Recognizing
the allergic nature of the disorder is very important from the outset of the
disease itself in order to treat the condition on time, and the patient will
receive detailed instructions on avoiding allergens and how to take medication.
Allergy
types and clinical presentation
Diagnosis
Avoiding
allergens
Medicamentous
therapy
Treatment
of severe allergic reactions
Conclusion
Allergy
types and clinical presentation
The
symptoms of an allergy that lead to a patient being a doctor are the most
frequent sneezing, clear nasal secretions, narrowing of the eyes and irritable
cough.
The
first trees (such as hazel, alder, hornbeam, birch, willow and oak) and plants
(such as grasses, nettles, dandruff, and later ambrosia) begin flowering in
spring, so the number of newly diagnosed and worsening pre-existing allergies
in the family medicine clinic . Allergic rhinitis is most commonly seen, and
allergic laryngitis, allergic dermatitis, asthma, as well as various food, drug,
dust or pollen allergies are common.
The
symptoms that bring a patient to the family medicine office are the most
frequent sneezing, clear nasal secretions, narrowing of the eyes and irritable
cough. These symptoms are usually associated with allergen exposure and are
exacerbated upon contact with the allergen, such as the proximity of flowering
trees, stay in a specific room, and exposure to dust in patients responding to
dust, dust mites, or contact with dogs and cats (for animal hair allergies)
Sometimes
the symptoms are not typical, but only a long-term irritant long-term cough
without any other problems can be present. Therefore, for a long-term cough
(ie, for a period longer than three weeks), it is always necessary to think
about the diagnosis of a new allergic event.
Diagnosis
Allergic
testing is commonly done on a dozen common allergens and is direct evidence of
an allergic reaction.
After
a clinical examination in an outpatient clinic, which includes a pharyngeal,
nasal examination (so-called rhinoscopy, ie examination of the nasal cavity),
auscultation of the heart and lungs, measurement of blood oxygen saturation,
and spirometry (according to the physician's assessment), the doctor will treat
patients who have not been diagnosed before allergy It is common to seek
laboratory indicators of allergy.
Blood
tests useful for the diagnosis of allergy are immunoglobulin E (IgE), which can
be done in most clinical laboratories, but also the specific determination of
RAST and RIST immunoglobulin for individual allergens that are done exclusively
in specialized laboratories. A nasal swab can be routinely performed to prove
allergy to eosinophils, which is evidence of an allergic reaction at the level
of the nasal mucosa and confirms the diagnosis of allergic rhinitis. Allergic
testing is commonly done on a dozen common allergens and is direct evidence of
an allergic reaction.
Avoiding
allergens
For
proven allergies to pollen, grass or trees, it is advisable to try to avoid
staying near a harmful allergen.
After
clinical examination and insight into the laboratory work done, it is possible
to diagnose the allergy and give the patient advice on how to proceed. In the
treatment of allergic rhinitis (which is the most common allergic disease in
the population), allergen avoidance is the most important measure - the patient
is accordingly instructed how (if the allergen is known) to avoid exposure to
an allergy-causing factor.
If
the allergy is caused by household dust, it is advised to remove all
unnecessary sources of dust (such as carpets, drapes, curtains, pillows,
stuffed animals or tablecloths), frequent ventilation of the living quarters,
regular cleaning of the same rooms as well as cleaning, ie. ventilation of
sleeping mattresses.
Preventing
allergic reactions caused by responding to animal hair (either dogs or cats)
also requires avoiding contact with said animals. Such allergies are more
commonly seen in pediatric than in the adult population. For proven allergies
to pollen, grass or trees, it is advisable to try to avoid staying near a
harmful allergen. There has been a lot of talk and talk lately about the
pronounced allergic action of ambrosia and the community measures that are
being applied to eradicate this highly allergenic plant.
Medicamentous
therapy
If
your allergy symptoms do not subside with antihistamines, your doctor may
recommend corticosteroid preparations.
The
next step in treating allergies is, of course, medication. These include, first
of all, the so-called. antihistamines, which are medicines that successfully
suppress allergy symptoms and bring relief to patients. There are several forms
available in our market that effectively counteract allergy symptoms, relieve
and prevent sneezing, eye tears, and cough. These are primarily loratidine,
desloratidine, cetirizindichloride and bilastine. They are taken strictly as
directed by the doctor, and the dose and time interval of the administration
are determined according to the patient's condition and other indicators of the
disease. The medicines in this group come in the form of pills, which are
usually taken once a day, although the dose can be increased as needed.
If
allergy symptoms do not subscribe to antihistamines, especially in cases of
allergic rhinitis (ie, inflammation of the nasal mucosa), your doctor may
recommend local therapy for allergic rhinitis - corticosteroid nasal sprays.
These are drugs that at the level of the nasal mucosa reduce the allergic
reaction, reduce the abundant secretion from the nose and target the excessive
sneezing. Medicines from this group are also numerous in the market, with
budesonide, mometasone-furoate and fluticasone-propionate being the main
agents. The indication for their administration is set by a physician who
prescribes the dose of the drug and the time interval for its administration.
It
is important to note that the drugs in the latter group are not recommended to
be taken constantly, but during periods of the most severe symptoms, since
their long-term administration can lead to damage to the nasal mucosa,
occasional nosebleeds and, in the long run, reduced odor. For the treatment of
allergic conjunctivitis (inflammation of the eye joint), local corticosteroid
drops are used, also at a strictly defined interval of time and only on the recommendation
of a doctor.
Treatment
of severe allergic reactions
In
cases of severe allergic reactions, when antihistamines and topical nasal
corticosteroids are not effective, other types of medication may be
administered: corticosteroids in tablet form and inhalation drug therapy if the
cough does not settle for antihistamines.
However,
any additional therapy for severe allergic reactions requires additional
diagnostic procedures. Thus, in case of severe allergic reactions accompanied
by severe cough, it is always necessary to think of a possible diagnosis of
allergic asthma, which is why pulmonary treatment should be done to prove the
disease.
Furthermore,
in conditions of severe nasal secretion and shortness of breath on the nose,
when medications and topical sprays do not help, it is important to have an
otolaryngological examination to exclude the possibility of nasal polyps, sinus
disease, or other diseases of the nasal mucosa.
However,
most allergic reactions consist of allergic rhinitis and allergic
conjunctivitis, which are successfully treated with antihistamines, topical
corticosteroid sprays and corticosteroid eye drops. This is a therapy that a
family medicine specialist can quickly and qualitatively recommend after
diagnosis, which brings relief to the patient and quality of life.
Conclusion
Physician-patient
communication, i. detailed patient referrals to the nature of the disease, how
to take the medication, the measures the patient must take independently to
avoid allergens, and planning a treatment time interval remain the most
important step in approaching allergic diseases.
A
joint treatment plan and good doctor-patient communication ensures the best
possible quality of treatment, as well as the prevention of complications of
any disease - including allergies. For this reason, the relationship between
the patient and the chosen GP is the basis for the treatment of each disease
and for the long-term quality of life of all patients.
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