On this episode of the Texas ENT Specialists audio blog, we talked to Dr. Abib Agbetoba about spring allergies. He walked us through how to tell the difference between allergies and a cold, and the different treatment options available. Tune in for more!
Shelby Stockton (00:00):
Welcome to the Texas ENT Audio Blog. I'm Shelby Stockton. Today I spoke with otolaryngologist Dr. Abib Agbetoba. We talked about spring allergies and how they affect Texans, and how to tell the difference between allergies and a cold. Dr. Agbetoba explains the different treatment options and educates us on why it's important to seek help to minimize allergy symptoms. Hi, Dr. Agbetoba. Thanks for spending some time with me today.
Dr. Abib Agbetoba (00:24):
Thanks for having me. I'm happy to be here.
Shelby Stockton (00:28):
So you know spring has sprung, and spring allergies are a really big deal in this part of the country. What do spring allergies look like for Texans?
Dr. Abib Agbetoba (00:37):
They look very, very aggressive. This is typically the season, the time of year, when we see patients flood into our offices. Particularly in Texas and in the spring, we definitely see quite a few tree allergens, but really anything, any type of pollen can really flare up an allergy response and cause an array of symptoms. We're all aware of cedar, but any type of tree, grasses, etc., Can really stir symptoms up, and if you have allergies to other things, such as dust mites or animals or anything that may be floating around in the air, the two together, or three or four things that you may be allergic to, can really start to add up and really affect quality of life.
Shelby Stockton (01:23):
So our symptoms for allergies, some of them are so similar to a cold. How would someone know if they are suffering from allergies or have a minor cold of some sort?
Dr. Abib Agbetoba (01:32):
Yeah, this is a common question we get. Patients oftentimes come in with a running nose, a nasal congestion, postnasal drip, and just kind of feeling worn down. Sometimes, it's very, very difficult to determine whether or not they're dealing with an allergy flare up or they're dealing with a viral cold or illness, especially in the time of COVID. So some big tip off points that may point towards an infection, like a viral cold or a sinus infection versus an allergy flare up, would be the presence of a fever, colds and chills, body aches. These things are typically associated more with viral illnesses, as opposed to an allergy response where you should not see an elevated temperature, fever, body chills, and aches. But there is definitely quite a bit of symptom overlap, and in some patients, the allergies can become severe enough where it can and make them maybe more prone to developing other types of illnesses, such as sinus infections and viral colds.
Shelby Stockton (02:36):
Okay, so you have allergies, you've determined it's allergies, what are some treatment options?
Dr. Abib Agbetoba (02:43):
It really depends on the patient as well as the severity of symptoms. I am all for making sure that we are aware of what you're allergic to and the severity, because sometimes we can go down a treatment path and be treating the wrong thing. We may think that you have allergies, when in reality you have severe sinusitis or nasal polyps or something like that. So once we've diagnosed the allergies, then it comes down to the patient. The first line of treatment typically involves some form of an oral antihistamine. Your second generations, such as Allegra, Claritin, Xyzal, or any generic equivalent. And then for nasal based symptoms, like nasal congestion, runny nose, postnasal drainage, intranasal steroid sprays, and or intranasal antihistamine sprays, become a good option.
Dr. Abib Agbetoba (03:38):
For many patients, they suffer from not only the nasal based symptoms, but also the watery itchy eyes, the itchy throat, sneezing, ear fullness and pressure, et cetera, and they oftentimes need to be dual managed with both an oral antihistamine and an intranasal steroid spray. For those where symptoms still aren't fully treated or patients are still suffering while still on those medications, we will sometimes add in singular. But at this point, if you're someone who finds yourself reliant on a daily antihistamine and daily use of intranasal steroid sprays, or someone who requires three different medications to really get symptoms under control, this is when I strongly, strongly advise looking into what we call immunotherapy, which is basically allergy shots or drops.
Dr. Abib Agbetoba (04:26):
If you think of allergies as basically your immune system overreacting to what's in the environment, the idea behind immunotherapy is to get your immune system to respond in a more appropriate way, so that when you breathe in that grass or tree pollen, it no longer leads to this severe flare up. Instead, your body sees it for what it is, it processes it, and you don't end up suffering from the severe allergies that you may have in the past. At Texas ENT, we offer both allergies shots or allergy drops, which is a nice option for patients who can't come into the office. It's a special sublingual solution that we put together based off of someone's allergy testing profile, and we give them specific instructions on how to take it, but you can administer it at home. It is extremely, extremely, extremely safe. The risk of things like anaphylaxis or severe reactions are very, very, very low.
Dr. Abib Agbetoba (05:30):
We definitely have a number of different ways that we can treat severe allergies with medication or with immunotherapy, and then when symptoms are maybe more localized to nasal based symptoms like congestion or nasal obstruction, there are definitely a number of different procedures that we can also offer that are more targeted, that allow a patient to breathe much better, whether it's something we can do in the office or something that may require going to the operating room for.
Shelby Stockton (06:01):
Wow. Okay, so for some reason, allergies seem to be one of those things that a lot of people just try to tough it out. So, if you don't get your allergies treated, can it get worse?
Dr. Abib Agbetoba (06:13):
A very tough and complicated question. The idea of how we develop an allergy is pretty complex, but the short answer would be, yes, it can get worse, and that can happen for a number of different reasons. One is simply that you just may become more allergic to something that you're already allergic to, or you may develop more allergies, and by developing more allergies, instead of having to just deal with maybe cedar pollen, now you have to deal with cedar pollen, ragweed pollen, and grass pollen. And so the three added together can produce a much, much more severe response.
Dr. Abib Agbetoba (06:55):
What you're allergic to is actually a specific protein in a pollen, and sometimes things that we put in our body can look very similar to that. So there is something also known as food oral allergy syndrome, where certain foods mimic and look very much like certain inhaled environmental allergens. For instance, certain apples may interact with certain tree pollens, and so if it's an aggressive tree pollen season or week and you're inhaling quite an abundance of tree pollen, and you bite into a certain apple, you may have a very, very severe response, because now, again, your body is kind of overloaded with the aggressive allergy response. Or certain bananas and ragweed during ragweed season.
Dr. Abib Agbetoba (07:54):
So, again, the short answer is yes, your allergies can definitely get worse. That's why we encourage patients to really come in, get tested, so we can really try and determine what may be the best means of treating you longterm. Our goal is always more curative as opposed to trying to constantly prescribe medications that you may be on indefinitely. Every medication that I talked about previously, or that we prescribe in the office, they're all temporary and they're all geared at treating symptoms. None of them really address the underlying issue, which is, again, your immune system overreacting.
Shelby Stockton (08:34):
Wow. That's some really interesting information. Doctor, thanks again so much for spending time with us today to talk about spring allergies.
Dr. Abib Agbetoba (08:42):
Absolutely. Thanks for having me. It's a passionate field of mine. And again, at Texas ENT we treat a number of patients, a large number of patients for uncontrolled allergies, or patients who want something outside of just your typical over-the-counter medications and nasal sprays.
