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Respiratory Symptoms From Inhaled Substances

Respiratory Symptoms From Inhaled Substances

Allergens

An allergen is a substance which is capable of initiating an allergic reaction. The most important inhaled allergens are tiny invisible pollen grains, mold spores, house dust and animal danders.

Allergy-causing pollens come from plant flowers which at certain times of the year release large quantities of light buoyant pollen which can be carried for miles by the wind. These flowers are inconspicuous and often don’t really look like blossoms. They include trees which pollinate in spring, grasses in summer, and weeds in the fall. (See OAAC educational material handout Pollen Seasons) Ornamental flowers are generally not very important in allergy. They have large sticky pollen grains that are carried to other flowers by insects. They are not sufficiently abundant in the air to cause symptoms unless an allergic person is very close to them. However, some ornamental flowers are related to weeds. This is why some ragweed-allergic patients have symptoms when they are close to chrysanthemums, zinnias, asters, daisies, etc.

There are many types of molds in our environment. They have varying preferences for the types of places and conditions under which they grow into colonies. Some prefer to colonize indoors, some outdoors. The spores released by colonies are carried through the air to new places suitable for new colony formation. These spores are smaller than pollen grains but like pollens can cause allergic symptoms when they are inhaled.

The important constituents of house dust are the products of microscopic organisms found in most homes. House dust mites and molds thrive in warm moist conditions.

Like humans, fur-bearing animals continually grow new layers of skin. The indoor pet’s “dander” (tiny flakes of the outer layer of skin) falls off, disintegrates, and causes symptoms when inhaled. During early stages of allergy to a pet, patients are often unaware that the animal is contributing to their symptoms.

If a person is allergic to a pet, he/she should strictly avoid the animal. Outdoor pets are not of major concern. Pets that are confined to a limited part of the house (such as a tiled or wood-floored utility room and kitchen) are better then pets that contaminate the entire house. At the very least, pets should be kept out of the allergic person’s bedroom at all times. (See OAAC educational material handout Environmental Controls for Indoor Allergens.)

Irritants

An irritant is a substance which may trigger certain symptoms strictly because of its irritating effects. The symptoms mimic allergy, but in fact they are not really the result of an allergic reaction. Some individuals are extremely sensitive to these inhales substances (which incidentally bother the average person very little). The basis for this extreme membrane sensitivity is not well understood, but it is not allergy.

The most common offenders are smoke, cold air, wind, temperature changes, and weather fronts. Other provoking factors which bother some people in varying degrees include sharp pungent odors (paint, turpentine, aerosol sprays, perfumes, cleansers, cosmetics, chemical odors, exhaust smoke, insecticides, detergents and new fabric odors).

Respiratory infection is included in this category as is external wheezing in asthmatics.

Some substances are not only allergens or irritants but can be both. Examples include house dust, feed and grain dusts, and live Christmas trees. In any given patient allergens, irritants or a combination of both may be of major importance in the production of either asthma or nasal symptoms.

Occasionally patients who are sensitive to both irritants and allergens will have useful reduction in nasal and chest symptoms caused by irritants when their allergies are successfully treated. More commonly their susceptibility to irritants remains a separate problem and the treatment is by appropriate medication and avoidance. Irritant induced symptoms are more difficult to treat than those from allergens.

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Pregnancy and Allergies

A woman’s body experiences many changes when pregnant. Some women may develop allergies during pregnancy. It’s more common for women to already have allergies before conception.

Can allergies worsen during pregnancy?

About one-third of moms-to-be find their allergy symptoms get worse during pregnancy. The same number of women said their allergies stayed the same. Another one-third found their symptoms actually improved during pregnancy.

Common Symptoms

Symptoms are basically the same for those not pregnant which includes: itchy, watery eyes; sneezing; sore or itchy throat; runny nose and sinus congestion.

Stuffy Nose

Many pregnant women can develop stuffy noses. Nasal congestion normally starts in the second trimester cause mucus membranes to swell and soften. Some doctors call it pregnancy rhinitis.

Pregnancy rhinitis can feel like a cold or an allergy. It can also cause nosebleeds during pregnancy and even a post nasal drip that can cause coughing and even gag at nighttime. Typically, pregnancy rhinitis goes away after the pregnancy ends.

What is the difference between allergies and pregnancy rhinitis? For those who have allergies, symptoms experienced included congestion, coughing, sneezing and itchy eyes. If itchiness and sneezing isn’t causing issues, it could be hormone-related pregnancy congestion. Discuss any issues you are having with your doctor.

Allergy Medicines for Pregnant Women

Women need to be very careful taking any medications during pregnancy and most importantly during the first trimester. It’s important to discuss any allergy medications with your doctor. Reducing allergens in the home without using medications could be a first line of defense for the mom-to-be. Allergy proofing the home, avoiding allergy triggers and trying a saline nasal spray, nasal irrigation or nasal strips.

After the first trimester – oral antihistamines treat nasal and eye allergy symptoms of allergic rhinitis.

Considered safe for pregnancy according to multiple studies – Loratadine and cetirizine are second-generation antihistamines. These drugs do not cause drowsiness like first-generation oral antihistamines do – chlorpheniramine, diphenhydramine and tripelennamine.

Corticosteroid nasal sprays are mostly safe and can be prescribed to pregnant women with moderate to severe allergy symptoms that last more than a few days. Budesonide is considered the safest. Mometasone and fluticasone are also considered safe.

Decongestant nasal sprays can cause issues. Some studies point to a risk of birth defects when pregnant women use these products. They are not recommended during pregnancy especially in the first trimester.

Pregnant women should avoid any antihistamine nasal sprays since there is not enough research to prove their safety.

Always discuss which nasal spray might be right and any medication risks to the pregnant woman and her baby with her physician.

Allergy Shots during Pregnancy

Women can continue allergy shots that began before they were pregnant. They should stay at the current dose during pregnancy and if there are any reactions, the allergist may reduce allergy shot dosage. Generally, it is best not to begin allergy shots during pregnancy which can trigger changes in an already-changing immune system and may cause a systemic reaction.

Anaphylaxis treatment is the same during pregnancy as for non-pregnant women with food, insect venom or latex allergy. Use epinephrine at the first sign of symptoms.

Breastfeeding and Allergy Medications

Medications used during pregnancy can be continued while nursing. The baby gets less medicine through the breast mile than in the womb. Your allergist can discuss the best medications for nursing moms to use.

Do Allergies Cross Over to the Baby while Pregnant?

Allergy symptoms experienced by the mom during pregnancy are not believed to have an impact on the baby and developing allergies. Genetics play a major factor in developing allergies. For children with a parent or sibling with allergies, they have an increased risk of getting allergies.

A pregnant mother’s diet can be a factor in developing the child’s allergic rhinitis, food allergies, asthma or eczema. One study found that moms who ate plenty of food-based vitamin D reduced the child’s risk of developing allergic rhinitis. Foods with lots of vitamin D include dairy products, cereals, fish, eggs and mushrooms.

Reducing Allergy Symptoms without Taking Medications

Stay away from people who are smoking which can make allergies worse. Plus, secondhand smoke is not good for mom or her baby.

Pollen Allergies – stay inside as much as possible. Try wearing wrap-around sunglasses to keep pollen out of the eyes. Coming back inside, take off shoes, washing hands and face and changing clothes will help keep the pollen off. Put clothes in the wash. Shower and wash hair before bedtime to reduce nighttime symptoms.

Dust allergies – have someone clean the home regularly (if possible) and use a HEPA filter vacuum. A wet mop and a sweeper can help avoid stirring up the dust. Microfiber is better than a duster to trap the dust.

Pet allergies – for those allergic to their own pets, try to make one room that is pet-free.

Avoidance diets do not prevent allergic disease according to the American Academy of Pediatrics. This means that pregnant women shouldn’t worry about avoiding common food allergens such as peanuts, tree nuts, milk or wheat. Studies have shown that consuming peanuts, milk and wheat in the first and second trimesters can reduce the risk of a child developing a peanut allergy, allergic rhinitis and asthma. Unfortunately, no specific diet or food can prevent allergic disease.

Always discuss with your doctor before making any changes in diet during pregnancy.

The post Pregnancy and Allergies appeared first on Oklahoma Allergy and Asthma Clinic.

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