By Ashli Collins, MD
As springtime comes to our area, local doctors offices are filling up with itchy, watery eyes, runny noses, sneezing and coughing. Adults certainly know the telltale signs of allergies in theOhioValleybut for our younger counterparts, the symptoms are sometimes less obvious. Louisvilleand the surrounding areas often rank in the top five of highest allergy sufferers. Many families that move to the area are amazed at just how much of an impact allergies can cause on their lives. An estimated 44 million Americans suffer from allergies-a lot of which are kids. Allergies rank as the sixth leading cause of chronic disease!
For children, the single most important factor for having allergies is the family history. A strong family history of allergies, asthma or eczema predisposes the child significantly. It is estimated by theAmerican Academyof Allergy, Asthma and Immunology that if one parent suffers from allergic disease, the child’s risk is 48% and if both parents are sufferers, that risk is 70%.
Allergies are triggered by allergens-pollens, molds, pet dander, foods to name a few. When a susceptible child encounters the offending allergen, the immune response occurs and a series of reactions occur causing the typical allergic responses.
The most common allergic symptoms in children are clear nasal discharge, sneezing, sniffing, watery eyes, scratchy throat and nasal itching. Parents are often greeted with the “allergic salute”, which is the child rubbing their nose vertically to alleviate the itching and stuffiness. Other frequent symptoms are eye blinking, itchy watery eyes, headaches, restless sleep, coughing, rashes and post nasal drip. These children often have dark circles under their eyes and stuffy swollen nasal passages. For some children, ongoing nasal symptoms with stuffiness can lead to sinus infections or ear infections. Allergies can trigger asthma attacks in some children.
Diagnosing allergies is usually made by the history and physical exam of the child. Sometimes a referral to an allergist will help the child’s pediatrician make an accurate diagnosis. There is occasionally the history of “frequent colds” or recurrent ear infections that will prompt the referral as well. In infancy, rashes and reactions to certain foods often trigger an earlier referral to the allergist whereas in toddlerhood it is more commonly the constant drippy nose or watery eyes. As children get to school age, full blown allergy symptoms are usually observed.
Testing for allergies is often done by skin testing. This test is very useful in identifying certain allergens that can potentiate a child’s symptoms. There are blood-based tests that are used, but skin or scratch testing has remained the gold standard.
Once a diagnosis of allergies has been made, a treatment plan is established. For many allergens, strict avoidance is preferred, however, it is nearly impossible to eliminate all allergens from a child’s environment. House dust, or dust mites, is the most common trigger of year round allergies in children. Frequent vacuuming, encasing pillows and mattresses in dust-proof plastic will help. Carpet tends to harbor these mites so for many, changing to hardwood floors may be beneficial.
Other common triggers, including pets and pollen are hard to avoid. 10-15 percent of the population suffers from pet allergies. Pet dander, or microscopic flakes of the pets skin are the main component of the allergic reaction with cats being twice as likely to cause allergies as dogs. If the pets are in the home to stay, keep them out of the child’s room and frequently change the air conditioner filters. For pollen sufferers, keep children inside in late afternoon as that is when pollen falls from its source. Also, monitor for high pollen count days and keep children indoors.
Many allergy sufferers, including children, rely heavily on their pharmacy to help them cope with their symptoms. The most commonly used medicine is an antihistamine. These medicines work by blocking the chemicals released in an allergic reaction. There are now 24 hour, non-sedating antihistamines available for children. Intranasal sprays are also very helpful in calming the chronic drippy nose allergy sufferers and will also help stop the allergic reaction before it gets started. Allergy shots are also available for some sufferers. Newer medicines are also available and may be discussed with your child’s doctor.
Children suffering from allergies are able to live happy, healthy lives. Often times avoidance of potential allergens is all that is needed, however, if further evaluation is needed, speak to your child’s doctor or allergist for an in depth evaluation.
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Ashli Colins, MD. Dr. Collins is a pediatrician with Oldham County Pediatrics, PLLC. They have offices in LaGrange and in Louisville near the Summit. Dr. Collins is the mother of twins, Sarah and P.J. For more information call 502-225-6277 or www.oldhamcountypeds.com