress, smoke, perfume or other environmental irritants also may play a role.
Types of allergy problems
An allergic reaction may occur anywhere in the body but usually appears in the nose, eyes, lungs, lining of the stomach, sinuses, throat and skin. These are places where special immune system cells are stationed to fight off invaders that are inhaled, swallowed or come in contact with the skin.
Allergic Rhinitis (Hay Fever)
Allergic rhinitis is a general term used to describe the allergic reactions that take place in the nose. Symptoms may include sneezing, congestion, runny nose, and itching of the nose, the eyes and/or the roof of the mouth. When this problem is triggered by pollens or outdoor molds, during the Spring, Summer or Fall, the condition is often called “hay fever.” When the problem is year-round, it might be caused by exposure to house dust mites, household pets, indoor molds or allergens at school or in the workplace.
Asthma symptoms occur when airway muscle spasms block the flow of air to the lungs and/or the linings of the bronchial tubes become inflamed. Excess mucus may clog the airways. An asthma attack is characterized by labored or restricted breathing, a tight feeling in the chest, coughing and/or wheezing. Sometimes a chronic cough is the only symptom. Asthma trouble can cause only mild discomfort or it can cause life-threatening attacks in which breathing stops altogether.
Atopic and Contact Dermatitis/Hives/Skin Hypersensitivities
Atopic and contact dermatitis, eczema and hives are skin conditions that can be caused by allergens and other irritants. Often the reaction may take hours or days to develop, as in the case of poison ivy. The most common allergic causes of rashes are medicines, insect stings, foods, animals and chemicals used at home or work. Hypersensitivities may be aggravated by emotional stress.
Anaphylaxis is a rare, potentially fatal allergic reaction that affects many parts of the body at the same time. The trigger may be an insect sting, a food (such as peanuts) or a medication. Symptoms may include:
· vomiting or diarrhea
· a dangerous drop in blood pressure
· redness of the skin and/or hives
· difficulty breathing
· swelling of the throat and/or tongue
· loss of consciousness.
Frequently these symptoms start without warning and get worse rapidly. At the first sign of an anaphylactic reaction, the affected person must go immediately to the closest Emergency Room.
What medical conditions do immunologist/allergists manage?
Clinical immunologist/allergists treat all allergic and autoimmune conditions, including:
· Systemic lupus erythematosus (SLE)
· Raynaud’s disease
· CREST syndrome
· Sjogrens syndrome
· Rheumatoid arthritis
· Other arthritis
· Chronic fatigue syndrome
When to see an allergist?
If you feel like you’re always getting sick, with a cough or head congestion, it’s time to see an allergist. Often, the manifestations of asthma or sensitivities build up slowly over time.
Sensitivity sufferers may turn out to be used to frequent indications such as sneezing, nasal congestion or wheezing. With the assistance of an allergist, these manifestations typically can be prevented or controlled with major improvement in value of life.
Effectively controlling asthma and sensitivities require planning, skill and patience. The allergist, with his or her specialized training can develop a treatment plan for an individual condition. The goal will be to enable you to lead a life that is as normal and free from manifestations as possible.
A visit to the allergist might include:
Allergy testing. The allergist will usually perform tests to determine what allergens are involved.
Prevention education. The most effective approach to treating asthma or sensitivities is to avoid the factors that trigger the condition in the first place. Even when it is not possible to completely avoid allergens, an allergist can help you decrease exposure to allergens.
Medication prescriptions. A number of new and effective medications are available to treat both asthma and sensitivities.
Immunotherapy can be given as allergy shots or sublingual tablets.
Allergy shots are given to patients every week or two and contain some or all of the allergens that cause their sensitivity problems. Gradually the injections get stronger and stronger. In most cases, the sensitivity issues get less and less over time.
Sublingual immunotherapy is only available to ragweed, grass pollens and dust mites. These tablets are taken daily at home. However, the first dose is taken at the allergist’s office. Sensitivities improve over time while on the immunotherapy.
You should see an allergist if:
· Your hypersensitivities are causing symptoms such as chronic sinus infections, nasal congestion or difficulty breathing.
· You experience hay fever or other allergy symptoms several months out of the year.
· Antihistamines and over-the-counter medications do not control your allergy symptoms or create unacceptable side effects, such as drowsiness.
· Your asthma or hypersensitivities are interfering with your ability to carry on day-to-day activities.
· Your asthma or hypersensitivities decrease the quality of your life
· You are experiencing warning signs of serious asthma such as:
· You sometimes have to struggle to catch your breath.
· You often wheeze or cough, especially at night or after exercise.
· You are frequently short of breath or feel tightness in your chest.
· You have previously been diagnosed with asthma, and you have frequent asthma attacks even though you are taking asthma medication.
Treatments provided by allergists/immunologist/allergists
Clinical immunologist/allergists/allergists provide treatment for the many hypersensitive and autoimmune problems people may suffer generally involves the administration of medications. These may include steroids or other immunosuppressant medications.
What to expect at your first visit with an immunologist/allergist
Your clinical immunologist/allergist will focus on your current manifestations, then ask about prior indications. They may also ask you about:
· Previous treatments and their efficacy is also very important
· Other medical problems
· Current medications
· Family and social history
Your clinical immunologist/allergist will begin with a general examination and will then focus on the area causing you most trouble. This will vary depending on the clinical presentation.
Training and qualifications
Entry into immunology training is usually very competitive. Once selected 4 years of specialty training follows.
Trainees work and operate under the supervision of a consultant / specialist immunologist/allergist.
Registrars must sit examinations, manage inpatients and outpatients and are encouraged to conduct research before eventually reaching specialty level.
· Basic medical training
· Specialty training
Specialty areas of interest
· Paediatric immunology
· Blood tests particularly for autoantibodies
· Skin prick testing for allergy