Archive for the ‘Allergies’ Category


Sunday, February 6th, 2011

This group of illnesses includes those disorders that are not due either to allergic causes or to some abnormality of the anatomy of the nose.

Atrophic Rhinitis
More common in women for reasons that are not clear, this is a disorder in which the lining of the nose becomes chronically inflamed and thinned and large numbers of scabs accumulate on the lining membrane of the nose. Patients with this problem are most bothered by two symptoms: a characteristic sensation of nasal congestion in spite of a wide-open nasal passageway, and a foul odor, called ozena, that comes from the nose. Ozena is caused by a bacterial infection of the lining of the nose.
Atrophic rhinitis is uncomfortable to have and difficult to treat. The cause of atrophic rhinitis is not known, although a causative role for bacteria, chemical fumes, cigarette smoke, and viral agents all have been suggested.

Cold Air Rhinitis
You’ve probably walked down a cold, windy street and experienced mild nasal congestion, runny nose, and occasional sneezing. This is such a common experience that most of us consider it to be normal. However, some people experience severe nasal symptoms on exposure to cold air. In these people, mast cells release the same mediators that they would if the person had been exposed to something to which they were allergic, causing these people to experience symptoms very similar to severe allergic rhinitis. However, this is not an allergy because cold is not an allergen and no IgE antibodies are involved.

Eosinophilic Non-allergic Rhinitis (E-NAR) Syndromes
When a physician makes a smear of your nasal mucus to examine under a microscope, he or she is looking to see what type(s) of cells are present as a means of differentiating one form of rhinitis from another. The eosinophil, a red-staining cell easily seen in nasal smears, is one cell doctors always look for. Although common in each of the three types of allergic rhinitis and frequently called “allergy cells,” they also appear in the nasal mucus of a group of non-allergic rhinitis syndromes called the eosinophilic non-allergic rhinitis syndromes (E-NAR syndromes).
The symptoms of E-NAR syndromes are no different from those of the other forms of non-allergic rhinitis, and can include nasal congestion, runny nose, and sneezing. These syndromes are likely to be seen in patients who also happen to suffer from asthma, chronic sinus infections, nasal polyps, or have severe reactions to aspirin.
While only your doctor can distinguish the subtleties between one form of eosinophilic rhinitis from another, you should be aware that these forms of nasal dysfunction exist and can be identified by a nasal smear. It is also important that you and your doctor know that a nasal smear full of eosinophils does not always mean that you are allergic, a misconception held by many physicians and patients.


Monday, April 20th, 2009

Tom was in his late thirties when he first started to get migraines. With a demanding job as a social worker in a hostel for alcoholics, and three young children to bring up, he put his symptoms down to stress. Over the next ten years the problem gradually got worse, until he rarely had a day without some sort of head pain. He was also very tired and lacked the energy to join in with family activities or help look after the children at weekends. This inevitably led to friction, and his marriage was in danger of breaking up.

In the hope of improving his health and keeping the family together, Tom and his wife decided to move to the country and he gave up social work for a job in a garden centre which did not pay as well but was much less taxing. Moving house involved registering with a different doctor, who asked all his new patients to come in for an initial check-up. The doctor spent some time with Tom, and asked him what he thought the cause of his headaches and tiredness might be. ‘Stress,’ Tom replied, without hesitation, ‘That’s why we’ve moved out here.’ The doctor suggested that he come back and see him after a year, when he had had time to settle in and judge the effects of a slower pace of life.

Tom did so, and had to report that, while there was some improvement, it was not nearly as much as he had hoped, and he was still very tired, with migraines several times a week. The doctor then suggested that he try changing his diet, for an experimental period, and told him to eat nothing but meat and vegetables, and drink only spring water for ten days. Tom felt very ill on this diet at first, with stomach pains and a severe migraine. But after a week he noticed a remarkable improvement, his energy restored and his head without any pain. The doctor then explained to Tom that he should test foods individually, which he did. To test wheat, he ate some spaghetti. Within

an hour of eating the pasta he was his ‘old self again, and with a vengeance -exhausted, depressed, nauseated, and with a throbbing pain on one side of his head. Cow’s milk, oranges and rye had similar effects. After avoiding these foods for a year, he finds he can now eat them occasionally without ill-effects. His children are amazed and delighted with the transformation in their father, who now plays football with them, takes them swimming and is a lot more fun to be with. The family have decided they like country life, but Tom is planning to go back into social work as soon as he can get a job locally.