PROPHYLACTIC MEDICATIONS FOR ALLERGIC NOSES: CROMOLYN SODIUM NASAL SPRAY
Cromolyn sodium, manufactured by Fisons Corporation and available in the United States as Nasalcrom Nasal Solution since the early 1970s, was the first allergy prophylactic medication developed and marketed worldwide. A prophylactic medication is defined as one that acts as a preventative against disease. Cromolyn sodium functions as a prophylactic medication because it prevents the allergic process from developing. No process, no symptoms. This is in contrast to the other medications for allergic rhinitis-antihistamines, decongestants, corticosteroids, and ipratropium bromide – which act to relieve the symptoms, caused by the allergic process, but do not alter the process itself.
Since the early ’70s, much has been learned about this remarkable medication. Its list of actions currently includes the following:
- Preventing the release of mediators from mast cells
- Preventing the accumulation of inflammatory cells in the lining of the nose
- Blocking both early and late allergic reactions
- Inhibiting the action of cells that cause inflammation
It is the chemical mediators released during allergic reactions that cause the persistent inflammation characteristic of chronic rhinitis. Because of its ability to prevent the release of these chemicals into the nasal tissue, cromolyn sodium is widely prescribed by physicians as an allergy “blocking” drug. Of note is that cromolyn sodium is not an antihistamine, a decongestant, or a steroid.
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PROPHYLACTIC MEDICATIONS FOR ALLERGIC NOSES: CROMOLYN SODIUM NASAL SPRAYCromolyn sodium, manufactured by Fisons Corporation and available in the United States as Nasalcrom Nasal Solution since the early 1970s, was the first allergy prophylactic medication developed and marketed worldwide. A prophylactic medication is defined as one that acts as a preventative against disease. Cromolyn sodium functions as a prophylactic medication because it prevents the allergic process from developing. No process, no symptoms. This is in contrast to the other medications for allergic rhinitis-antihistamines, decongestants, corticosteroids, and ipratropium bromide – which act to relieve the symptoms, caused by the allergic process, but do not alter the process itself.Since the early ’70s, much has been learned about this remarkable medication. Its list of actions currently includes the following:- Preventing the release of mediators from mast cells- Preventing the accumulation of inflammatory cells in the lining of the nose- Blocking both early and late allergic reactions- Inhibiting the action of cells that cause inflammationIt is the chemical mediators released during allergic reactions that cause the persistent inflammation characteristic of chronic rhinitis. Because of its ability to prevent the release of these chemicals into the nasal tissue, cromolyn sodium is widely prescribed by physicians as an allergy “blocking” drug. Of note is that cromolyn sodium is not an antihistamine, a decongestant, or a steroid.*49/322/5*

OUR MARITAL HEALTH/SEX AND PROBLEMS OF DAILY LIVING: WORKING IN SEXUALITY

1 think the only people who can have a career and have a lot of sex must be prostitutes. They do it for their living. I have to make a living and then try to make time for sex, and there isn’t much of that at all.

WIFE

Working and the workplace are two of the major sources of stress in our society. They take a physical and emotional toll everyday of our lives, sometimes leaving us with little time or interest in other areas of daily living. My interviews indicated that, unless we are able to enjoy our work, little else will bring us happiness.

Although there were exceptions, men interviewed tended to view their work as closely related to their self-esteem. They often felt sexually invigorated by some “conquest” or “victory” at work. “I can tell when he’s made a big sale,” said one wife. “He comes home horny. He wants victory sex.” “That’s true,” responded her husband. “When I’m on my game, I want to get on her.” Even though both partners laughed during this exchange, the male success-object orientation is often seen in the work/sex connection.

Women are equally involved in their careers, but they continue to be expected to “add” career or working outside the home “to” their lives. The men interviewed tended to be more supported in their work, and more adjustments were made for their working than was true for women. Women were expected to find more hours in their day, to add to an already heavy home workload. Sometimes token, sporadic chore-sharing on the part of husbands was the only accommodation made for the working wife. The increased frequency of wives working outside the home is more an addition to rather than change in the role of the married woman.

I recently asked an all-male audience how many of their wives worked. Several hands were raised. I then asked how many of their wives worked outside the home. Many of the men were perplexed, even embarrassed at their own sexism, which resulted in their failure to see work done at home as “real work.” This same sexism causes many wives to attempt to carry an unhealthy burden of career development, income production, and almost solo home maintenance.

Recent data indicate that over one third of women with master’s degrees in business administration “opt out” of the business world. More likely they are “pushed out” when they hit the ceiling of resistance to women in high positions, and confront the inevitable sexist assumption that they, more than men, have “other things” that are more important. An increasing health risk exists for women unless the “Wonder Woman” syndrome of doing it all is addressed. Doing it all can seldom allow for fulfilling sexuality.

“I feel like I’m drained,” said the wife. “At work, I get calls about the kids’ school and even think about dinners, entertaining, house issues. At home, I hardly have time to think. I certainly don’t have much energy left. Sex takes energy, so it gets on the agenda, reported in the minutes only when we can both find some time.”

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TREATING CHEMICAL SENSITIVITY: FOOD ADDITIVES

Avoid all packaged foods and drinks with additives listed on the label. Remember that ‘flavourings’ count as additives, even though they have no E-numbers, and that ‘No Artificial Additives’ can be very misleading – some ‘natural’ additives are potentially harmful. Bear in mind that bread from a bakery can contain additives although it does not have to be labelled – buy bread from a healthfood shop or make your own. Unwrapped cakes, sweets and deli-catessan foods are exempt from detailed labelling, as are alcoholic drinks. Do not drink alcohol, unless you have home-made wine brewed from pure fruit and sugar (no Campden tablets), or can buy organic wine (see p333 for suppliers). Restaurant, cafeteria, or take-away food, including fish-and-chips, is often very rich in additives. Also avoid tinned foods, because the phenolic resin that is used to line the tin can contaminate the food. If you are taking any vitamin tablets with coloured coatings, give these up. If you are taking medicines that appear to contain colourings, ask your doctor if he can prescribe an uncoloured version.

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ALLERGIC REACTIONS: VAGINITIS

The maddening itch of vaginal inflammation may be caused by three different microscopic organisms. One is the yeast-like fungus Candida. As you might guess, Candida is biologically related to moulds in cheese; yeasts in beer, wine, vinegar and bread; yeast-based  vitamins; and mushrooms.

Most of the time, Candida lives compatibly in the intestines and vagina along with other microorganisms that keep Candida in check. Under certain circumstances, though, Candida can overrun its fellow organisms, causing infection and inflammation (candidiasis). The vagina is especially prone to Candida infections for a number of reasons. Mainly, the fungus thrives in the warm, moist climate of the vagina. And Candida from the intestinal tract can easily find their way to the vagina from the nearby rectum, multiplying the chances for infection.

Candida infections are a special problem for people with allergies to yeasts and moulds. Their bodies react to an overgrowth of Candida as they would to any other yeast or mould. Nystatin and other anti-fungal medicines – in tablets or suppositories – can help kill off the fungus. But in allergic people, the itching and inflammation may not go away until all forms of fungus, dietary and internal, are kept under control.

One tactic is to adopt a low-mould diet, says a gynaecologist we spoke to from Sulphur Springs, Arkansas. ‘Eating moulds or yeasts overloads the system, and the infection flares up.’

The low-mould diet is most effective when combined with yoghurt therapy. Yoghurt contains Lactobacillus acidophilus, a special bacteria that suppresses Candida.

‘Candida vaginitis can be controlled by applying yoghurt [live cultures] to the vagina,’ we were told. ‘Eating yoghurt, too, helps by controlling Candida growth in the intestines.’

Chemical irritants aggravate vaginitis of any kind. Women plagued by vaginal inflammation should avoid using deodorant soaps, perfumed sprays, bubble baths and colored or perfumed toilet paper in the vaginal area.

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ALLERGIC REACTIONS: IRRITABILITY

Coping with an allergy can make anyone cranky. A stuffy nose or itchy skin can leave you tense and tired.

But irritability can also be a direct allergic reaction to foods, chemicals and other inhalants. Their effect on the nervous system can leave you restless, emotional, tense, sullen and tired despite having had enough sleep. Allergists call allergy-induced irritability the ‘tension-fatigue syndrome’.

An irritable person may be described by others as argumentative, easily hurt, excitable, hard to please, highly-strung, hot tempered, jittery, jumpy, moody, nervous, over-sensitive or temperamental. If any of those labels apply to you, you may be allergic. An irritable, allergic child may be hostile, hyperactive and subject to fits of crying.

‘Although the most frequent cause of this problem is a food, such as food colouring, sugar, milk, chocolate, eggs or corn, it is also possible that other common allergenic substances can be at fault (pollens, dust, moulds, perfume odours),’ says Dr Doris J. Rapp, an allergist in Buffalo, New York.

Staying away from those allergens that spark tension can make life more pleasant for the allergic person – and everyone around him. For example, Dr Rapp tells of an eleven-year-old youngster named Sean who was irritable, clumsy, restless and hostile. Sean fought constantly with his family and schoolmates. Within one week of eating a diet free of common allergenic foods, Sean was much easier to get along with.

‘As foods were re-added to his diet, it was found that . . . food colours and sugar caused irritability, hostility and violent behaviour,’ says Dr Rapp. When Sean avoided those foods, he led a peaceful life. Several months later he tried to eat a normal diet. His teachers reported a dramatic return of irritable behaviour. Back on his allergy-free diet again, Sean calmed down and played happily with others.

Sean’s story shows how rearranging one’s diet to omit allergens can make a person less edgy and argumentative.

‘The allergic tension-fatigue syndrome should be considered in every patient who for no obvious reason is subject to [hyperactivity], irritability, weakness or sluggishness,’ says Frederic Speer, M.D., in his book Allergy of the Nervous System. ‘This is especially true if other causes have been ruled out. Certainly no patient should be classified as [neurotic] until allergy has been considered.’

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ALLERGIC REACTIONS: DIARRHOEA

Diarrhoea is one of the most common symptoms of food allergy, especially in children. In allergic people, the bowel tends to react to certain foods as though they were laxatives, unpredictably flushing out loose stools throughout the day.

But being caught off-guard is only part of the problem. Prolonged diarrhoea – lasting more than a week – leaves the body dangerously weak and dehydrated from loss of fluid and minerals like potassium. With too little water and nutrients, your muscles and nerves don’t work. In children, diarrhoea is especially risky – their bodies are too small to deal with drastic losses of water and minerals. As a result, uncontrolled diarrhoea can leave children as limp as a ragdoll. Or they can have convulsions.

Diarrhoea has several possible causes other than allergy. But if your doctor has ruled out infection or disease, you should consider food allergy. In children, milk is to blame for one out of three cases of diarrhoea caused by food allergy. For them, diarrhoea is nature’s way of rejecting a food that it regards as harmful.

‘Because cow’s milk is not a natural food for an infant, the body often tries to reject it with allergic reactivity, especially when a family tendency to allergy exists,’ says Dr Albert Rowe, Jr, co-author of the book Food Allergy. Dr Rowe mentions one study which found that out of 140 children allergic to cow’s milk, 24 per cent – about one out of four – had diarrhoea.

In infants, breast milk nearly always relieves allergy to cow’s milk, especially if the nursing mother also avoids cow’s milk. When the child gets older, he or she may eventually be able to tolerate milk. It may take six months, or it may take twelve years. Trial and error is the only way to tell.

After milk, fruit and sugar are frequent causes of allergic diarrhoea. Apparently, some people cannot tolerate fructose, the sugar found in honey and sweet fruits such as plums, apples and grapes. In still others, any kind of sugar causes diarrhoea. Two Swedish doctors report the cases of four people who had suffered diarrhoea, abdominal pain and bloating for up to six weeks at a time. Between these episodes, they had milder discomfort. ‘All had noticed an aggravation of symptoms whenever they had eaten fruits, or food containing appreciable amounts of cane sugar,’ say the researchers. ‘All patients were free from symptoms on a fructose-free diet’. (Acta Medica Scandinavica)

And based on a study of several young children with diarrhoea, doctors at Adelaide Children’s Hospital in South Australia suggest that children with chronic diarrhoea should eat a sucrose-free diet for at least two months. If sugar is the problem, the diarrhoea will go away (Lancet).

In still other children, both milk and sugar must be avoided in order for diarrhoea to let up. One group of pediatricians studied seventy-five children (all younger than one year) treated for diarrhoea and other related problems. After several days on a milk-free, soya-based diet formula, some of the children were gradually given cow’s milk again, while the others received a soya formula free of milk and sugar. The children drinking cow’s milk continued to have diarrhoea indefinitely, while the children on milk-free and sugar-free formula got better fairly soon (Lancet).

Occasionally, wheat and other cereals will cause diarrhoea. To test for any of those foods, the diet must be tried for at least one week and often longer, since it takes several days after food is eaten for it to be completely eliminated from the body.

Sometimes food causes diarrhoea during the pollen season, but not during the rest of the year. For example, a child may be able to drink milk or eat cereal all year round with no diarrhoea, but will suffer several weeks of loose bowels when trees and grasses are pollinating in spring or summer.

Parents of children with diarrhoea should not hesitate to see a doctor, because of the immediate threat to health and the possibility of infection or disease.

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ALLERGIC REACTIONS: ALCOHOLISM

If you’ve ever craved a chocolate bar, you know how an alcoholic feels about his or her next drink. That preoccupation with alcohol, along with the compulsion to continue drinking once he or she’s started, is what separates an alcoholic from a social drinker. Alcoholics also tend to drink large amounts every day, and to start early in the day. Others drink in binges. Either way, an alcoholic responds to alcohol quite differently from the way most of us do.

Why some people become alcoholics and others do not is one of the unsolved mysteries of medicine. Heredity takes its share of the blame – although some of the biggest drinkers have parents who are strict teetotalers, and some abstainers have parents who are alcoholics.

In other words, in spite of their attraction to alcoholic beverages, problem drinkers may actually be allergic to the stuff. They may either be allergic to the alcohol itself, or to the grains, corn, fruits, yeast or sugar from which alcoholic beverages are made.

And alcoholics do tend to have more food allergies than other people. A research team at Deaconess Hospital in St Louis, Missouri, tested seventy-five drinkers for allergy to seventy foods. Compared with non-drinkers, alcoholics were nearly twice as susceptible to food allergies (Modem Medicine).

Alcohol may also aggravate food allergies indirectly by interfering with the complete digestion of food proteins in the stomach, leading to bowel troubles, gas and diarrhoea, among other discomforts.

We’re not saying that alcoholism is always caused by allergy. After all, alcoholism is a complex problem. But if you’ve reached a point where you know you’re drinking too much, too often, understanding your compulsion could be the first step towards controlling it. If you are indeed allergic to foods from which alcohol is made, eliminating them could help you beat the problem once and for all.

Incidentally, doctors have noticed that people who drink a lot seem to suffer more than their share of stubborn skin problems. If you drink heavily and have a skin rash that you can’t get rid of, it might clear up if you stay away from alcohol.

Because depression and anxiety can lead to alcoholism, people with drinking problems should also read the entries on those topics in this section.

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ALLERGIES: NEUTRALIZATION THERAPY – A PROMISING ALTERNATIVE

Frustrated with the limitations of traditional immunotherapy, a few doctors (most of them known as clinical ecologists) are trying to revive a system of allergy testing and immunotherapy developed several years ago and collectively known as serial dilution titration and neutralization therapy. This variation of standard immunotherapy still involves lots of time in a doctor’s surgery, considerable expense and allergy injections. In some ways, however, it may make up for a few of the shortcomings of traditional immunotherapy.

Serial dilution testing: what they can and cannot tell, is done on the skin (although a few doctors use drops of the test extracts which can be placed under the tongue in people who are not fond of needles). Doctors test for several common allergens, plus any others to which the individual seems to be particularly sensitive. In that respect, the test is similar to standard tests. However, the individual is not necessarily tested with one absolute amount of each test extract, but possibly with a series of up to fifteen or twenty increasing dilutions, one every ten minutes or so. The size of any weal and the nature of symptoms are noted. Doctors experienced with serial testing use the dose which does not produce symptoms – the ‘endpoint’ – as a guideline for choosing the optimal dose for this therapy. Again, the dose that is too small to produce a reaction yet large enough to prevent reactions is considered optimal. Doctors feel that, in this way, they can get a better picture of not only what a person is allergic to, but also how he or she reacts as an individual. What’s more, they claim that the treatment dose can be used to neutralize, or turn off, a reaction. The therapeutic dose usually turns out to be much smaller than that employed in standard immunotherapy, and takes only one or two testing sessions to achieve. That compares with a period of about six months of such experimentation to reach maintenance doses in standard therapy. Once the correct treatment dose is arrived at, doctors using neutralization claim that some people gain immediate relief.

One big difference between the two therapies is that some doctors using neutralization send patients home with premixed doses of extract to help them tolerate foods and inhalants to which they are allergic. That’s rare with standard therapy except for carrying emergency vials of adrenaline to be used in case of a severe bee sting reaction or other serious symptoms.

Another major difference is that neutralization is used to treat sensitivities to car exhaust, tobacco smoke, formaldehyde and other hard-to-avoid chemicals, although shots for those do not work nearly as well as injections for conventional allergens.

‘People always ask us for injections against air pollution,’ says Constantine J. Falliers, a traditional allergist and editor of the Journal of Asthma. ‘Well, we have no such thing.’

Many doctors using neutralization feel that, unlike conventional therapy, it can be successfully used to treat food allergy, holding out hope to the many people who are allergic to wheat, yeast or other ubiquitous dietary items.

Standard immunotherapy and neutralization seem to work in approximately eight out of ten people on whom the particular method is used, and both are relatively safe – they’re used without reservation on the young, the old, the pregnant -and even in people who are suffering a cold or the flu. For the individual who’s endured years of standard immunotherapy without relief of symptoms, neutralization certainly holds promise.

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