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bfitzpatrick@allergy.ie

Our Treatments

Food Allergy

Conditions Treated Food Allergy

Food hypersensitivity is a general term for adverse reactions to food. This can be broadly divided into:

  1. Food allergy e.g. nuts, seafood, eggs, milk, kiwi, sesame
  2. Food intolerances. These reactions are normally more delayed occurring to a variety of commonly ingested foods e.g. milk, wheat, yeast, sugar and eggs. Mechanisms are non immunological with a variety of different causes e.g. enzyme deficiency, pharmacological reactions, gut fermentation and natural chemicals.

Food Allergy is particularly common in childhood especially children with eczema.

Can occur with many foods but most reactions are to milk, eggs, wheat, peanuts, shellfish, soya and sesame.

a. History is very important.
b. Timing (most true allergies occur within 2 hours).
c. Suspect food (? Taken before)
d. Duration – most allergic reactions resolve within 24 hours
e. Risk factors e.g. personal or family history of asthma and eczema
Most children (80-90%) grow out of milk, egg and wheat allergy. Suitability to re-introduce foods is clarified by history, skin and blood testing.

A small minority (10-20%) only will grow out of nut and shellfish allergy.

Adrenalin injections are prescribed depending on the severity of the reactions and food involved. Most peanut allergy patients will require injections unless the reaction has been minor and localised.

Urticaria

Conditions Treated Urticaria

Urticaria (nettle rash) consists of hives or general redness. It may be either a)acute (sudden onset) or b)chronic.

Acute urticaria e.g. peanuts, seafood and medication can normally be diagnosed from the history and Allergy testing.

Chronic urticaria is more complex with many aggravating factors including food, other illnesses, reduced immunity and also aggravated by physical factors e.g. contact, heat, sweating, exercise.

Diagnosis and management of urticaria requires a detailed history and Allergy test if indicated. Food can also aggravate urticaria through non-allergic mechanisms. Blood tests are required if symptoms are persistent or associated with other signs of ill health. Foods can affect this condition but not always by an allergic mechanism.

Hay Fever

Conditions Treated Hay fever/rhinitis

Hay Fever affects 15% of the population and is due to an inflammatory/allergic response affecting different target organs, e.g. nose, eyes and chest. There is some yearly variation, but hay fever generally peaks in Ireland from mid-May to late June. Reactions before or after this are often due to other allergens, e.g. trees, shrubs and moulds particularly in late Autumn. Diagnosis is usually obvious from the classical symptoms of rhinorrhea, sneezing, watery eyes and perhaps “hay asthma” which can occur in 15-20%. Hay Fever can significantly affect overall general health and well being. The clinical diagnosis is usually confirmed by history and skin prick testing (SPT).

Treatment:

  1. Medication i.e. eye drops, nasal sprays, inhalants and antihistamines.
  2. Low dose sub lingual neutralisation – This involves serially diluting a standard extract of grass pollens by a factor of 5. Depending on the patient’s clinical sensitivity and allergy test result, one drop of a particular dilution is placed under the tongue until a relieving concentration is found. The patient is then given a bottle with this particular dilution, which should be taken regularly during the hay fever season. This is different to Sub lingual immunotherapy (SLIT) which involves a much higher dose of grass pollens taken regularly for three years.

First Aid Treatments

Hay Fever sufferers are well aware of these but it is important to remember:

a. Keep windows of the house and car closed during peak pollen times i.e. late morning and afternoon
b. Avoid mowing lawns or use a face mask if doing so
c. Smear some Vaseline inside the nostrils to trap the pollen entering the nasal passages
d. Use wraparound sun glasses particularly if eye symptoms are a problem feature
e. Keep medication, including anti-histamines and decongestants ready for sudden attacks.

Acupuncture – 1-2 treatments before the Hay Fever Season may be of benefit.

Inhalant Allergy

what we offer Inhalant Allergy

Inhalant allergies are important in diagnosing Hay Fever, Rhinitis, Sinusitis, Asthma and Eczema.

History is very important with winter suggesting house dust mite allergy, Spring – tree pollens, mid May – mid July grass pollens, August – moulds.

Inhalants tested include house dust mite, feathers, grass pollens, tree pollens, silver birch, moulds and candida. Pets tested for include cats, dogs and horses.

Rhinitis/ Sinusitus

Conditions Treated Rhinitis/ Sinusitus

There is a particularly high incidence in Ireland of respiratory infections including Sinusitus and Chest infections and this is partly related to our damp climate. In general, infections peak from September to around April and many people get on a spiral of recurrent antibiotics and infections. Antibiotics and nasal sprays can obviously be very beneficial but people are concerned about the possible long term side effects.

Other treatment approaches can be very useful in these problems:

  1. Allergy diagnosis and testing. The increased mucus and moisture present in the nose is a suitable breeding ground for infection and patients with allergic nose symptoms are more at risk of recurrent infections. Allergy management is crucial in this condition and this includes a comprehensive history taking as well as allergy testing. One of the reasons for peaking of infections in winter months is increased rhinitis due to dust mite and mould allergy. Dust mite elimination techniques are helpful but often not sufficient and house dust mite de-sensitisation is often of benefit.The low dose neutralisation method used at the Clinic involves testing with specially prepared dilutions of house dust mite to find a particular concentration which clears symptoms. No injections are involved and these drops, taken regularly over a period of months, often relieves symptoms and builds up long term immunity to dust mite. This can be similarly used in relation to grass pollen neutralisation.
  2. Yeast/sugar sensitivity (Candida Syndrome)
    This refers to patients who have yeast/sugar sensitivity, often with a history of frequent antibiotics, fungal infections, thrush, irritable bowel syndrome and a variety of other symptoms. Treatment of this condition by a combination of diet, supplements, homeopathy and herbal medicines improves overall well being and immunity as well as reducing overall tendency to allergies.
  3. Our modern diets are not as healthy as we would like to believe, with a high intake of refined carbohydrates, caffeine and alcohol. Patients with recurrent infections can benefit from a variety of supplements including B Vitamins, Zinc, Probiotics, Vitamin C, Garlic and short courses of Echinacea.

Asthma

Conditions Treated Asthma

A common lung disorder in which inflammation causes the bronchi to swell,  narrowing the airways and creating breathing difficulties .

Symptoms include  wheezing , shortness of breath and chest tightness .

Increasing evidence Asthma is part of United Airways disease involving nose, sinus and chest.

Aggravating factors include  weather changes, infections ,  stress and allergy.

Allergy consultation and testing is an important part of Asthma management.

Testing is carried out for a wide variety of inhalants and foods.

Irritable Bowel

what we offer Irritable Bowel

Irritable Bowel Syndrome is the cause of significant ill health in the community in that approximately 20% of the population have symptoms of it and 50% of patients attending Gastroenterology Clinics are diagnosed with it.  Common symptoms include bloating, flatulence, diarrhoea, constipation and pain. 

Patients may also have a wide variety of other symptoms, including muscle pains, hormonal imbalance, increased premenstrual tension and poor overall energy and well being.

How is it diagnosed?

There is no diagnostic test of Irritable Bowel Syndrome.  It is usually diagnosed by exclusion of other illnesses e.g. ulcers, gall bladder, bowel cancer, colitis and by the typical symptoms outlined above.

What is Conventional Treatment?

  1. When bowel investigations are normal, patients are generally reassured that there is “nothing serious”.  This is welcome, but they are still left with the problem.
  2. Dietary Advice: Fibre rich diets have been traditionally recommended but approximately 50% of IBS patients are worse with this.
  3. Medication for symptomatic relief e.g. colofac, motilium, and immodium. 

What causes Irritable Bowel Syndrome?

Common precipitating factors include a significant gastroenteritis, frequent antibiotics, stress and food allergy/intolerance.  Causes vary in different individuals, but the work of Hunter (a Gastroenterologist in Cambridge) would suggest that 60% of patients with IBS obtain significant improvement with dietary elimination.  Allergy testing is only one aspect of allergy management and this should always be combined with a comprehensive history and evaluation of response to elimination and challenge.

How long do I need to be on the diet to see a response?

The good news is that two weeks is often sufficient to clarify the role of diet in the condition.  Re-challenging of the omitted foods should be systematic, both to confirm results and avoid strong allergic reactions.

Will I have to keep off these foods forever?

No, these intolerances are often temporary and different to highly allergic foods e.g. peanuts and seafood.  Prolonged diets are difficult and other treatments are required to reduce the level of food sensitivity.  These may include anti-fungal medications if indicated, Pancreatic enzymes and Nutritional Supplements to improve the leaky gut/imbalanced gut permeability, which contribute to IBS.

What is Gut Dyspiosis/Fermentation?

This can be a cause of IBS and broadly involves disturbance of the normal gut bacteria/flora.  Diagnosis can be made from the history and sometimes allergy test. 

Candida Syndrome is one cause of this condition.  Symptoms of this include sugar craving, poor alcohol tolerance, fungal infections e.g. thrush, Athlete’s Foot, dandruff, poor energy and well being as well as irritable bowel symptoms particularly flatulence and bloating.  This responds well to a combination of diet, Supplements and anti-fungal medication.

Is stress causing my Irritable Bowel?

Stress is undoubtedly an aggravating factor, but it is rarely the only factor.  Stress has a greatly reduced impact when the underlying cause is corrected.  If stress is a particularly strong feature, relaxation techniques, regular exercise and perhaps hypnosis can be of benefit.

Will I ever be rid of my IBS?

Yes.  In general IBS is a condition that responds well to treatment.  The natural history is for it to improve with age.

Can Acupuncture help?

Our digestion is very much under nervous system control.  Not surprisingly, Acupuncture can be helpful either alone or in conjunction with other treatments.

Eczema

Conditions Treated Eczema

Eczema is a very common skin condition affecting infants, children and adults. It is normally easily identified by redness, itching and flaking of the skin. Food allergy is important especially in the first few years of life. This is evaluated by Skin prick testing (SPT) and blood tests and history. A variant of eczema, i.e seborrhoeic dermatitis which affects the scalp, forehead and nose area may be part of a yeast /sugar sensitivity.

In addition to diagnosing allergies present, it can also guide as to likelihood of growing out of the Eczema and risk of Asthma and Hay Fever.

Inhalant allergies e.g. house dust mite, moulds, grass and tree pollens and animals become more important after the first few years.

In addition to Allergy diagnosis and management, Nutritional Supplements may also be individually selected which may boost the body’s immunity to Allergies and Intolerances.

Anaphylaxis

Conditions Treated Anaphylaxis

Anaphylaxis is a severe, potentially life threatening allergic reaction to a foreign body (allergen) often occurring within seconds to one hour after exposure.  Symptoms may include widespread hives (urticaria), itching, sensation of lump in the throat, constriction of the airways, swollen tongue, wheezing, weakness and collapse. 

Common causes include:   

  1. Food – e.g.  peanuts, tree nuts, seafood, eggs, milk and sesame
  2. Medication – e.g . Penicillin
  3. Bee stings    
  4. Latex/rubber

Diagnosis is based on history, Skin testing, sometimes combined with blood tests ( specific IGE )    The need for adrenalin  injections is based on a combination of the above.

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