| An
Algorithm for Allergic Disease: When to Consider Allergy
Immunotherapy Allergic
Diseases, specifically Allergic Rhinitis and Allergic
Asthma are common. Most patients will try various
over-the-counter medications before seeing their doctor.
Many will experience some relief at this first line
of therapy, although these patients should be warned
that many of these medications are associated with
sedation and cognitive impairment. The primary care
physician can offer additional medications, including
non-sedating antihistamines and nasal corticosteroids.
The physician can also try to identify the asthma
triggers through history and recommend environmental
controls to limit exposures to allergens. Pollen allergy
may be identified by seasonal symptoms which are worse
outside during a pollen season (Trees begin pollinating
in early spring, and persist through June. In this
area Grass pollens spike in April, but can persist
in lower levels into the autumn. Weeds begin pollinating
in late summer through early autumn).
Closing the windows and using the air conditioning
will decrease the pollen exposures. Avoiding the outdoors
is also effective, but would be unacceptable to many
people and would interfere with our efforts as physicians
to encourage our patients to be more active.
Allergy Immunotherapy
Allergy Immunotherapy is also a safe and
effective option that you should consider for your
patients with Allergic Rhinitis, especially if they
do not experience significant relief from the other
treatment options. Some patients may prefer immunotherapy
because of the high cost of medications, or they may
prefer not to rely on medications for their relief.
Even if you find an effective medication, there is
a chance that it may fail in the future. You may also
want to consider immunotherapy for patients who have
other related diseases, such as asthma or sinus disease.
Children with Allergic Rhinitis are at a higher risk
of developing allergic asthma, and Allergy Immunotherapy
has been demonstrated to significantly reduce the
development of asthma in these patients. While the
other treatments for Allergic Rhinitis focus on symptom
control, allergy immunotherapy targets the cause.
It can make the patient less allergic and often effects
a cure.
The biggest downside to allergy immunotherapy is that
it is often inconvenient for patients to come in for
routine injections, but most patients are able to
go 3-4 weeks between injections after the first year,
and even less frequently after that. Also, most patients
are able to discontinue allergy injections after 3-5
years and still maintain the benefit for many years
later.
About The Author
Gary B. Moss M.D
www.allergydocs.net
|