Stress Can INCREASE a Person's Allergies!

Researchers at Ohio State University recently published an article in the June 2009 journal Psychoneuroendocrinology titled "How stress and anxiety can alter immediate and late phase skin test responses in allergic rhinitis."

What they found was that allergic responses to a skin prick increased after a stressful event compared to a non-stressful event. Anxiety also substantially enhanced the effects of stress far into the future as even skin tests performed the day after the stressor reflected the continuing impact of the stressor among the more anxious participants.

Read the NYT article on this here.

Yet another thing to think about in allergic patients...

Read more about the study here.

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Allergy/Pollen Tracker for Your iPhone

I was amazed to find that there are a few programs out there for the iPhone that provides allergy count information as well as forecasts... at last check, there are 4 main ones in the app store on iTunes.

Some are rated highly and others not so high. I'm not going to go too much into the description and ratings as this info can be easily found on the iTunes app store. Links are provided.

The most highly rated application I found is called Zyrtec AllergyCast and is FREE!



Another fairly new but so far highly rated program that looks promising is called Allergies! and is $1.99.



There are 2 other programs that didn't get rated so well and include:

Pollen Journal for $4.99



Allergy Alert for FREE

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Drinking Alcohol Increases Risk of Allergies!

Well at least in women and only for perennial allergies (not seasonal allergies) according to a study published in July 2008 in the journal "Clinical Experimental Allergy." The study entitled Alcohol consumption and the risk of self-reported perennial and seasonal allergic rhinitis in young adult women in a population-based cohort study found that in Danish women between the ages of 20-29 who drank more than 14 drinks/week were significantly more likely to develop around the year allergies when compared to those who drank <1 drink/week.

Interestingly, smoking was found to not increase the risk of allergies.

It seems there is yet another reason not to drink alcohol! Whether men and other age groups are similarly affected is unknown.

Read more about this here.

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Allergies CAN Appear for the First Time in the Elderly!

Although most patients with allergies develop symptoms of allergy during childhood or young adulthood, allergies CAN appear for the first time even in the elderly population!!! This fact is important as many elderly with allergies are misdiagnosed with sinusitis and other conditions for which they are treated with a number of medications which do little to help. Some even fail to seek treatment since they attribute their symptoms to the aging process or other non-allergy problems.

It is felt that many of these elderly patients develop allergies due to the "lifetime load theory" which states that living among a lifetime of exposure to pollen, dust, mold, etc can aggravate the immune system to the point that allergies develop much later in life than usual.

As such, if an elderly patient presents with symptoms that appear to be allergies, than you may be right even if the patient has never had allergies before!

Read more about this topic in an article published in the Wall Street Journal here.

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Office Workers Hospitalized From Filthy Office Fridge

ABC reported that an office worker cleaning a fridge full of rotten food created a smell so noxious that it sent co-workers to the hospital and made many others ill. The building was evacuated and a hazmat team even got called in.

The "funny" part of the story was that the worker who was cleaning out the refrigerator did not notice the smell because she was suffering from bad allergies.

Click here to read the news article.

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New Webpage on the Evaluation and Treatment of Nasal Polyps

A new webpage has been posted describing nasal polyps and how they are treated. The most common cause of nasal polyps is allergies and though surgery may remove all nasal polyps, they WILL come back unless underlying allergies are aggressively contolled by medications and allergy shots. Click here to read more.

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Mucus in Throat or the Phlegmy Throat!!!

NOTE: A more complete discussion on this topic can be found here.

A common complaint of patients seeing an ENT doctor is for a persistent phlegmy throat or sensation of mucus in the throat. Other symptoms that a patient may complain of include constant throat-clearing, cough, raspy voice, and a lump sensation in the middle of the throat (aka, globus).

Reflux (Acidic or Non-acidic)

In the VAST majority of patients with this complaint, it is due to a disorder called "laryngopharyngeal reflux" or LPR for short. This disorder is due to reflux whether acidic or non-acidic from the stomach that travels up to and settles in the throat region. This mucus collection can even be seen on fiberoptic endoscopy as shown in the picture here. Of note, most patients with LPR do NOT complain of heartburn, nausea, indigestion and other symptoms commonly associated with reflux.

The treatment is the same as for the more common and related GERD disorder except that treatment usually takes much longer... sometimes for as long as 6 weeks to 3 months. Some over-the-counter medications one can try are listed at the end of this article.

To read more about this disorder as well as treatment options, click here.

Post-Nasal Drainage

Sometimes, the throat mucus can come from the nose. In these patients, they literally feel the drainage travelling from the nose and down into the throat. Often, when one looks in the back of the throat, the drainage can be seen. Treatment for this drainage depends on what it is caused by. If due to sinusitis, antibiotics is the treatment. If due to allergies, allergy treatment is recommended. If due to vasomotor rhinnitis, nasal sprays such as atrovent, patanase, and astelin may be quite helpful. In these patients, turbinate reduction may quite helpful to reduce the amount of drainage.

Food "Sensitivities"

Uncommonly, food "sensitivities" can cause excessive throat mucus to develop. The most common culprit is dairy products (many folks develop lots of phlegm in the throat when drinking lots of whole milk for example). Other common triggers include egg and wheat. Treatment for this problem is mainly avoidance.

To be clear, we are NOT talking about food allergies.


Zenker's Diverticulum

Even more rarely, there may be an anatomic abnormality in the throat called a Zenker's Diverticulum. Basically, this abnormality is a pouch that protrudes from the esophagus (swallowing tube) which catches food and mucus preventing it from going down towards the stomach. At random times, the contents in the pouch may suddenly regurgitate causing aspiration as well as mucus collection in the throat.

Treatment is surgical. Click here for more info.

Read more about these and other cause of phlegmy throat conditions here.

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Medications that may help reflux:

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New Webpage on Nasal Obstruction and Congestion

A new webpage has been added to our practice's website summarizing the various causes of nasal obstruction and congestion in patients. The most common causes include turbinate hypertrophy, deviated septum, allergies, and adenoid hypertrophy.

Read more about this aggravating symptom here.

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New Video on Pediatric Nasal Saline Flushes

A new video has been created showing a young child performing saline flushes to his nose without assistance. Indeed, kids older than 5 years are able to tolerate flushes without difficulty. A nasal saline flush kit using the Neilmed Sinus Rinse bottle is shown here. This video can also be found on YouTube.



There are also devices that perform the same thing:

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Video on How to Perform a Saline Sinus Flush

Given the dearth of video on the internet showing exactly how to perform a saline sinus flush using the NeilMed Sinus Rinse bottle, our practice has gone ahead and made one for educational purposes. It has been posted on our YouTube channel, but can be viewed below as well. Click here to go directly to the YouTube video. This link can also be found on our website here.

Instructions on making your own saltwater using home kitchen supplies can be found here.

Saline sinus flushes are generally recommended to patients who have chronic sinusitis or allergy problems which can help alleviate and/or even eliminate symptoms. Children from the age of 5 years and older are able to perform this procedure as well without any difficulty.



There are also devices that perform the same thing:

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