Westside Allergy Care has moved!
In July,2010,  the Greece office moved from Latona Road to 99 Canal Landing in the Canal Ponds office complex.  Then, in January, 2011, we opened an office in Batavia, currently seeing patients  on Wednesdays.  We have hired a 3rd physician,  Anitha Shrikhande, M.D., who joined us last August after completing her Allergy Fellowhip at New Jersey Medical College.  She is Board Certified in Allergy and Immunology. We are very privileged to have her.

Give a warm welcome our new staff:
We hired 2 new receptionists last year, and we ask your patience as they get to know you and learn how to serve you better,  We need to update everyone’s insurance information and sign new Hipaa forms as we welcome you and your family for your initial visit of the new year.

What is a food Allergy?
Questionnaires that ask people to report a history of food allergy have led to claims of food allergy in more than 20% of the population in some studies. Yet when those same people are independently tested, true allergic reactions generally can be confirmed in no more than 2% to 8%.  What accounts for this difference?

A true food allergic reaction is based on the presence of immunoglobulin E, also known as IgE, a substance produced by the immune system of the allergic person.  While most immunoglobulins help to fight infection, IgE interacts with the allergic food to stimulate the immune system to produce the symptoms of an allergic reaction.

Physicians can test for IgE associated with a specific food allergy by allergy blood or skin tests. However, the presence of IgE alone is not sufficient to diagnose a food allergy.  It must be clear that the person had exposure to the suspected food at a relevant time prior to the reaction and that the symptoms reported are those likely to be produced by an IgE triggered immune system reaction.  When in doubt, allergists can confirm the presence or absence of food allergy by again exposing the patient to the food in a controlled and carefully monitored setting, known as an “oral challenge test”.

Other adverse reactions to foods can occur, some also based on immune system reactions. Gluten found in wheat and some other grains can cause a reaction associated with other varieties of immunoglobulin, primarily immunoglobulin A, also called IgA.  Gluten sensitivity can be related to gastrointestinal symptoms (celiac disease) or skin rash (dermatitis herpetiformis).

In most people, heartburn and gastroesophageal reflux are not related to specific food allergies. However, in recent years increasing numbers of people with esophageal symptoms have been found to have an excessive number of eosinophils, a type of white blood cell associated with allergy, in the esophagus. These eosinophilic esophagitis patients frequently have food allergies, and may benefit from avoidance of the allergic food and from treatment with medication to block the allergic reaction.

Food intolerances are generally defined as food related adverse reactions caused by digestive or metabolic, rather than immune, abnormalities. The most well known of these is lactose intolerance. Lactose intolerant individuals have a deficiency in lactase, the enzyme needed to digest the lactose sugar found in milk. The undigested lactose is fermented in the gastrointestinal tract causing abdominal distress. Lactose intolerance can be permanent or temporary, caused primarily by genetic factors or attributable to gastrointestinal illnesses or medication.

In conclusion, while food allergy is an important cause of adverse reactions to food, many other potential causes exist. The most effective management can depend on identification of the underlying cause. See your physician for evaluation and for referral to an allergist and other specialists when needed.

Are allergies the cause of my Hives?
Hives or urticaria occur when an immune cell in our body called the mast cell releases histamine.  The mast cell is complex and can be triggered to release in many different ways.  Allergies are only one of the ways that the mast cell can release histamine leading to hives.   Sometimes we are unable to determine what is triggering this cell and we are often left with a diagnosis of “idiopathic” hives.

Talking to an allergist about your hives can help determine what type of testing should be done. Sometimes hives can occur in response to cold air.  Other times a food allergy or animal allergy may be the cause of hives.

Most of the time hives are an unwanted nuisance but an evaluation by an allergist will help in identifying any potential dangerous causes of hives such as underlying infection or autoimmune disease.

After a detailed evaluation, your allergist can help determine the best way to manage your hives.  Most importantly, talking to an allergist about your hives can help you worry less and cope better with the problem.

Spotlight on Xolair:
Xolair (Omalizumab) is an injected asthma medication.  Xolair is used for people who have allergic asthma (asthma triggered by allergies) whose symptoms are not controlled despite being on high doses of inhaled steroids.  Xolair helps to reduce the number of asthma exacerbations.  Xolair works by blocking Immunoglobulin E.  This is the antibody that triggers allergic inflammation and can lead to asthma.  By blocking Immunoglobulin E, Xolair prevents the release of chemicals from the immune system that lead to airway narrowing and inflammation.

Xolair may help some with chronic idiopathic urticaria, but further studies will need to be done.