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The Allergy Clinic |
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"Spring : When your nose does more running than you do!"
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Allergy has fast become an epidemic of the 21st century. Keeping pace with the
western world, India's incidence of allergic diseases is increasing at an alarming
rate. At present, almost 30 % of the Indian population suffers from one or other
allergic disease, be it Allergic rhinitis, Allergic sinusitis, Allergic conjunctivitis,
Allergic asthma, Skin allergies, Food allergy, Drug allergy, Pet allergy or Insect
allergy.
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One of the major factors responsible for this is the adoption of an urban lifestyle
and a western diet. Studies have shown that people living in farms suffer much
less from allergies than people living in urban settings. Increasing levels of ambient
air pollution, occupational exposures, stress, hygiene habits, increase in viral and
other exotic infections and so many more factors that are presently being intensely
researched, add to these. Many of these factors are also triggers for auto-immune
diseases; and there lies the link between allergies and auto-immune disorders,
both of which ultimately deal with defective immune systems in our bodies.
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Allergic symptoms occur when the body's immune system overreacts to
something that is harmless to most other people, but triggers a reaction in a
person who is allergic to it (similar to the body's immune system reacting to it's
own tissues in a person who has auto-immune disease).
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Allergic symptoms range from respiratory symptoms like sneezing, runny nose,
cough, wheezing, chest tightness, breathlessness to skin symptoms like itchy
rash, hives or urticaria, swelling of skin or angioedema; to gut symptoms like
stomach cramps, bloating, nausea and diarrhoea. Sometimes, arthralgia and
chronic migraine can also be manifestations of an allergy. The most severe
allergic reaction known as anaphylaxis can be life-threatening.
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Today, the commonest allergies, globally and in India, are Respiratory Allergies like
Allergic rhino-sinusitis, which in most patients leads to Allergic asthma in later life;
now a major health concern in India. Another area of growing concern is allergy to
foods and food intolerance, entities that are so similar in presentation yet so
different in pathophysiology; entities that were mostly restricted to the western
world, but are now increasingly being seen in Indians. Common allergens that we get exposed to are dust mites, pollen, animal dander,
mould, insect stings and foods like eggs, milk, fish, shellfish, nuts, peanuts
and wheat.
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Dr. Ritu Malani (Pulmonologist and Allergy Specialist) has undertaken formal
training in the field of Allergy, Asthma and Immunology. She believes that, as a field
growing in epidemic proportions, Allergy needs to be given the status of a
specialised branch of Medicine, so that proper guidance is made available to
patients who have been suffering from chronic allergic symptoms for years and
have learnt to live with their allergies, however deforming they might have become
to the quality of their lives.
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As she says, "Don't try to just sneeze away your allergies...get rid of them!" Allergy, being a chronic, complex and multi-system disease, Dr. Malani uses a
functional care approach to addressing it, keeping in mind that the individual's
diet, lifestyle and environment, all play a major role in influencing his/her genetic
make-up and his/her immune system. She thereby uses an integrative approach to
the treatment of allergies - using pharmacotherapy, allergen specific
immunotherapy as well as diet, exercise and lifestyle counselling therapy.
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An Allergy consultation at our clinic consists of the patient filling up an allergy
questionnaire, which is followed by a detailed elicitation of his history and a
general examination by the doctor. If required, he is then advised investigations,
which may include blood tests, lung function tests, radiology and skin prick tests.
Being a trained allergist, Dr. Malani herself conducts the skin prick tests. The
patient is then advised further treatment in the form of pharmacotherapy,
counselling (diet and lifestyle) and if indicated, allergen specific immunotherapy
(allergy vaccines) and/or biologicals. If the patient wishes, or if the case so
requires, a nutritionist consultation is arranged.
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