Allergy prevention


1、Allergic conjunctivitis 

Allergic conjunctivitis is caused by aeroallergen. Aeroallergens come into contact with eye and trigger an allergic reaction. Common complications in children are: allergic rhinitis, allergic asthma, and atopic dermatitis

2、Symptoms

Eye itching, redness, tears, conjunctival hyperemia.

3、Classification

  1. Seasonal allergic conjunctivitis, SAC(Seasonal allergic conjunctivitis, SAC)
  2. Perennial allergic conjunctivitis, PAC(Perennial allergic conjunctivitis, PAC)
  3. Atopic keratoconjunctivitis, AKC(Atopic keratoconjunctivitis, AKC)

 

SAC and PAC are commonly seen ocular allergies. SAC is caused by pollens and spores. PAC is caused by house dust mites, molds, and pets. AKC is a relatively uncommon, often seen in patients with atopic dermatitis.

4、Treatment and health care

In the treatment of allergic conjunctivitis, it is important to determine the substances that cause allergic conjunctivitis by the following tests: tear IgE, blood IgE, specific allergen test. Avoid contact of allergens: use an indoor air purifier and goggles; avoid outdoor activities. Using ice pack to get relief. Rinse with normal saline or artificial tear. If infection occurs, use antibiotics. For more severe cases, antihistamine, mast cell inhibitors, and vasoconstrictors may be used under doctors’ instruction


1、Allergic rhinitis

Allergic rhinitis is also known as hay fever. When the immune system overreacts to allergens, such as crabs, pollens, dust, mites, molds, etc., inflammation in the nose may occur. Allergic rhinitis may be seasonal or perennial. Seasonal allergic rhinitis occurs in particular during pollen seasons. Perennial allergic rhinitis caused by mites and molds occurs throughout the year.

2、Symptoms

Sneezing; a runny nose; a stuffy nose; an itchy nose/eyes/throats an itchy nose.

Other symptoms include:

◎Dark circles under eyes
Caused by chronic inflammation of nasal cavities and poor lymph circulation

◎Complications of stuffy nose
A stuffy nose may lead to mouth-breathing, snoring, losing sense of smell, otitis, losing sense of hearing, dizzy, headache and bad breath.

◎Rhinosinusitis
Caused by bacterial infection.

◎Unable to concentrate
The nasal complications caused by allergic rhinitis will disturb daily life, lead to inability to focusing on learning or working. Patients with allergic rhinitis often suffer from atopic dermatitis,      allergic conjunctivitis, urticaria and allergic asthma.

 

3、Treatment and health care

Generally speaking, treatment and health care of allergic rhinitis include medications, surgeries and environmental control of allergen.

Medication:

Antihistamine drugs: Effectively relive the sneezing and running nose. However, some antihistamine drugs may have side-effect of somnolence and some of patients show the antihistamine-resistance.

  1. Antihistamine drugs:

    Effectively relive the sneezing and running nose. However, some antihistamine drugs may have side-effect of somnolence and some of patients show the antihistamine-resistance.

  2. Anti-inflammatory drugs:

    Mast cell stabilizer (Intal) and steroids. Mast cell stabilizer affects mast cells in nasal mucosa to mitigate the symptoms. However, continuous application of mast cell stabilizer for 3~ 4 weeks is required.

  3. Steroid nasal spray:

    Intranasal corticosteroids decrease the number of mast cells in the nasal mucosa.

  4. Antibiotics:

    For complications of allergic rhinitis, include rhinosinusitis and bacterial infection, antibiotics are needed.

 

Non-drug treatments:

1.Surgeries

  • Turbinectomy:
    All or part of the lower turbinate was removed. This can be done in several different ways, but sometimes a tiny, high-speed device (microdebrider) is used to shave off the extra tissue. The surgery may be done through a lighted camera (endoscope)that is placed into the nose.
  • Turbinoplasty:
    A tool is placed in the nose to change the position of the turbinate. This is called the outfracture technique. Some of the tissue may also be shaved off.
  • Radiofrequency or laser ablation:
    A thin probe is placed into the nose. Laser light will go through this tube and shrinks the turbinate tissue.

2.Environmental control
Avoid contact of allergens. The followings are recommended:

  • Allergy test.
  • Avoid drinking ice-cold water and irritants.
  • Eat natural food, vegetables, and fruits. Avoid pickled food.
  • Less seasonings, such as salts, and food coloring.
  • Functional probiotics and polysaccharides (glucans) are helpful.

 


1、Allergic asthma

Allergic asthma is triggered by inhaled allergens. Symptoms are: inspiratory dyspnea, chest tightness, coughing, wheezing, and shortness of breath.

2、Symptoms

Asthma is characterized by recurrent episodes of wheezing, shortmess of breath, chest tightness, and coughing. Sputum may be produced from the lung by coughing but is often hard to bring up. During recovery from an attack it may appear pus like due to high levels of white blood cells called eosinophils. Symptoms are usually worse at night and in the early morning or in response to exercise or cold air. Some people with asthma rarely experience symptoms, usually in response to triggers, whereas others may have marked and persistent symptoms.

3、Causes

Asthma is a disease caused by many factors: genetic factors, emotions, lifestyles, climates changes, allergen exposure (pollens, dusts, mites, food, furs), etc. According to studies, environmental allergens play a major role in the exacerbation or induction of asthma.

4、Treatment and health care

Treatments of asthma include medications and environmental control of allergens. Medications commonly used to treat asthma include: anti-inflammatory drugs and bronchodilators. Inhalation can help reduce side effects of drugs. For children under age five, inhaler or nebulizer may be used.

Environmental control of allergens is to avoid the contact of allergens.

  1. Sanitization and humidity control to mitigate dusts, mites, and cockroaches.
  2. Using anti-dust mite pillows and bedding.
  3. Avoid plush goods and toys.
  4. Avoid contact of pollens, cigarettes, perfumes, and pesticides.

 

The followings are recommended:

  • Allergy test.
  • Avoid drinking ice-cold water and irritants.
  • Eat natural food, vegetables, and fruits. Avoid pickled food.
  • Do mild exercises.
  • Functional probiotics and polysaccharides (glucans) are helpful.

1、Allergic enteritis

Allergic enteritis is caused by consumption of certain food. Some children or adults are hypersensitive/allergic to egg, crab, fish, shrimp and milk. Consumption of these food may induce gastrointestinal discomfort.

2、Symptoms

Bellyache/abdominal pain, diarrhea, watery feces, abdominal distention, bloating.

3、Treatment and health care

Symptoms of allergic enteritis are similar to enteritis caused by other causative agents. Consult doctors for the cause of enteritis.

The followings are recommended:

  • Allergy test.
  • Avoid consumption of allergenic foods.
  • Avoid raw food.
  • Avoid stimulating foods.
  • Multi-vitamins are helpful.
  • Functional probiotics and polysaccharides (glucans) are helpful.

1.Atopic dermatitis

Atopic dermatitis is a chronic, recurrent skin disease. It results in itchy, red, swollen, and cracked skin. In Taiwan 10-20% children suffer from atopic dermatitis.

2.Symptom

Itchy, red, swollen, and cracked skin. Clear fluid may come from the affected areas. Sensitive to environmental irritants. Skin thickens. These signs are often seen on arms or legs, face, and neck. The itchiness often leads to scratching and then rashes, causes inconvenience in patients with atopic dermatitis.

3.Phases of atopic dermatitis

  • (1)The infantile stage (2 month~2 years old)

    Redness and eczema on head, face and neck. Blisters even crusts may occur.

  • (2)The childhood phase (2~12 years old)

    Rash widely distributed throughout the body and in the bends of limbs, arms, knees Mild erythema and blisters may occur. However, chronic scratching makes the skin lesions thickened and vulnerable to infection.

  • (3)The adult phase (Above 12 years old)

    Eczema may be seen on face and neck. Large thickened plaques and scaling can be seen in in the bends of limbs. Flexural folds are also seen on the hands of patients.

 

4.Causes

The causes can be different from the age of patients. For infants, major causes are food such as eggs, milks, shrimps, and peanuts. For children above age five, the major causes would be S. aureus and airborne allergens because of the establishment of immunity. Long-term medication is needed.

The causes of atopic dermatitis are very complicated. Studies have shown that the atopic dermatitis is correlated with immune deficiency. Skin pathogens such as S. aureus also play an important role. Infection of S. aureus is often seen in the patients with atopic dermatitis, therefore, use of antibiotics is recommended. S. aureus secretes toxins to induce the production of pro-inflammatory cytokines in type I T helper cells; however, it will induce the cytokines production from type II T helper cells in atopic dermatitis patients. In addition, the IL-4 produced by Type II T helper cells can inhibit the necrosis of T cell. These findings suggest that in patients with atopic dermatitis, necrosis of T cells will not occur, T cells stay activated and inflammation persists, thus atopic dermatitis is hardly curable.

5. Treatment and health care

Treatments of atopic dermatitis include ointments and oral-drugs. Ointments for anti-inflammation include NSAIDs or steroids. Oral antihistamines may alleviate the itchiness. Antibiotics may be used if you have a bacterial skin infection (by Staphylococcus aureus) or cracked skin caused by scratching.

Avoid contact of environmental allergens. Regularly clean up bedding with hot water to kill dust mites. In patients suffer from skin inflammation, neutral shower gel and topical creams are helpful. Keep your home well ventilated. Wipe the sweat away in hot days. Wear comfortable clothing, preferably made of cotton.

For infants, major causes are food allergens. We recommend the followings:

  • Allergy test.
  • Avoid solid food before six-month-old.
  • Avoid food (eggs, milks, shellfish, and peanuts) which may lead to atopic dermatitis before age two.
  • Breast milk and hydrolysed formula are recommended.
  • Eat natural, fresh, cooked food with less sugar and oil.
  • Supplement of vitamin B group is helpful.
  • Functional probiotics and polysaccharides (glucans) are helpful.

 


1.Urticaria

Also known as hives. Urticaria is a kind of skin rash with red, raised, itchy bumps, similar to mosquito bites. Typically the symptoms last less than 24 hours, usually as a result of an allergic reaction to allergens.

2、Causes

Common causes of urticaria are:

  1. Medications:

    Antibiotics, aspirin, sedatives, diuretics, OTC drugs, etc.

  2. Physical agents:

    Temperature, humidity, friction, pressure and sunlight.

  3. Food:

    Crabs, shrimps, kiwifruit, dairy food, peanuts, egg, strawberry, nuts, etc.

  4. Chemical contact:

    Cosmetics, accessories, hair dyes, chemicals.

  5. Insects:

    Dust mites, fleas, bees, mosquitoes, etc.

  6. Infection:

    Virus, Mycoplasma, molds, bacteria, parasites, etc.

 

3.Treatment and health care

In patients with urticaria, topical steroids are often used for anti-inflammation and to relieve itching. Oral antihistamines are used to mitigate allergic symptoms. Do follow doctors’ advice and directions to avoid chronic urticaria. The symptoms and duration in patients with urticaria are varied. Some people show the resistance of topical steroid; frequent recurrence of urticaria is often observed. Since urticaria is related to autoimmune reactions, modulation and regulation of our immunity are important.

We recommend the followings:

  • ◎Allergy test.
  • ◎Fresh fruits and vegetables rich in vitamins are helpful.
  • ◎Eat alkaline foods: grapes, green tea, seaweeds, tomato, sesame, cucumber, carrot, banana, apple, tangerine, mung beans, pearl barley.
  • ◎Functional probiotics and polysaccharides (glucans) are helpful.
  • ◎Have a good rest, do moderate exercise.

 

Allergy treatments

Effect\Treatment Medications Hyposensitization therapy Probiotic therapy Immunity modulation Rotation diet
Efficacy ☆☆☆☆ ☆☆ ☆☆☆ ☆☆☆
Persistence ☆☆☆ ☆☆☆ ☆☆☆☆ ☆☆☆☆
Health improvement ☆☆ ☆☆ ☆☆☆☆ ☆☆☆☆
Side effects ☆☆☆☆ ☆☆☆ negligible negligible negligible
Course of treatment Instant Six months
~two years
Two weeks
~six months
One week
~four months
One week
~four months
Cost acceptable expensive moderate acceptable acceptable


Allergy avoidance

1.Start from fetal development

In Taiwan, 30% of infants are atopic and may suffer from dermatitis, rhinitis, allergic conjunctivitis, chronic urticaria, etc.
Studies have shown that with one atopic father, 25% of siblings may suffer from atopy (the risk is even higher with one atopic mother). With both atopic parents, 66% of siblings may suffer from atopy. Thus, it is important to take good care of health 6- month before pregnancy. With a good developmental condition, the risk of atopy could be reduced.

2.Prevention of allergies in children

  • Allergy test before pregnancy

    Adjust food consumption according to test results. Avoid food allergens.

  • Avoid contact of allergens

    Keep house clean, avoid contact of environmental allergens as possible as you can.

  • Balanced diet

    Eat a variety of food. Choose natural and fresh food rich in vitamins and minerals. Rotation diet is helpful.

  • Immune modulation

    Immune modulation in pregnant women not only lowers the risk of atopic siblings but also increase the immunity in mothers. Thus, mothers are more resistant to diseases and uses of medications could be decreased.

 

 

Allergen avoidance

Control of dust mites

  • ◎Keep air clean in consistent temperature and humidity (24-28°C, RH 50-65%).
  • ◎Clean bed sheets with hot water (>55°C), iron bed sheets every week.
  • ◎Avoid use of carpets and rugs.
  • ◎Use bed sheets and pillow cases.
  • ◎Use vacuum cleaner with high performance filter and multi-layer dust bag.
  • ◎Avoid stuffed toys.

 

Control of animal allergens

Avoid keeping pets indoors, if not possible:

  • ●Keep pets out of bedroom and living room.
  • ●Clean pets weekly.
  • ●Avoid use of carpets and rugs.
  • ●Use vacuum cleaner with high performance filter and multi-layer dust bag.
  • ●Use air cleaner with high performance filter.

 

Control of molds

  • ◎Keep air clean in consistent temperature and humidity (24-28°C, RH 50-65%).
  • ◎Clean surface with 5% bleach.
  • ◎Discard contaminated (moldy) carpets.
  • ◎Keep walls in a dry condition.
  • ◎Avoid exposure in moly area.
  • ◎Wear protective equipment (respirator) if exposure to mold is inevitable.
  • ◎Keep well ventilation.

 

Control of cockroaches

  • ●Do discard food waste.
  • ●Fix water leak.
  • ●Fix cracks in walls and ceilings.
  • ●Use pesticides if necessary.
  • ●Use drain plug.

 

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