If an allergy is suspected, it is important that the condition is accurately diagnosed. Usually, a physician enquires about the nature of the symptoms, when they happen, how often they occur and if anything is triggering them. Advice and treatment for mild allergies with a clear cause is given by general practitioners.
If the allergy is more severe or it is not obvious what type of allergen is triggering the symptoms, the patient should be seen by an allergologist (specialist for allergies) for allergy testing. Our allergologist at ENT in Cayman Ltd. will ask the patient to give a detailed account of the allergic reactions, the past medical history, the home and work/ school environment and relevant family history.
After a thorough ear-nosethroat examination, usually an allergy test is recommended as the next diagnostic step. When the cause of the allergy is unknown, an allergy test will attempt to discover if an allergen is responsible for an allergic reaction. Even if cause of the allergic reaction is known, the diagnosis needs to be confirmed by an allergy test, especially if the allergic reaction was severe.
Allergy tests are helpful if there is confusion about whether the problem is caused by an airborne or food allergy or whether it might be caused by an intolerance, sensitivity or have an non-allergic cause. The result of allergy tests will be interpreted by our allergologist and discussed with you in detail. Allergy tests do not always deliver a clear yes/no answer. Often the allergy test result is only a clue in the clinical puzzle.
Skin-prick testing is one of the most common allergy tests. It involves putting a drop of a substance onto the forearm. The skin is then gently pricked with a needle. In case of an allergy to the substance, a red bump will appear within 20 minutes. The red bump is often itchy. Skin-prick testing is almost painless and very safe. Antihistamines, steroids and certain antidepressant should be
avoided before the test as they can interfere with the results.
In addition to skin-prick testing, blood tests may be used. Specific allergy antibodies can be measured in the blood by using a RAST (radioallergosorbent test). A positive result confirms that the immune system has produced increased level of IgE (antibodies) in response to an allergen, for example grass pollen.
RAST is useful when skin-prick testing is impossible or the skin-prick testing showed a wide range of positive responses. A careful interpretation of a RAST result by a board certified allergologist is important because positive results can occur in patients without an airborne or food allergy, and negative tests can occur in patients who do have that specific allergy.
Patch test is used to investigate a type of eczema known as contact dermatitis. A small amount of the suspected allergen is added to metal discs and left in place on the skin for 48 hours and monitored for reaction. The patch test is a simple and very safe form of testing, but in severe cases, blistering may develop as a response to the allergen.
In a few cases, the best way of diagnosing an allergy is to provoke an allergic reaction by deliberately exposing the patient to the suspected allergen. Challenge testing is always carried out in a hospital setting where a severe reaction can be treated if it does develop.
In case of a suspected food allergy, the patient may be advised to avoid eating a particular food to see if the allergy symptoms improve
The patient is keeping a record of the symptoms on a daily basis along with details of the factors suspected of causing them. This is helpful to see the relationship between various triggers and the specific allergy symptoms.
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