Treatment of AR reduces risk of Asthma
With natural exposure to inhaled allergens, small amounts of environmental allergen maintain the patient symptoms, due to the minimal persistent inflammation.
Uncontrolled allergic rhinitis leads to worsening of coexisting asthma.
Conversely, treatment of allergic rhinitis improves coexisting asthma.
Relief of inflammation is important for the management of both the disorders!
Allergies And The Ear :
" Glue ear " – accumulation of fluid behind the ear is very common in children with allergies. Allergies cause chronic nasal obstruction and adenoid enlargement. This causes blocking of the ventilation of the middle ear, due to Eustachian tube obstruction. (The Eustachian tube connects the nose to the ear… we feel the Eustachian tube functioning when we travel in an aircraft or go in a high speed elevator and feel the pressure changes in the ear). Undiagnosed, it may cause long-term consequences in the form of deafness and disease (Retraction of the drum leads to cholesteatoma and chronic mastoiditis).
In India, in the home environment, mild to moderate hearing loss due to fluid behind the ear drum may not manifest due to loud talking. However, this will cause the child to suffer learning deficiency.
Often, though the tubal dysfunction is diagnosed early in the pediatrician’s office, more often than not the actual ear pressures are not measured. In follow-up, if the patient is clinically better, no further action is taken. However, it is imperative that the treatment and follow up should continue till the patient’s middle ear measurements have come back to normal, otherwise the child would continue to suffer recurrent attacks of ear infection due to residual disease which has remained undiagnosed after the initial treatment due to a lack of symptoms.
Relief of inflammation is important for the management of both the disorders!
- Allergy diagnosis in children may involve:
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Skin Prick Tests
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Specific IgE testing (immunocap)
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Component testing (the most precise allergy diagnosis)
Management of allergies in early childhood is critical to prevent allergy and asthma development later on. Children tend to have multiple allergies, causing multiple symptoms due to allergic rhinitis, asthma, eczema and food intolerance.
Primary management is medical, using anti-histaminics and intranasal/inhaled corticosteroid sprays but in cases of severe allergic rhinitis or mild to moderate asthma requiring continuous or frequent intermittent therapy, it may be advisable to consider immunotherapy administered as sub-lingual (below the tongue) drops (SLIT).
It has been demonstrated that SLIT is the only therapy that can modify the natural history of atopic diseases, causing a permanent desensitization towards the responsible allergen and modifying the immune system of the atopic patients, even if until now there is no evidence on a possible prevention role of the same therapy. Its efficacy and safety has been widely demonstrated both in adults and in children.
