Childhood Allergies: What You Need To Know

Robert Winkler Robert Winkler

Over the last years doctors  have seen allergy numbers rising and rising all over the world.  In the western world, around 30% of the population suffer from allergies.  Childhood allergies have almost doubled in the last decade.  And yet, allergies are still underdiagnosed and-undertreated ! But there is also good news…

What exactly is an allergy?

 Simply put, an allergy is an exaggerated response of our immune system to common substances, such as food, pets or pollen.

Our immune system is a very complex system. It protects our body  against invaders from the outside such as viruses and bacteria.

 In allergies, the immune system believes  a normally harmless substance is  “dangerous”- and starts a clinical reaction which then causes the child harm- such as eczema, asthma or hayfever.

These substances , called “allergens” should not harm our body in the first place!

“Typical “ allergic diseases  are food allergies, hives (urticaria), eye allergies (allergic conjunctivitis), nasal allergies (allergic rhinitis), asthma, animal dander allergies or insect veom (mostly bees and  wasps) allergies.

When the allergens are found in the environment, such as pollen, dust mite or animal dander, allergists use the term environmental allergies.

People who are prone to allergies are often called “atopic”- originating from the greek word “atopos” for strange.

The clinical symptoms can range from mild to major, can be acute or chronic. They can even be life-threatening as in anaphylactic shock- the most severe form of an allergy.

Allergies can develop at any age, can stop (“outgrow”) but often come back after years.

What causes allergies?

A lot of  paper has been written about this issue and we continue to learn more and more every day.

Family history (Genetics) plays an important part.

That means if parents or siblings have allergies-your child` s  risk is increased. Over the last year the role of the environment has become more of a focus as well. Tobacco smoke, air pollution,the role of  C- sections and the so called “hygiene hypothesis” -to name a few.

The latter has shown that our immune system “needs” to learn fight enemies-that is why children who grow up on farms (with contact to various animals and bacteria) have significantly less allergies than children from the cities.

How do doctors diagnose an allergy?

Firstly, allergy testing is a bit of an art and requires a lot of expertise. It should hence be done by a doctor who has specialised in this field, usually  a pediatric allergist . There are a variety of skin test and also blood tests available. There are pros and cons for both, generally speaking, the combination of both tests is recommended in most cases- as the chance to miss an allergy is higher  if only one test is used. The interpretation of these tests is not as easy as it may seem- a positive test result does not always equal clinically relevant allergy! There is a high rate of so called false positive results-especially in the growing field of food allergies. Eventually this means there are a lot of children (and adults) who are put on (sometimes harmful) diets-for no reason at all.

Very often a so called challenge test is needed in order to “prove” the allergen is truly responsible for your child`s symptoms. Few doctors know how to perform these tests though .

Another big challenge -and this can sometimes be even more  confusing for the patient- is the field of scientifically based tests versus unscientific tests. There are currently a lot of tests available who have no scientific  value at all-in act they can be dangerous for the patient. It is impossible to list all of these “fraud” tests here-do speak to an allergist that you trust and he will be happy to discuss the value of the different tests with you.

Can we cure allergies-what is the best treatment?

Again, there is no “one fits all answer” for this question. Sadly, most allergies are still un treated – and if they are treated, patients are being offered medication, mostly antihistamines alone.

The treatment options vary amongst the different allergic conditions.  The three pillars of allergy treatment are allergen avoidance (not always possible!), medication and allergen immunotherapy.

Allergen specific immunotherapy -or “allergen shots” are currently the only causal treatment-and the only treatment that has the potential to not only improve symptoms, but also to alter the underlying problem that causes a lifelong chronic disease.

This is the real good news, because for the first time allergists can actually start to cure allergies diseases versus just treating symptoms. It is important to know that the earlier an allergy is properly diagnosed-the better the chances are for treating and potentially curing it. There is currently a lot of research in this area and the results are quite promising.