Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Since allergic rhinitis is frequently caused by pollen, symptoms occur when pollen is in the air. Trees primarily pollinate in the spring, while grasses pollinate in the spring and summer. Weeds usually pollinate in the late summer and fall. Of all allergy sufferers in the United States, 75% are allergic to ragweed, 50% are allergic to grasses, and 10% are allergic to trees. Of course, many people are allergic to other substances such as mold spores, animal protein, and mites, to name a few. Food is an uncommon cause of allergic rhinitis. If you wish to know the pollen count in your area, this information can often be found in the newspaper in the weather section or you can access the National Allergy Bureau's pollen count information at their
web site (http://www.aaaai.org/nab/index.cfm).
How is allergic rhinitis diagnosed, and how are allergies identified?
If a person is experiencing the typical symptoms of hay fever, a consultation with an allergy specialist can help identify the offending substances. Since the ideal way to manage an allergy is to avoid the substances that cause allergic reaction, it is therefore very important to first identify these substances (allergens). Many allergens can be suspected from information obtained in a patient's particular history. For example, if symptoms usually worsen with exposure to cats, then cat
dander protein is a probable allergen causing the symptoms. If cutting grass is associated with the onset of symptoms, then grass allergy is probable. A patient's history of reactions is very important in determining his/her unique allergies.
Because the identification of allergens is important and often difficult
to pinpoint, skin testing is often needed to identify exactly the specific
substance causing the allergy. Skin testing is now done with minimal
discomfort and is performed as follows:
A small amount of the suspected allergy substance is placed on the skin.
The skin is then gently scratched through the small drop with a special sterile needle. This is known as the prick-puncture method and is typically used for initial evaluations. A second method, known as the intradermal method, involves injection of a small amount of the test substance into the skin. Intradermal testing is more sensitive but also tends to lead to more false-positive results.
If the skin reddens and, more importantly, swells, then an individual is said to be "sensitized" to the particular allergen. If typical symptoms occur when a sensitized individual is exposed to the suspected substance, then allergy to that substance is probable.
The skin testing described is tolerated by the youngest of patients and should be the standard of testing.
Skin testing is not indicated for people who are at risk of a severe (anaphylactic) allergic reaction, who have certain skin conditions, or who are taking certain medications.
A number of blood tests are also available to aid in the diagnosis of allergy. These blood tests may be useful in people who cannot be skin tested due to skin diseases, who are taking medications that interfere with skin testing, or who are at a high risk of having an anaphylactic reaction to skin testing. These blood tests typically use various techniques to look for IgE antibodies in the blood and by inference suggest allergy in the tissues. If the allergy testing agrees with the history of symptoms upon exposure to the substance, then a diagnosis of allergic rhinitis is likely.
Eczema, also known as dermatitis, is a general term for many types of skin inflammation. The most common form of eczema is atopic dermatitis. The other forms of eczema include: contact eczema, seborrheic eczema, Nummular eczema, Neurodermatitis, stasis dermatitis, and dyshidrotic eczema. Symptoms, diagnosis, and treatment of eczema may vary from person to person and may depend on the type of eczema.
Sinus infection (sinusitis) signs and symptoms include headache, fever, and facial tenderness, pressure, or pain. Treatments of sinus infections are generally with antibiotics and at times, home remedies.
Allergic rhinitis symptoms include an itchy, runny nose, sneezing, itchy ears, eyes, and throat. Seasonal allergic rhinitis (also called hay fever) is usually caused by pollen in the air. Perennial allergic rhinitis is a type of chronic rhinitis and is a year–round problem, often caused by indoor allergens, such as dust, animal dander, and pollens that may exist at the time. Treatment of chronic rhinitis and post nasal drip are dependant upon the type of rhinitis condition.
Itching can be a common problem. Itches can be localized or generalized. There are many causes of itching to include: infection (jock itch, vaginal itch), disease (hyperthyroidism, liver or kidney), reactions to drugs, and skin infestations (pubic or body lice). Treatment for itching varies depending on the cause of the itch.
Asthma is a common disorder in which
chronic inflammation of the bronchial tubes (bronchi) makes them swell, narrowing the airways. Signs and symptoms include shortness of breath, chest tightness,
cough and wheezing.
An allergy refers to a misguided reaction by our immune system in response to bodily contact with certain foreign substances. When these allergens come in contact with the body, it causes the immune system to develop an allergic reaction in people who are allergic to it. It is estimated that 50 million North Americans are affected by allergic conditions. The parts of the body that are prone to react to allergies include the eyes, nose, lungs, skin, and stomach. Common allergic disorders include hay fever, asthma, allergic eyes, allergic eczema, hives, and allergic shock.
Sinus headache is caused by a sinus infection or inflammation of the sinus cavities. The primary symptom of a sinus infection is pain and increasing pressure overlying the area and associated tenderness to the touch. Treatment of a sinus headache depends on the cause.
Before treating a cold, the flu, or allergies with over-the-counter (OTC) medications, it's important to know what's causing the symptoms, which symptoms one wishes to relieve, and the active ingredients in the OTC product. Taking products that only contain the medications needed for relieving your symptoms prevents ingestion of unnecessary medications and reduces the chances of side effects.
Mold exposure may cause symptoms in people who are sensitive to molds. Symptoms of mold allergy include sneezing, runny nose, wheezing, coughing, redness of the eyes, and rash. Prevent mold growth by keeping indoor humidity low, between 30%-50%, using bathroom fans when showering, repairing plumbing leaks quickly, and using an air conditioner during humid seasons.
Genetic disease is a disorder or condition caused by abnormalities in a person's genome. Types of genetic inheritance include single inheritance (for example, cystic fibrosis, sickle cell anemia, Marfan syndrome, and hemochromatosis), multifactoral inheritance, chromosome abnormalities (for example, Turner syndrome, and Klinefelter syndrome), and mitochondrial inheritance (for example, epilepsy and dementia).
Common sources of indoor allergens include dust mites, cockroaches, molds, pets, and plants. Managing allergies caused by indoor allergens means reducing your exposure to them.
Occupational asthma is a type of asthma caused by exposure to a substance in the workplace. Symptoms and signs include wheezing, chest tightness, and shortness of breath. The usual treatment for occupational asthma involves removal from exposure and the use of bronchodilators and inhaled anti-inflammatory medicines.