Allergy and Immunology
At Northside ENT we have our own internal allergy department. We specialize in allergies that affect the ear, nose and throat causing sinusitis, hearing loss, and dizziness. By incorporating allergy testing and treatment into our ENT practice, we are able to treat our patients more effectively.
If patients are experiencing trouble breathing through their nose, post nasal drainage, rhinitis or frequent sinus infection, we can explore whether allergies might be an underlying cause of these ailments.
Allergic rhinitis is a reaction of the lining of the nose to particles in the air.
- Occurs when the nose and usually the ears, eyes, sinuses, and/or throat come into contact with allergy-causing substances.
- The allergy-causing substances are called allergens. The most common allergens are pollens, molds, dust, and animal dander.
- Some allergens are present only during certain seasons, for example, ragweed in the fall. The allergic reaction they cause is called seasonal allergic rhinitis or hay fever.
- Other allergens are present year-round, such as the mites in house dust. These allergens cause a type of rhinitis called perennial allergic rhinitis.
When the lining tissues of the nose and sinuses come into contact with allergens, a chemical called histamine is released from cells in the nose. Histamine causes the nose lining to swell, itch, and make too much mucus.
What are the symptoms of allergic rhinitis?
- Itchy, runny nose
- Nasal and Head Congestion
Other Possible Symptoms
- Fatigue and lethargy
- Itchy Throat
- Postnasal Drainage
How is allergic rhinitis diagnosed?
Your health care provider will ask about your symptoms, medical history, and family history.
- It may take some detective work to figure out exactly what you are allergic to. You may have tests for specific allergies.
- For most people the best tests are skin scratch or prick tests. For these tests your health care provider or an allergy specialist places tiny amounts of suspected allergens under your skin and looks for reactions. These allergy tests will identify which of many possible allergens are causing your symptoms.
- In some cases you may have blood tests to look for antibodies to suspected allergens.
Allergy tests can be expensive depending on your insurance coverage. Your health care provider will probably recommend that you try treating your symptoms with medicine first. If medicines do not control your symptoms, you may need allergy tests.
Allergic Rhinitis Treatment Options:
- Identify and avoid contact with the things you are allergic to. Usie an air conditioner and special filters rather than an attic fan to lessen the amount of pollen that gets into your home. Put plastic covers on to help you avoid dust and mold. You may also cover pillows with plastic.
- Prescription or over the counter medication. Your health care provider may suggest that you first try decongestants for mild symptoms. You may have some side effects from decongestants, such as a rapid heart rate or trouble sleeping. Sometimes these medicines can also raise your blood pressure.
- Prescription or over the counter antihistamine medicines can help treat and prevent allergy symptoms. There are different types of antihistamines. Drowsiness is a common side effect of some of them. This may not be a problem if a dose at bedtime is all you need. Or you might try the medicine for several days despite the drowsiness. Often the drowsiness goes away after you have taken the drug for 3 to 5 days. Or you may want to try the newer antihistamines that don’t usually cause drowsiness.
- There are several steroid nose sprays that can be used daily to treat or prevent symptoms. A different and nonprescription nose spray containing a medicine called cromolyn is also available. Depending on your other allergy symptoms, a nose spray may be the first and only medicine you need.
- When symptoms are severe in spite of medicines, your health care provider may suggest allergy shots. A mixture is prepared that contains the allergens identified in your allergy tests. The mixture is injected into your skin in tiny but increasing amounts over the course of many months. Over time, the shots make you less sensitive to the allergens. Usually after 4 to 6 months of allergy shots you will begin to have relief from your allergies. However, you will probably need to continue the shots for 2 to 3 years or longer.
Proper treatment of allergy symptoms is the best way to prevent complications of allergic rhinitis, such as ear and sinus infections.
How long will the effects of allegic rhinitis last?
If you have had allergies since you were a child, you will probably have them the rest of your life. New allergies can develop any time, even if you have not had allergies before. Allergy symptoms depend not only on the season and weather but also on location. This means your allergies may wax and wane, depending on where you are living.
How can I help prevent allergic rhinitis?
There are no known ways to prevent the development of allergic rhinitis. Once allergies have developed, you can try to limit exposure to the things that cause them, for example, pollens or animals. In severe cases, you may need to move to another area, but you may develop allergies there as well.
Allergy testing can identify your allergies, and we can help you manage them. Our board certified otolaryngologists will perform a complete exam of your ears, nose and throat. Their recommendations may range from avoidance to medications to immunotherapy.
Your Doctor has recommended allergy testing. What can you expect?
Your allergy technician will greet you and escort you to the testing area. You may be a bit apprehensive, but you will quickly feel at ease with our technician. She will explain every single part of the allergy test experience for you. If the patient is your child, you will be pleased to know that our technician has worked with children for many years. Our allergy technician also has extensive experience with pediatric and adult patients with physical and mental challenges.
Northside ENT is one of the few healthcare providers in Central Indiana using the Modified Quantitative Test (MQT) method for allergy testing.
There is minimal discomfort and the test is well tolerated well by adults and children. Your test results will be read and recorded just 20 minutes after application of the test. These results will indicate if the second test called “intradermal” testing is required.
Not everyone will need this secondary type of testing. Intradermal testing involves the placement of small bubbles on the skin surface of your upper arm. This test also involves minimal discomfort. Results are read and recorded after just 15 minutes. Patients receive copies of their results and informational packets concerning their treatment prior to leaving.
We also offer Allergen Specific IgE testing via a one serum blood sample. It is a cost effective, compact, and flexible system that measures up to 61 antigens simultaneously. There are inhalant, food and combination panels available. This testing enables you to stay on your medications. Results are obtained in as little as 48 hours if needed by this fast, accurate and reliable testing method.
Your physician will explain test results and treatment options. These may include avoidance measures, medications, allergy shots, allergy drops placed under your tongue or a combination of these.
Patients on “subcutaneous therapy” begin with weekly injections. Then the frequency will vary over time with Immunotherapy treatment response. Shots may eventually be every two weeks; then every three weeks , and finally, once a month. Most insurance plans cover some, if not all, of the costs. Your allergy serum can address all of your allergens. For 30 minutes after injection, you will be required to stay in the office for observation. Children receiving allergy shots do very well. They quickly realize there is little, if any, pain associated with therapy. And they are happy to be playing outside symptom-free.
Like vaccines, allergy shots help your body’s immune system fight what you’re allergic to. Your body will eventually learn not to treat those allergens as enemies.
The Allergy Tracker smartphone app is an innovation empowering patients to actively manage their immunotherapy treatment with easy access to their treatment and injection progress. Northside ENT has been utilizing Roche Visionary software for patient electronic records since 2008.
Drops under your tongue or “sublingual therapy” may be an option, allowing you to spend less time in a doctor’s office. Maintenance is achieved in less than a month. Then the drops remain the same for the duration of therapy.
Allergy drops, however, only contain your “high-end” allergens. These are substances you are most allergic to. Doctors have been treating allergies with sublingual therapy in Europe for over 60 years. And many physician practices throughout the United States now offer sublingual therapy.
The U.S. Food and Drug Administration (FDA) has approved the allergens used in the preparation of sublingual vials. The FDA has not, however, approved the method of placing sublingual drops under the tongue. Therefore, most insurance plans will not cover the cost of sublingual therapy.