FAMILY MEDICINE® COLUMN
By John C. Wolf, D.O.
Associate Professor of Family Medicine®
Ohio University College of Osteopathic Medicine

[READER SHOULD SEND STUDENTS TO DOC FOR NEW ALLERGY TREATMENT ]

Question: I am an instructor in the Ohio Program of Intensive English. My students [who come from many countries] often have allergy problems here, as do many Americans, of course. They seem to have trouble understanding how to use their prescription and non-prescription medicines. They end up half-doped and half-asleep all quarter and still suffer with allergy. Can you offer some guidelines for what medicines they should take and for how long they should take them?

Answer: Allergy is certainly a common problem that troubles at least 15 percent of the United States population to the point that they take medicine to relieve their symptoms. My experience suggests that the incidence of allergy in individuals living in areas with lush vegetation growth - like here in Athens, Ohio - is considerably higher. So, your concerns apply to many people, not just those who are learning English as a second language.

The first exposure to an allergic substance sensitizes the immune system in susceptible people. Then the next time you encounter the substance, your body reacts as though it's being invaded by a harmful germ, like a cold virus. It not just coincidence then that familiar symptoms of allergies - like runny nose, itching eyes, nasal congestion, cough, and general lassitude - are somewhat similar to those of the common cold.

Examples of substances which can trigger an allergic response are tree or grass pollen (typically in the springtime) and weed pollen in the summer and fall. Also, people often develop allergies to substances which are in the air all year around - such as molds, animal dander from pets, and dust mites.

Allergy medicine provides relief by preventing the allergic response or by reversing the congestion and increased drainage caused by an ongoing allergic attack. Antihistamines can prevent attacks, if they are taken regularly. Many of these products contain an additional decongestant that helps reverse the congestion and drainage if symptoms have already begun.

Many allergy products are sufficiently safe to be available without a prescription. Unfortunately, safe doesn't mean without side effects. All the non-prescription antihistamines cause drowsiness for most people when they are taken at the maximum recommended strength ñ the amount many people need during peak allergy season. I suspect this side effect is what causes your students to appear half-doped and half-asleep.

So what's an allergy sufferer to do? Well, the best treatment is avoidance of the offending allergen, or at least minimizing exposure to it. Unfortunately, this is often not possible.

Antihistamines are an excellent addition to allergen avoidance. The lowest strength that gives satisfactory relief should be used. If drowsiness occurs, try another antihistamine, but be sure it is a different drug rather than just a different brand of the same product.

We physicians have a wide range of treatment options, including prescription antihistamines. These tend to cause less sleepiness than their non-prescription counterparts, but they are also more expensive. Despite the cost, they are the best choice for millions of people. Nose sprays containing corticosteroids are more effective than antihistamines at relieving nasal symptoms, and they have no drowsiness side effects. They can be used alone or in combination with antihistamines. The final step in allergy treatment is allergy desensitization, treatment that is also known as allergy shots.

For allergies which are only present at certain times of the year, the appropriate medicine should be used every day. It should be stopped when the allergy season is over or whenever the side effects of the drugs are unacceptable. In other words, wake your sleeping students up and send them back to the doctor for another treatment choice. Remind them that it is their job to tell the doctor about any troublesome side effects they experience. We doctors aren't mind readers, you know.

Family Medicine® is a weekly column. To submit questions, write to John C. Wolf, D.O., Ohio University College of Osteopathic Medicine, Grosvenor Hall, Athens, Ohio 45701.