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Allergy Specialist in Bangalore | Allergy Specialist | Mahapranajeeva

Allergy Specialist in Bangalore - Mahapranajeeva Clinic is the best allergy specialist in Bangalore. Get allergy blood test, skin allergy test etc.

Allergy Specialist in Bangalore | Allergy Treatment | Mahapranajeeva

Allergy Specialist in Bangalore - We are here with you at every step empowering you to achieve your good health. There is nothing as excited and adventurous as attaining happiness by achieving good health. In this endeavor we help you even by rendering our services at your doorstep in all aspects. Happiness is attained through healthy living!!!

HEALTHCARE AT HOME

• Doctor visits to home for regular health checkups
• Regular Nurse visit to home for vital monitoring and drug administration
• Home delivery of medicines
• Home laboratory sample collection
• Geriatric home counselling
• Pulmonary Rehabilitation
• Cardiac Rehbilitation
• Neuro Rehabilitation
• Ortho Rehabilitation

PREVENTIVE HEALTHCARE

• Periodic health checkups
• Nutrition advice
• Smoking Cessation
• Alcohol & Drug abuse Clinic
• Counselling
• Yoga & Meditation
• Vaccination - Pneumonia, H1N1

We Offer Our Services To

• Consultation
• Screening Of Snoring, Sleep Disorders & Allergies
• Pulmonary Function Testing
• Home Sleep Study
• Home Pulmonary Rehabilitation
• 6 Minute Walk Test
• Personal Counselling
• Quit Smoking Clinc
• Allergy Skin Testing
• Allergy Blood Testing
• Allergy Immunotherapy
• Nutrition Advice
• Pneumonia Vaccinations
• Laboratory Investigations

All investigations are performed with ultramodern and internationally acclaimed devices. Laboratory services are performed at National accredited labs.

If you have any allergy related issues feel free to contact us for a consultation.

How to identify Allergic Rhinitis and how to prevent it ?

What are the symptoms of Allergic Rhinitis?

Common complaints include sneezing, headache, cough, running/stuffy nose, sinus pressure, itching, eye and ear irritation, hives, and sore/itchy throat.

What are the tests to diagnose Allergic Rhinitis?

Clinical examination by a specialist is the most important way of diagnosing Allergic Rhinitis. However there are serum (blood) tests available, which can identify the antibodies produced against possible allergen exposure, they are called as serum specific IgE tests for aeroallergens and food allergens. Also the specialist on evaluation may find it appropriate in certain cases to do a skin prick test (SPT) – the Gold standard of Allergy diagnosis.

How do we prevent occurrence of Allergic Rhinitis?

Regular nasal saline rinses can be followed in case of people having heavy exposure to dust and other common allergens such as pollen grains. They will have an immense benefit of preventing the occurrence of Allergic Rhinitis.

What are the treatment options for Allergic Rhinitis?

Consultation with an Allergist, Pulmonologist or ENT physician is a must to confirm the diagnosis of Allergic Rhinitis. Typical therapy for mild, intermittent symptoms is Over the counter (OTC) medicines - oral antihistamines such as loratadine, cetirizine, fexofenadine, desloratadine, levocetirizine, and diphenhydramine. These medications are most effective at decreasing rhinorrhea, nasal itching, and sneezing.

On discussion with an expert specialist physician, they may suggest you Allergen specific Immunotherapy for longer lasting relief from Chronic Allergic Rhinitis.
If you have any allergy related issues feel free to contact us for a consultation.

Allergy Specialist in Bangalore | Dr. Puneeth K Nagendra

Dr Puneet. K. Nagendra. MBBS, DTCD, DNB (Pulmonary Medicine)

Professional services:

Presently I render my clinical services as an Allergist & Pulmonologist in Bengaluru Allergy Centr, PD Hinduja Sindhi Hospital, Excelcare Hospital and Mahapranajeeva - Speciality Centre for Respiratory diseases at Bengaluru.

In Bengaluru Allergy Centr I have been practicing Immunotherapy for Respiratory Allergies. I have been providing pulmonary rehabilitation services by incorporating the principles of yoga therapy into rehabilitating the chronic respiratory illnesses.I have trained a dedicated team of counsellors for Lifestyle modification program called “Involve to Evolve” & Smoking cessation program called “Get over it”.

Social services:

Mahapranajeeva rolls out a program ‘FUFU’ (Fun Unlimited with Fitness Unexplored). It is a designed especially for school going children, where in I have tried to make them aware of the importance of physical activities in achieving academic excellence, yet they can be enjoyable when compared to games in the electronic gadgets, which is the new generation addiction. Through collaboration of Suyoga (Organization for social transformation through yoga) & Rotary International, I have been in the process to implement this program for children at BBMP schools.

I have taken part in health camps for rural population at Ramakrishna Mission Dispensary, Shivanahalli-Bengaluru & Chennai. Also involved in periodic school health checkups at the Government Primary Schools around various parts of Bengaluru (Rural).

Academic and Research activities:

At Bengaluru Allergy Foundation (BAF), I have the privilege of taking forward the academic and research activities related to Allergy. Arrange programs to train the doctors in allergy diagnosis and management through periodic workshops & CME’s.

Currently performing research project which is focused on importance of integrated approach to treatment of medical diseases. This is based on the principle of the occurrence of the diseases not limited to the malfunctioning of the physical body alone.

Training:

Pursued Medical Under graduation from Shri B.M. Patil Medical College, Vijayapura. Post graduate training in Pulmonary Medicine from Sri Ramachandra University, Chennai (DTCD) and BMJH, Bengaluru (DNB). Had experience of managing SRBD in Jain hospital, Bengaluru. Received training in Pulmonary Rehabilitation from John Muir Hospital, California, USA.
I have undergone Yoga Instructor Course from S-VYASA University, Bengaluru. Following which I have been learning Yoga therapy from Dr Nagendra Kumar, Agadi Hospital, Bengaluru.
I have been trained in Counselling skills at Banjara academy, Bengaluru. Following which I have initiated special counselling classes to the professional Counsellors to meet the unmet needs of patients at hospitals and clinics.

If you have any allergy related issues feel free to contact us for a consultation.

4

What are the types of Food Allergy and how to prevent them ?

What are the types of Food Allergy and how to prevent them ?

Allergy is an exaggerated reaction of the immune system to certain, normally harmless environmental substances. These substances are called allergens.

Types of Food Allergy

There are two types of Food Allergy: Primary and Secondary Food Allergies.

Primary Food Allergies usually first appear during childhood. The symptoms appear shortly after consumption (2 hours at most) of certain food substances.

In Secondary Food Allergy there is an underlying allergy to pollen or dust mites. Some elements in foods are similar to these allergens and may trigger allergic reactions.

Clinical symptoms in Food Allergies

  • EYES: redness, watery, swelling
  • MOUTH: Swelling of the lips, tongue, gums and/or larynx, itching of the mouth and throat
  • SKIN: Rash, hives, redness, itching
  • STOMACH: Nausea, vomiting, abdominal pain, diarrhea, heartburn
  • RESPIRATORY: Nose itch, running
  • LUNGS: cough, tightness in the chest, wheezing breath sounds, difficulty breathing
  • ANAPHYLAXIS: Shock, drop in blood pressure, elevated pulse, brief unconsciousness

How a child describes allergy reaction

  • Put hands to mouth, pull or scratch tongue, voices may change
  • May comment that “Food is too spicy”
  • “My tongue is hot, something is poking it”
  • “My mouth is tingly, itches, or feels funny”
  • “My tongue feels full, my throat feels thick”
  • The foods that most frequently trigger allergic reactions
  • Peanuts, fish, cow’s milk, wheat and chicken eggs. Allergies to cow’s milk or chicken eggs may diminish over time as children grow up. In some cases, they may in fact be able to consume the foods after a few years. However, allergies to peanuts, fish are usually life-long.

Exercise induced anaphylaxis
Usually occurs within two hours of eating the allergenic food. Onset is during physical activity.

Foods most frequently reported to have induced exercise-induced anaphylaxis:

  • Wheat (omega-5-gliadin) and other grains
  • Shellfish (shrimp; oysters)
  • Chicken
  • Squid
  • Peaches and other fruits
  • Nuts especially hazelnut
  • Peanuts and soy beans

Hidden Allergens:
The known food allergen may be hidden as an unknown ingredient or contaminant:

  • Eggs – baked goods, noodles
  • Milk – pies, cheese
  • Soy – baked goods, candy, tv dinners
  • Wheat – flours, soup mixes, snacks
  • Peanut – candy, baked goods, ice cream
  • Fish – seafood flavors

Identifying Food Allergy

  • Physician
  • Allergy Specialist
  • Medical history, physical exam
  • Skin test
  • Lab tests
  • Oral food challenge
  • Elimination diet
  • Double-blind food challenge

Treatment Options:
Avoiding the allergens is the safest measure when suffering from food allergy. Allergy sufferers often report that the symptoms are much lesser outside of the pollen season. Many foods especially some fruits and vegetables when heated, can be consumed without a problem.

Patients who have had severe allergic reactions to food allergens in the past (Anaphylaxis: Breathing problems, dizziness, drop in blood pressure) should keep an emergency kit with them, which usually contain an antihistamine, a corticosteroid (cortisone) and an adrenaline injection.

How can one avoid development of Food Allergy?

  • Identify those at risk
  • Consult a doctor
  • Consider breast feeding
  • Maternal diet avoiding eggs, cow milk, peanuts, fish
  • Children and Food Allergy
  • For babies, discuss formula options with doctor
  • Don’t introduce solid foods too early – wait about 6 months
  • Wait on foods with common allergens
  • Cow milk – age 1
  • Eggs – age 2
  • Peanuts, nuts or fish – age 3

Differentiate food intolerance and allergy:
Food intolerance is more common than allergies and is often misconceived as food allergy. It is a physiological response to the chemicals in food. There is no immune response, no life threatening effects. Usually one develops Bloating, gas, abdominal discomfort.

Following are the intolerance events:

  • Food poisoning
  • Histamine toxicity (happens on consumption of cheese, wine, fish)
  • Lactose intolerance
  • Food additives (MSG in taste makers)
  • Gluten intolerance
  • Corn products
  • In case of true allergy – avoid food (this prevents the reactions in the immune system)

*Intolerance – small amount is ok (usually tolerated by the digestive system)
*

Being safe from Food Allergies:
On the processed food package, read the ingredient lists on food products carefully. This will help you to trace the allergens in the food (e.g. nuts).

For people with food allergies, it can often be difficult to identify the trigger. Hence maintain an allergy book, which will help you to remember or someone else to identify substances causingallergy in you.

If you have an allergic reaction to fruit, heat it before eating. Some allergens can be destroyed this way, which can make the fruit more tolerable for you.

Resources:
Food Allergy and Anaphylaxis Network (FAAN)
American Academy of Allergy, Asthma, and Immunology
Food and Drug Administration
USDA – National Agriculture Library

If you have any allergy related issues feel free to contact Allergy Specialist in Bangalore - Dr. Puneeth KN for a consultation.

5

What is Seasonal allergy and how to diagnose it ?

What is Seasonal allergy and how to diagnose it ?

What is Seasonal Allergy?

Seasonal allergy is commonly called hay fever. They result from exposure to airborne substances like pollen grains, that changes or appear during certain time periods, so their pollen allergy season may be from early spring up to late fall.

When does Seasonal Allergy usually happen?

The term hay fever is somewhat misleading because symptoms do not occur only in the summer when hay is traditionally gathered and it never includes a fever. Hay fever is usually a reaction to pollens and grasses. The pollens that cause hay fever vary by season:

Spring: Usually trees (such as oak, elm, maple, alder, birch, juniper, and olive)
Summer: Grasses (such as Bermuda, timothy, sweet vernal, orchard, and Johnson grass) and weeds (such as Russian thistle and English plantain)
Fall: Ragweed
Seasonal Allergy is also caused by mold spores, which can be airborne for long periods of time during the spring, summer, and fall.

What are the symptoms of seasonal allergy?

Seasonal allergies cause itchy skin, a runny nose, watery and redness of eyes, and sneezing. It can make the nose, roof of the mouth, back of the throat, and eyes itch. Itching may start gradually or abruptly. The nose runs, producing a clear watery discharge, and may become stuffed up. The lining of the nose may become swollen and bluish red.

The sinuses may also become stuffed up, causing headaches and occasionally sinus infections (sinusitis). Sneezing is common.

The eyes may water, sometimes profusely, and itch. The whites of the eyes may become red, and the eyelids may become red and swollen. Wearing contact lenses can irritate the eyes further.

Many people who have allergic rhinitis also have asthma (which results in wheezing), possibly caused by the same allergy triggers (allergens) that contribute to allergic rhinitis and conjunctivitis.

The severity of symptoms varies with the seasons.

How is seasonal allergy diagnosed?

An Allergy Specialist can usually diagnose these allergies when typical symptoms (such as a runny, itchy nose and itchy eyes) develop during a particular season. Typically, no testing is necessary, but occasionally, the nasal discharge is examined to see whether it contains eosinophils, typically present in an allergic condition. Sometimes a skin test or an allergen-specific immunoglobulin test will help identifying the allergen.

What are the options to get rid of seasonal allergy?

Regularly flushing out the sinuses with a warm water and salt (saline) solution may help loosen and wash out mucus and hydrate the nasal lining. This technique is called sinus irrigation.

Corticosteroid nasal sprays, antihistamines, and decongestants help relieve symptoms. When these treatments are ineffective, a corticosteroid may be taken by mouth or by injection for a short time. One can even undergo allergen immunotherapy if it’s a long standing problem.

What is Allergen immunotherapy?

Allergen immunotherapy also called as desensitization helps some people when other treatments are ineffective. It is needed in the following situations: when symptoms are severe, when the allergen cannot be avoided, when the drugs usually used to treat allergic rhinitis or conjunctivitis cannot control symptoms.

Allergen immunotherapy for hay fever should be started after the pollen season to prepare for the next season. Immunotherapy has more side effects when started during pollen season because the allergens have stimulated the immune system. Immunotherapy is most effective when continued year-round.

How to protect from seasonal allergy?

One can protect from seasonal allergy by wearing an allergy mask, use air filters indoors, keep windows and doors shut, change the clothes after exposure, and shower before bed.

Resources:

American academy of Allergy Asthma & Immunology, Beaumont, MSD manuals, Indian College of Allergy Asthma & Immunology.

If you have any allergy related issues feel free to contact Allergy Specialist in Bangalore - Dr. Puneeth KN for a consultation.

6

Symptoms of Anaphylaxis and its Treatment

Symptoms of Anaphylaxis and its Treatment

What is Anaphylaxis?
Anaphylaxis is a serious allergic reaction that is rapid in onset and may cause death. It is a condition caused by an IgE-mediated reaction.

What are the common causes of anaphylaxis?
Common causes of anaphylaxis include:

*Food: *such as peanuts, tree nuts, milk, fish and shellfish (although any food can cause a reaction)
Medication
*Insect stings: *such as yellow jackets, honeybees, wasps, hornets and fire ants
*Latex: *natural rubber products such as condoms or latex gloves

What are the typical symptoms of a severe allergic reaction?
Any of these signs or symptoms may be present. Identifying anaphylaxis as soon as it starts is important.

*Skin: *hives, eczema flare, itchy, red rash
*Gastrointestinal: *cramps, nausea, vomiting, diarrhea
*Respiratory: *runny nose, sneezing, cough, tightness of chest, wheezing, shortness of breath.
*Cardiovascular: *drop in blood pressure,
*Others: *fainting, watery eyes, Itching or swelling of lips, tongue, or throat, change in voice, difficulty swallowing

What is the treatment of anaphylaxis?
When exposed to a known allergen, involvement of any two systems of the body necessitates immediate treatment with epinephrine.

How to prevent occurrence of anaphylaxis?
Any delay in the recognition of the initial signs and symptoms of anaphylaxis can result in a fatal outcome, either because of airway obstruction or vascular collapse.

Prevention:

  • School personnel should be informed about a student’s history of anaphylaxis and the specific food (or foods) to which the child is allergic.
  • An allergen-free environment should be constructed for the child at mealtime to prevent accidental ingestion such as might occur with shared food.
  • There should be a written response plan available that can be initiated immediately if a reaction occurs.

Preparedness:

Medications should be stored in an easily accessible location. The best place to keep medications is with the student.

Recognition:

  • Are history and physical findings compatible with anaphylaxis?
  • Are there cutaneous manifestations, specifically pruritus, flush, urticaria and angioedema?
  • Is there any sign of airway obstruction involving either the upper airway or the lower airway?
  • Are there gastrointestinal symptoms (ie, nausea, vomiting or diarrhea)?
  • Are syncope or presyncopal symptoms present?

What are the medications for anaphylaxis treatment?
Epinephrine is the only medication that can reverse severe anaphylactic symptoms. It is available by prescription.

Other medications:

Antihistamines are used to relieve the itching and dermatologic symptom.

Steroids: Steroids are often given in an attempt to protect against the “late” reaction that can occur several hours after the allergic reaction. Steroids do not reverse the acute symptoms of anaphylaxis; the effects of steroids may take hours. For some patients, particularly those with asthma, this late reaction could be even more severe than the initial reaction.

If you have any allergy related issues feel free to contact Allergy Specialist in Bangalore - Dr. Puneeth KN for a consultation.

7

What is Allergy Diagnosis?

What is Allergy Diagnosis?

Introduction
Allergy Diagnosis is based on a combination of the person’s clinical history, family history, physical examination, skin tests and laboratory tests. These tests serve to confirm the diagnosis of allergic disease and to identify potential allergic triggers, knowledge that is useful to guide allergen avoidance strategies.

Your doctor uses the following information to make a diagnosis of allergy:

  • History:The diagnosis of allergy begins with a clinical history. Your doctor will ask questions about your general health and then will focus on allergies and conditions that commonly coexist with allergic disorders, such as asthma and eczema (atopic dermatitis). Your doctor will need to know all the symptoms that are troubling you.
  • Family History:Your doctor will ask you whether any of your close relatives have allergic symptoms and whether they have been diagnosed with an allergic disorder such as asthma, hay fever or eczema, or allergic sensitivity to foods or medications.
  • Physical Examination:Your doctor will perform a complete physical exam with special emphasis on your eyes, ears, nose, throat, chest and skin.
  • Allergy Tests:Allergy tests will likely be performed to determine whether you are allergic and what you are allergic to. Skin tests are carried out by applying drops of allergens to your skin and then scratching or pricking though them. Blood tests may also be performed to evaluate for the presence of sensitizing antibodies.

Is it allergy?
Allergy can be defined as a detrimental immune-mediated hypersensitivity response to common environmental substances. While the word “allergy” can mean many things literally, but clinically the diagnosis of allergies is critically dependent on identifying the immune processes involved in the allergic response.

The immune processes of allergy usually rely on the production of IgE antibodies specific to common allergens. Allergic diseases are caused by the activation of mast cells and basophils through cell-surface-bound IgE. This causes the release of histamine and other mediators, leading to allergic inflammation.

Chronic allergic inflammation characteristically involves a cellular tissue infiltrate of eosinophils and lymphocytes associated with chronic tissue damage. This is mediated by T cells rather than IgE.

A useful test for the clinical diagnosis is to ask whether the symptoms are IgE-mediated (IgE-mediated symptoms include asthma, rhinitis, urticaria, eczema, food hypersensitivity and anaphylaxis). If not, then the symptoms are unlikely to be the result of true allergy.

IgE is produced by B lymphocytes directed by cytokine release from T helper lymphocytes. In people with allergies, the T helper lymphocytes secrete cytokines that stimulate the production of IgE antibodies to allergens. The condition of secreting IgE in response to common environmental allergens is called “atopy”.

Predisposition to atopy is determined by both genetic and environmental influences, particularly in infancy, when immune responses to allergens are maturing, and T lymphocyte cytokine production is influenced by environmental exposures.

The Allergy Diagnosis depends on identifying both the symptoms on allergen exposure and the relevant allergen specific IgE. The manifestation of allergic diseases changes throughout life: food allergies and eczema are most likely to develop in infants, asthma in young children, and rhinitis in older children and adults. There is increasing evidence that appropriate treatment of allergies can prevent and alter the natural history of allergic diseases. Optimal treatment requires accurate determination of allergic triggers. Moreover, if an allergen avoidance strategy is to be pursued in relation to food or aeroallergens, it is critical to minimize the inconvenience of this strategy by making a correct diagnosis as early as possible.

Detecting allergen-specific IgE
Accurate diagnosis of allergic disease and the relevant allergens helps to determine appropriate treatment options. Allergen-specific IgE can be detected by skin prick testing and by blood specific IgE testing (ie, serum allergen-specific IgE testing [as distinct from total IgE testing]).

Skin prick testing
Skin prick testing relies on the introduction of a very small amount of allergen extract into the epidermis using a standardized method to ensure reproducibility and comparability of results. The results of skin prick testing are read at 20 minutes. The diameter of the resulting wheal is recorded in two dimensions and the average of it is recorded.

Where standardized reagents are not available, crude allergens can be used for testing, but the results require interpretation by an Allergy Specialist.

Intradermal allergy testing (in which a small amount of diluted allergen is injected into the dermis) has a very high non-specific reaction rate, but is useful in specific protocols for investigating drug and stinging insect allergy.

Other methods of skin testing such as “scratch”testing are no longer used, owing to inconsistency of results.

Blood specific IgE testing
Blood specific IgE testing to a wide range of allergens detects and quantifies allergen-specific IgE. It can be used to diagnose all types of allergies, but is generally less sensitive than skin prick testing. Blood specific IgE testing is particularly useful when anaphylaxis is being investigated, as testing carries no associated risk of anaphylaxis and there are very few contraindications.

Blood specific IgE testing can be performed in patients who are taking antihistamines or other drugs that are contraindicated in skin prick testing, and in patients whose risk of an adverse reaction to skin prick testing is high (eg, those with unstable asthma or anaphylaxis).

Blood specific IgE testing can be difficult to interpret in patients who have very high levels of total IgE (>1000kU/L) (eg, patients with eczema), as they may have low-grade reactions to many allergens. Although blood specific levels of Ig G antibodies, especially to food allergens, can be measured, such testing should not be requested, as there is no evidence that it is relevant to allergy diagnosis.

Reasons to see an Allergy Specialist:
Many people with allergies see a primary care doctor for allergy care. You may choose to visit an Allergy Specialist, which is a doctor who specializes in allergies, for your allergy testing and treatment.

Here are a few reasons for seeing an allergy specialist:

  • Your regular doctor refers you to an expert for specialized tests.
  • Your symptoms interfere with your daily activities.
  • Your symptoms are getting worse.
  • You are concerned about side effects of medicine.
  • You are interested in different types of therapies to treat your symptom

If you have any allergy related issues feel free to contact Allergy Specialist in Bangalore - Dr. Puneeth KN for a consultation.

8

Treating Allergy With Allergen Immunotherapy

Treating Allergy With Allergen Immunotherapy

INTRODUCTION
An allergy is an exaggerated defense reaction of the immune system to some normally harmless environmental substances. These substances are called allergens. The aim of allergy treatment is not only to reduce symptoms but also to prevent disease progression and subsequent organ damage.

Allergen immunotherapy is a form of long-term treatment that decreases symptoms for many people with allergic rhinitis, allergic asthma, conjunctivitis (eye allergy) or stinging insect allergy. They decrease sensitivity to allergens and often leads to lasting relief of allergy symptoms even after treatment is stopped. This makes it a cost-effective, beneficial treatment approach for many people.

Let’s answer some simple questions before we dig deep:

Q What is the goal of immunotherapy?

A To treat the cause of allergy.

Q What is the basis of this approach?

A To get the immune system accustomed to the allergens in the environment.

Q What is the Impact of such therapy?

A Alleviate discomfort. Prevent disease progression and emergence of new allergies.

ALLERGEN IMMUNOTHERAPY - TREAT THE CAUSE OF ALLERGY

Allergen immunotherapy (AIT) is the only form of treatment that counters the cause of allergy and may thus have a lasting effect on one’s state of health. Discomfort is alleviated and the quality of life improved. It also prevents progression of the allergic disease. Thus allergen immunotherapy may prevent the march of allergy from the upper airways (allergic rhinitis) to the lower airways (allergic asthma) as well as the development of new allergies. It is therefore best suited for young patients with allergy (≥ 5 years) and for patients with early allergic rhinitis or allergic asthma. Likewise, allergen immunotherapy may significantly contribute to symptomatic improvement even in patients with a prolonged illness.

COURSE AND DURATION OF ALLERGEN IMMUNOTHERAPY

Once you have opted for allergen immunotherapy, there are two ways to introduce allergy-triggering allergens into your body: either subcutaneous immunotherapy (SCIT) as an injection into subcutaneous tissue or via the oral mucosa (sublingual immunotherapy, SLIT). Allergen immunotherapy is generally given for three years. Symptoms may regress even in the first year after starting treatment and may continue improving noticeably in the following years.

SUBCUTANEOUS IMMUNOTHERAPY

Subcutaneous allergen immunotherapy (SCIT) is administered as a subcutaneous injection. A slow and gradual increase in the amount allows the body to become accustomed to the allergens and to tolerate them. Treatment itself may be divided into two phases:

INITIATION THERAPY

During initiation therapy or build up phase, an increasing amount of allergen is injected into the upper arm until the maximum dose for the individual patient (maintenance dose) is reached. The intervals between injections in this phase is usually one week. The length of this phase generally ranges from three to six months.

MAINTENANCE THERAPY

After reaching the maximum dose, intervals between injections in the so-called maintenance therapy may be extended to 4 or 8 weeks. Your Allergy Specialist will decide what range is best for you.

You may notice a decrease in symptoms during the build-up phase, but it may take as long as 12 months on the maintenance dose to notice an improvement. If immunotherapy is successful, maintenance treatment is generally continued for three to five years. Any decision to stop the therapy should be discussed with your Allergy Specialist.

WHAT IS THE THE RIGHT TIME TO BEGIN?

For seasonal complaints, such as due to pollen, subcutaneous immunotherapy (SCIT) is usually started at the end of the season during the symptom-free period. Therapy may be commenced at any time in patients with all-year-round symptoms, as happens with mite allergy.

WHO CAN BENEFIT FROM ALLERGY SHOTS?

Both children and adults can receive allergen immunotherapy, although it is not typically recommended for children under age five. This is because of the difficulties younger children may have in cooperating with the program and in articulating any adverse symptoms they may be experiencing. When considering allergy shots for an older adult, medical conditions such as cardiac disease should be taken into consideration and discussed with your Allergy Specialist first.

You and your allergist should decide regarding immunotherapy on:

  • Length of allergy and severity of the symptoms
  • How well environmental control measures are helping your allergy symptoms
  • Your desire to avoid long-term medication use
  • Time available for treatment (immunotherapy requires a significant commitment)
  • Cost, which may vary with the allergen used for therapy

Allergen Immunotherapy are not used to treat food allergies. The best option for people with food allergies is to strictly avoid that food.

HOW DO ALLERGEN IMMUNOTHERAPY WORK?
They work like a vaccine. Your body responds to injected or ingested amounts of a particular allergen, given in gradually increasing doses, by developing immunity or tolerance to the allergen.

HOW EFFECTIVE ARE ALLERGEN IMMUNOTHERAPY?

They have shown to decrease symptoms of many allergies. It can prevent the development of new allergies, and in children it can prevent the progression of allergic disease from allergic rhinitis to asthma. The effectiveness of allergy shots appears to be related to the length of the treatment program as well as the dose of the allergen. Some people experience lasting relief from allergy symptoms, while others may relapse after discontinuing the therapy. If you have not seen improvement after a year of maintenance therapy, your Allergy Specialist will work with you to discuss treatment options.

Failure to respond to the therapy may be due to several factors:

  • Inadequate dose of allergen in the allergy vaccine
  • Missing allergens not identified during the allergy evaluation
  • High levels of allergen in the environment
  • Significant exposure to non-allergic triggers, such as tobacco smoke

WHERE ALLERGEN IMMUNOTHERAPY SHOULD BE TAKEN?

This type of treatment should be supervised by a specialized physician in a facility equipped with proper staff and equipment to identify and treat adverse reactions to allergy injections. Ideally, immunotherapy should be given by an Allergy Specialist. If this is not possible, your allergist should provide the supervising physician with detailed instructions about your allergen immunotherapy.

ARE THERE RISKS?
A typical reaction is redness and swelling at the injection site. This can happen immediately or several hours after the treatment. In some instances, symptoms can include increased allergy symptoms such as sneezing, nasal congestion or hives.

Serious reactions to allergen immunotherapy are rare. When they do occur, they require immediate medical attention. Symptoms of an anaphylactic reaction can include swelling in the throat, wheezing or tightness in the chest, nausea and dizziness. Most serious reactions develop within 30 minutes of the allergy injections. This is why it is recommended you wait in your doctor's clinic or hospital for at least 30 minutes after you receive allergy immunotherapy.

POINTS TO CONSIDER:

  • Discuss your medical history with your allergist before beginning therapy to determine whether the allergen immunotherapy is suitable for you.
  • Be sure to keep your appointments to ensure success of therapy.
  • A variety of symptoms typical of allergy may occur after the injection. Therefore, you must wait at least 30 minutes in the doctor’s clinic or hospital after each injection. Inform the medical personnel about any discomfort you may have.
  • Refrain from physical exertion and alcohol after the injection, as these factors may amplify a possible reaction to the allergen.
  • Redness, itching and swelling may occur at the injection site even hours after the injection.
  • Inform your doctor how well you tolerated each dose. Also about the medical treatments and newly occurred illnesses.

If you have any allergy related issues feel free to contact Allergy Specialist in Bangalore - Dr. Puneeth KN for a consultation.