Suddenly suffering from sore eyes? Always sneezing? Yes ear, nose and throat allergies can develop as an adult. We speak to ENT specialist Dr Lynne Lim on what you can do about it.
The last thing you might expect in sunny Singapore is a chronic case of allergies afflicting the ear, nose and throat. Add a combination of haze, dust and dander, and you can almost guarantee that aggravated symptoms are in the forecast. All. year. round. The horror!
Stocking up on antihistamines is one solution, but if it turns chronic, what should you do next? ? We asked senior ENT consultant and surgeon, Dr Lynne Lim, about the typical symptoms that drive patients to her popular clinic at Mount Elizabeth Medical Centre in Orchard Road, and what we can do about those allergies.
I was fine until now… how can I have an allergy as an adult?
While it’s common for allergies to occur in children, allergic rhinitis can develop at any age. If there is a family history of allergic rhinitis, asthma or eczema, there is a predisposition to developing an allergy – why that happens at a certain age is still not fully understood.
However, not all chronic runny and blocked nose are allergy related. One in three are actually non-allergic rhinitis (NAR), which involves chronic sneezing or a congested nose without an identifiable cause. As such, many adult conditions may be misdiagnosed as allergic rhinitis.
Do my symptoms fit the bill?
Physical symptoms include: itchy ears, nose and throat; a runny or blocked nose; a chronic cough; sneezing, headaches, sore throat, and dark circles under the eyes. But that’s not all – complications like asthma, recurrent sinusitis, middle ear infections, snoring and obstructive sleep apnea can also result in the long run.
What could be the culprit?
Allergies in ENT are usually inhalant, and sometimes food related. Testing for allergies is complex, especially for delayed allergy reactions and some food allergies. There’s a continuing debate about these tests, as indiscriminate testing and careless interpretations of the results may confuse and frustrate patients instead.
If you’re testing for skin-related allergies, diluted extracts from common local allergens (such as dust mites, animal dander, grass and tree pollen, or mold) is lightly pricked onto the skin. Results are available within 20 minutes!
Is there an ‘allergy season’ here?
Singapore may not have the four seasons, where pollen allergies are worse in Spring or Summer, but perennial allergic rhinitis can be triggered by allergens such as dust mites. There is also an abundance of trees and plants that do cause pollen allergy, especially when the flowers are blooming, so you might see symptoms flaring up throughout the year.
What can I do about my nasal allergy?
Common types of medications available include steroid nasal sprays for decongesting the nose, and oral antihistamine to help in the reduction of symptoms like sneezing, itching and runny nose.
Nasal steroid sprays are not associated with the more significant side effects of oral steroids, and can be safely used on kids from two years of age, if appropriately dosed. They are not emergency rescue drugs, and optimal effects come only after regular usage of one to two weeks.
Second generation antihistamines are not as sedating as first generation ones. Oral decongestants are used intermittently in severe exacerbations.
Leukotriene inhibitors like Monteleukast are helpful in patients with asthma, but aren’t as effective for controlling nasal symptoms.
Immunotherapy (a type of treatment that boosts the body’s natural defenses) can significantly reduce the allergic reactions for longer term control of allergies, and also reduce the need for daily medications. It’s the only possibility of a cure for one’s allergic rhinitis to a specific allergen. However, it would be more challenging if one has multiple allergen sensitivities.
What else helps?
To reduce the need for multiple medications, it’s important to avoid exposure to these allergens. For common allergens such as dust mites, use a HEPA (high-efficiency particulate air) vacuum, anti-dust mite covers or powder on beddings, wash your sheets and curtains in 60 degree celsius, and remove all carpets. Turning on the air conditioner also helps reduce the humidity in your living spaces, and makes it harder for the dust mites to thrive.
Ensure your home is kept clean and decluttered, with good ventilation – you might also want to minimise the number of indoor plants, and water pooling in kitchens and bathrooms (that could cause mold to grow).
Lastly, nasal rinses work well to decrease the allergen count in the nose and also provide some decongestant effect.
For more information on adult allergies, check out this website or email [email protected].
Adj Assoc Prof, Lynne Lim, is Senior ENT Consultant at Mount Elizabeth Medical Centre (Orchard). Her clinic provides a one-stop service for treatments of ear, nose, allergy, snoring, throat and hearing problems for both children and adults.
LynneLim Ear Nose Throat & Hearing Centre, #17-07 Mount Elizabeth Medical Centre, 3 Mount Elizabeth, Singapore 228510, p. 6737 7787; #15-02, Farrer Park Medical Center, 1 Farrer Park Station Road, Singapore 217562, p. 6702 0990.
This article is sponsored by LynneLim Ear Nose Throat & Hearing Centre