Friday, September 25, 2009

Fruit and Vegetable Allergy

 Allergic reactions to fruits and vegetables are usually mild and often they just affect the mouth, causing itching or a rash where the food touches the lips and mouth. This is called oral allergy syndrome. A number of people who react in this way to fruit or vegetables will also react to tree and weed pollens. So, for example, people who are allergic to birch pollen are also likely to be allergic to apples.

Cooking can destroy a number of the allergens in fruits and vegetables, so cooked fruit often won't cause a reaction in people with an allergy to fruit. Pasteurised fruit juice might not cause an allergic reaction either, for the same reason. However, the allergens in some vegetables, such as celery, aren't affected by cooking. Some fruits and vegetables, such as tomatoes, are more likely to cause a reaction as they get riper.

Wednesday, September 23, 2009

Man, it's the Grass

No, not that kind of grass.  It's grass pollen, and its still hanging around in the air of Central New Jersey.  At this time we expect only mold and weeds outdoors to tickle noses, eyes and lungs, but the grass is still there.  As proof of this I saw a recent patient who only usually experiences symptoms in the summer, when grass pollinates.  He is experiencing his worst symptoms now, and tested negative for ragweed and the other weeds in our area.  I have developed my allergy testing panels especially for Central Jersey, but also to account for heredity. Allergies are inherited. Another recent patient was Scandinavian in origin, so I was not surprised to see sensitivity to birch tree.  Also, having 2 birch trees in the back yard did not help!  For some interesting graphs of the pollen count in your area over the past month, visit and enter your zip code.

Friday, September 18, 2009

Weekend off with a lump in my throat

In the last few days, I have seen 4 patients with a feeling of something in their throat all the time.  This may not be you, but think of silent (nonacid) gastric reflux. This was the problem for these 4 individuals who had symptoms lasting up to 5 years!  My ENT colleague can look down into the throat with a flexible endoscope, and the diagnosis can be made in minutes. This may not apply to you so please don't consider this as specific medical advice.  I"ll be back on Monday.  Have a great weekend!

Wednesday, September 16, 2009

Mr. Whiskers Caused my Runny Nose!

Cat Allergies (from WebMD)

Life with cat allergies -- whether they're yours or a family member's -- can raise a lot of questions. Could a cat allergy explain your son's never-ending cold symptoms? Will you regret giving in to your daughter's demands for a kitten, despite your allergies? Will a so-called hypoallergenic cat allow you to have the pet you've always wanted without making you a sneezing, sniffling mess?

Here are some answers -- what you need to know about cat allergies, from causes to treatments.

What causes cat allergies?

About 10% of the U.S. population has pet allergies, and cats are among the most common culprits. Cat allergies are twice as common as dog allergies. But contrary to what you might think, it's not the fur or hair that's the real problem. People with cat allergies are really allergic to proteins in the cat's saliva, urine, and dander (dried flakes of skin).

How do these tiny proteins cause such a big allergic reaction in your body? People with allergies have oversensitive immune systems. Their bodies mistake harmless things -- like cat dander -- for dangerous invaders, and attack them as they would bacteria or viruses. The symptoms of the allergy are the side effects of your body's assault on the allergen, or trigger.

Keep in mind that even if you don't have an actual cat allergy, your cat can still indirectly cause your allergies to flare up. Outside cats can bring in pollen, mold, and other allergens on their fur.

And what about so-called "hypoallergenic" cats? While some breeds -- like the "hairless" sphinx -- are said to be less likely to trigger symptoms of cat allergies than others, any cat has the potential to cause problems. This is true regardless of its breed, hair length, or how much it sheds. So if you know that you or another family member is allergic to cats, getting one -- no matter what the breed -- is not a good idea.

What are the symptoms of cat allergies?

Symptoms of cat allergies can include:

* coughing and wheezing
* hives or a rash on the chest and face
* red, itchy eyes
* redness of the skin where a cat has scratched, bitten, or licked you
* runny, itchy, stuffy nose
* sneezing

Symptoms of a cat allergy might develop in just a few minutes or take hours to appear. About 20% to 30% of people with allergic asthma have severe flare-ups after coming in contact with a cat.

How would I know if I have a cat allergy?

Although the symptoms of a cat allergy may seem fairly obvious, it's not always the cat that causes them. So it's a good idea to get confirmation from your doctor. After all, you wouldn't want to blame Mr. Whiskers unjustly.

Your doctor can do a skin or blood test to see if you're allergic. So the doctor may also want you to try living without a cat for a few months to see how it affects your allergy symptoms.

Monday, September 14, 2009

Is Swimming Pool Chlorine Fueling the Allergy Epidemic?

Only this morning, I saw a patient who had wheezing after swimming both indoors and outdoors.  This is a timely article.

Is swimming pool chlorine fueling the allergy epidemic?

NEW YORK (Reuters Health) – Swimming in a chlorinated pool may boost the odds that a child susceptible to asthma and allergies will develop these problems, a study released today indicates.
"These new data clearly show that by irritating the airways of swimmers chlorination products in water and air of swimming pools exert a strong additive effect on the development of asthma and respiratory allergies such as hay fever and allergic rhinitis," Dr. Alfred Bernard, a toxicologist at the Catholic University of Louvain in Brussels, Belgium, noted in an email to Reuters Health.
"The impact of these chemicals on the respiratory health of children and adolescents appears to be much more important -- at least by a factor of five -- than that associated with secondhand smoke," Bernard noted.
Taken together with his team's prior studies, he added, "There is little doubt that pool chlorine is an important factor implicated in the epidemic of allergic diseases affecting the westernized world."
In the current study, Bernard and colleagues compared the health of 733 adolescents, 13 to 18 years old, who swam in chlorinated outdoor and indoor pools for various amounts of time with that of 114 "control" adolescents who swam mostly in pools sanitized with a concentration of copper and silver.
In children with allergic sensitivities, swimming in chlorinated pools significantly increased the likelihood of asthma and respiratory allergies, the researchers report in the journal Pediatrics.
Among "sensitive" adolescents, the odds for hay fever were between 3.3- and 6.6-fold higher in those who swam in chlorinated pools for greater than 100 hours and the odds of allergic rhinitis were increased 2.2- to 3.5-fold among those who logged more than 1000 hours of chlorinated pool time.
For example, among children and teens who swam in chlorinated pools for 100-500 lifetime hours, 22 children out of 369 (6.0%) had current asthma, compared with those who had spent less than 100 hours (2 of 144, 1.8%). The proportions with asthma rose with longer exposure, to 14 out of 221 (6.4%) who had been swimming for 500-1000 hours, and 17 out of 143 (11.9%) who swam for more than 1000 hours.
The risk of asthma and allergy was not influenced by swimming in copper-silver sanitized pools and children without allergic tendencies were not at increased risk of developing allergies.
"The only plausible explanation" for these observations, the researchers argue, is that the chlorine-based toxic chemicals in the water or hovering in the air at the pool surface cause changes in the airway and promote the development of allergic diseases.
"It is probably not by chance," Bernard told Reuters Health, "that countries with the highest prevalence of asthma and respiratory allergies are also those where swimming pools are the most popular."
The current findings, he and colleagues conclude, "reinforce" the need for further study on the issue and to enforce regulations concerning the levels of these chemicals in water and air of swimming pools.
SOURCE: Pediatrics, October 2009.

Sunday, September 13, 2009

Nasal Allergies May Dim Sex Life

Occasionally I plan to post an article that you may find interesting.  This is for a quiet Sunday afternoon....You could ask me more about this in the office!
Chronic Sneezing, Runny or Stuffy Nose May Leave Patients Feeling Tired and Less Than Sexy, Researchers Suggest
By Miranda Hitti       WebMD Health News
Sept. 11, 2009 -- Having nasal allergies may dim people's sex lives, researchers report.
Nasal allergy symptoms such as sneezing and having a runny or stuffy nose may be to blame, note father-and-son research team Michael Benninger, MD, of the Cleveland Clinic and Ryan Benninger of Miami University in Oxford, Ohio. 
"Even the simple act of kissing may be altered by these symptoms. Many people may not feel 'sexy' or may actually be embarrassed by their symptoms so that they would avoid intimate contact," the Benningers wrote in a recent edition of Allergy and Asthma Proceedings.
The Benningers analyzed quality-of-life surveys completed by 320 nasal allergy patients, 337 patients with nasal problems other than allergies, and 44 people without nasal problems.
Those surveys included a question about fatigue and another question about the extent to which the person's nasal problems affected their sexual activity.
Few people reported that nasal problems were taking a heavy toll on their sex lives. But those reports were most likely to come from nasal allergy patients.
About 17% of people with nasal allergies reported that their problem "almost always" or "always" affects their sexual activity, compared to 5% of people with other nasal problems and none of the healthy people.
Tiredness might also be a factor; 42% of the nasal allergy patients said they didn't sleep well because of their nasal problem, compared to 31% of people with other nasal problems and none of the healthy people.
The survey only had one question about sexual activity, and the answers to those questions don't identify the cause of those sexual problems.
"Although it is a single question and it does not give enough detail to identify the specific effect on sexual activity, this study does suggest that this may be a more significant problem for allergic rhinitis [nasal allergy] patients than has been identified before," the researchers write.
In the journal, Michael Benninger, MD, discloses financial ties to various drug companies; Ryan Benninger says that he has no financial relationships to disclose. The study itself was funded by the Cleveland Clinic's Head and Neck Institute.

Friday, September 11, 2009

Clinical Research Update

I just finished reviewing scientific research abstracts for possible presentation at the American Academy of Allergy, Asthma and Immunology (AAAAI) Annual Meeting which will be held next March in New Orleans. The research studies I saw were on the pathology of rhinitis and new treatments.  I can't discuss what was in the material that was shared with me, but I can tell you that I am quite excited about the possibility for new treatments combining existing drugs in one product, some new drugs that will be more convenient to take, and some new treatment indications. Once the abstracts are reviewed by the other reviewers, a committee will select the best ones for publication and presentation. When they are made public, I will post some useful information here.

Monday, September 7, 2009

Happy Holiday

I hope you enjoy the holiday today.  Did you see the pollen count?  Interestingly, the grass count is still high in Northern and Central Jersey.  If you are grass-sensitive and you plan a picnic today, take care!  Make sure you have your medications with you, or if you are on regular medication don't forget to take it this morning. Enjoy!

Thursday, September 3, 2009

The High Pollen Count

Here is today's pollen count from UMDNJ in Newark;

Pollen Grains per cubic meter






In fact. today's count is always yesterday's, as the count reflects exposure over the last 24hr. Not surprisingly weeds and ragweed in particular are high, as well as molds - which have been very high for most of the summer.  It's surprising that grass is still high - this is probably a carry over from all the rain we have been having. we will see if this persists tomorrow.  Follow the pollen count at your favorite website or in the newspaper.