Complex Made Simple

DHA’s smart clinic discusses early identification, management of allergies

Late diagnosis of allergies is a common problem among patients, which often leads to complications and triggers the symptoms of other diseases

The Dubai Health Authority’s smart clinic discussed the importance of timely identification and management of allergies.

Allergy is an altered body reaction to a foreign substance (allergen) after prior exposure to that substance and according to recent studies; approximately one in five people in the UAE suffer from allergic rhinitis.

Latifa Hospital’s paediatric pulmonology department sees more than 1000 children per year for allergy and non-allergy related asthma cases, while Dubai Hospital’s allergy and immunology department treats approximately 800 patients per year for allergies.

The top three types of allergies, as per the data collected by these clinics, is allergic rhinitis, urticarial( mosquito-bite like symptoms) and food allergies.

Dr Hussain Ali Hattawi, consultant and head of allergy and immunology unit at Dubai Hospital said the reason for a high prevalence of allergies including allergic rhinitis is genetic predisposition and environmental factors.

Environmental factors include indoor and outdoor factors. Dust mites, pets or in some cases cockroaches are indoor allergens, while grass and tree pollens are outdoor allergens.

Other outdoor irritants like pollution, construction, do not directly cause allergies but aggravate the symptoms in people who already have them.

Al Hattawi said: “The most common problem we find is that people are unaware that they have allergies and continue to take other medications to manifest the symptoms of allergies but do not actually address the real problem. This often leads to deterioration of the condition. This is a common scenario in patients with allergic rhinitis because the symptoms include a runny or blocked nose, frequent sneezing and when it includes allergic conjunctivitis it can cause redness, itching and watery eyes. Yet, often patients assume this is due to a flu and common cold and continue taking over-the-counter medications. The rule of thumb should be that if the cold continues for more than six weeks and is a frequent occurrence, the patient should visit an allergist.”

Dr Fatma Al Jassim, consultant paediatric pulmonologist at Latifa Hospital, said: “Parents need to be very alert, particularly if they find exposure to a particular allergen has caused a reaction. An allergic reaction should not be taken lightly because allergies can have mild to extreme reactions.”

Al Jassim said that “Symptoms could include difficulty breathing, persistent colds, redness and rashes, mosquito bite like symptoms, pain and bloating in the stomach, diarrhoea, vomiting etc.”

Al Jassim, added: “Nowadays, simple tests can help detect the cause of the allergy. Since children do not like blood tests, a simple skin prick test can help identify allergens. In adults, a blood test can identify the source of the allergen and if that does not work, a skin test is the next option. Learning what triggers allergies and understanding how to treat them are the first steps toward controlling allergy.”

Al Hattawi said that “Treatment options include identifying and avoiding or minimizing exposure to allergens and irritants through environmental control. Since that is not always possible, patients are also given appropriate medication to control to minimize symptoms and to control the underlying inflammation associated with the allergic reaction. In some cases, allergen immunotherapy is an option. This treatment actually includes exposing the patient to minute doses of the offending substance, placed under the tongue or in the form of injections, in increasing doses. Over a period of few years, the patient’s body learns to accept the allergen and there will no longer be any reactions to that allergen.”

Food allergies:
Al Jassim highlighted that in cases of food allergies, especially in children, it is important to educate the child and his caregivers including the nurses at school about the situation.

Top food allergies in adults are nuts, shellfish and grains. Top food allergies in children include milk, eggs, grains, nuts and some fruits.

“People will feel or suspect an allergy to the food item because of the reaction they experience when they consume it,” said Dr Hattawi. “This should never be ignored and they should seek an allergist’s assistance. People with severe food allergies should carry with them an epinephrine autoinjector device at all times. Some allergies can cause life-threatening anaphylaxis, and patients should have access to this device within five minutes of consuming the food and they should ideally visit the emergency department within 15 minutes of such an episode,” he added.

“Children with food allergies must be taught how to use an epinephrine autoinjector device and if the child is too young the device should be kept with the caregivers and with the school nurse. School staff including all teachers in that year group, should be made aware of the child’s allergies,” he concluded.

Al Jassim said that “Management of allergies, especially in children, include education and teamwork so that all those who come into daily contact with the child are aware of the situation.”

The DHA’s allergy clinic located in Dubai Hospital is open every Tuesday from 3pm until 9pm. Walk-in patients require a passport and visa information to register. The facility is a sister clinic to the hospital’s immunology clinic.