June 2016

Allergy is the New Black

Author: Dr. Thomas Beller

In the clothing industry, black is always in fashion. When another color becomes popular, it is often said to be the “new black.” In medicine, allergy may be the new black.

Allergy is a term used commonly in American society. Over the past 30 years, the growth of allergy has been dramatic enough to be called an epidemic. Some symptoms of allergy have long been established. Sneezing, runny nose, nasal congestion, and itchy, watery eyes are recognized by most of us as typical allergy symptoms. Patients with these symptoms are often quick to inform us, “Don’t worry; it’s just allergies,” a popular justification since it implies “I’m not contagious.” Don’t be surprised if this expression becomes more common in the near future as we begin to recognize that allergy affects us in ways we didn’t previously understand.

There are a growing number of new symptoms that are now thought to have allergy as an underlying factor. For example, urinary urgency, diarrhea and/or constipation (often called “irritable bowel”), anal itch, excessive throat clearing, chronic dry cough and other symptoms are now being recognized to have allergic factors in some cases. It might be easier to understand these new symptoms if we explore what exactly the term “allergy” means.

An allergic response is an immune response. It occurs when the immune system has become overly sensitive and responsive to something that is non-infectious. It occurs mainly in clean societies, where cooking of food is commonplace and where chemicals, such as chlorine, have been added to the water supply. This leading hypothesis to explain the allergy epidemic is called the “hygiene hypothesis.” It suggests that by eliminating some common microscopic invaders of our past, we are creating a sense of confusion in the immune system. By eliminating exposure to infections that were once common, the body is mistaking other benign, non-infectious substances, or allergens, as potential invaders. In this way, our body now stimulates an immune response with exposure to pollen, dust mites, pet dander, and mold spores.

The allergic response is seen at the microscopic and macroscopic levels. On a microscopic level, antibodies are being produced, and cells are infiltrating affected tissues, resulting in inflammation. At the macroscopic level, meaning generally visible to us in our day-to-day experience, defensive actions can be seen that are used to flush (watery eyes, runny nose), expel (sneeze), and form barriers (mucous production prevents access to mucosal surfaces).

It is increasingly clear that our body uses these defensive actions not only in the nasal passages and eyes but in every orifice, or point of entry, of our body. This helps us recognize broader flushing and expelling responses as potentially being related to allergy. These include urination (urinary urgency, bedwetting), diarrhea (irritable bowel), cough, throat clearing, and excessive ear wax. Itching is another important defensive response since it triggers physically protective actions such as scratching, (itchy skin, itchy palette, vaginal itch, anal itch). Other symptoms with ties to allergy include nasal bleeding, sinus pressure, headache, ear pain, tinnitus, and vertigo. Not every symptom has an obvious purpose but may result as a side effect of inflammation at points of entry.

If we can ever expect to conquer these bothersome symptoms, we have to become more aware of their underlying cause. Allergy is surfacing as one potential factor and in this way is becoming an increasingly hot topic in medicine. Don’t be surprised to hear allergy blamed for even more symptoms never before associated with it in the future. Hmmm…yes, at least for now, allergy is the new black. 

Dr. Thomas Beller is an allergist-immunologist serving Hilton Head Island, Bluffton, Okatie, Sun City, Hardeeville, Ridgeland and Beaufort. For office locations and more information, call (843) 689-6442.

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