Podcast: WHAT DOES YOUR DOCTOR SAY?

Episode: Allergy step by step. From symptoms to treatment.

Leading: Dariusz Litera

Guest: Dr. Kamil Bar, MD, PhD, specialist in pediatrics, currently specializing in allergology

Duration: 17 minutes

Allergic diseases are among the most common health problems today. Epidemiological data indicate that allergy symptoms affect nearly half of the population, and their prevalence has increased significantly in recent decades. Hay fever, watery eyes, hives, shortness of breath, and reactions to insect bites are seasonal ailments for many patients, while for others they are a permanent part of everyday life.

In this episode of the podcast "WHAT YOUR DOCTOR SAYS," Dariusz Litera speaks with Dr. Kamil Bar, MD. He asks what allergy actually is and why it's mild in some patients while life-threatening in others. We learn about modern diagnostics and treatment of allergic diseases.

The discussion also touches on food allergies in children, asthma, and specific immunotherapy, also known as desensitization. The specialist also provides practical advice on procedures that can help patients reduce symptoms and improve their quality of life.

Full episode transcript:

[00:00:00] Introduction

Dariusz Litera:

Studies indicate that nearly half of Poles suffer from various types of allergies. Scientists emphasize that over the last hundred years, the percentage of patients complaining of allergic ailments has increased from one to over 40%. Which group are you in? In spring, you suffer from a runny nose and red eyes, and in summer, you're afraid of insects because every sting ends in uncontrollable swelling. Today, your doctor is Kamil Bar, MD. Good morning, Doctor.

Dr. Kamil Bar:

Good morning everyone.

[00:00:28] What is an allergy?

Dariusz Litera:

First, let's explain what an allergy is.

Dr. Kamil Bar:

An allergy, in short, is our body's reaction—an excessive response of our immune system, or perhaps of immunological mechanisms—to some external factor that poses no threat to most other people. Healthy individuals experience no symptoms upon contact with such a factor.

[00:00:53] Where do allergies come from?

Dariusz Litera:

What could be the causes of allergies?

Dr. Kamil Bar:

This is a very good question and if someone defines it clearly, they will probably get some interesting reward.

One hypothesis that emerged as early as the 1970s is the so-called hygiene hypothesis. It posits that living in increasingly sterile conditions prevents our immune system from constantly being exposed to various microorganisms. A lack of such "training" of the immune system can lead to malfunctions.

As a result, the body begins to treat harmless factors, such as birch pollen, as potentially very dangerous.

[00:02:09] The Role of Environment and Genetics

Dariusz Litera:

So it was not without reason that they said that dirty children are happy children.

Dr. Kamil Bar:

Yes, I live by this maxim too. Genetic background is also a major predisposing factor to allergic diseases. Depending on the type of allergic disease, this predisposition may be more or less severe.

We are discovering a growing number of genes directly linked to allergies. This is also linked to the theory of biodiversity – the importance of what lives around us and within us. The quality and quantity of contact with microorganisms influences the development of the immune response. Disturbances in this response can lead to the development of allergic diseases.

[00:03:11] Why are allergic reactions so different?

Dariusz Litera:

How is it that one person only has a mild rash after contact with an allergen, while another stops breathing?

Dr. Kamil Bar:

This is a difficult question. One simple answer is that the more antibodies the body produces against a given allergen, the stronger the reaction should be.

However, allergology isn't that simple. Sometimes, even minor reactions in allergy tests can lead to very severe, even life-threatening, reactions in real life.

[00:04:00] When does an allergy require medical consultation?

Dariusz Litera:

Statistics indicate that almost one in two of us suffers from allergies. At what point does an allergy require medical attention?

Dr. Kamil Bar:

We need to ask ourselves if we know what's causing our allergies and whether our quality of life is being maintained. If symptoms are sporadic and easily avoided, such as when we're exposed to a friend's dog, avoiding the allergen is often enough.

The problem arises when the allergen is unavoidable or when the disease significantly affects daily functioning.

[00:05:01] Allergy and allergic diseases – the example of asthma

Dr. Kamil Bar:

Allergic disease doesn't always equate to allergy. Asthma is an example. Approximately 70% children with asthma have allergy-confirmed tests, but in the remaining 30%, we can't pinpoint the specific allergen, even though the disease persists.

[00:05:44] Inflammatory Mechanism in Asthma

Dariusz Litera:

So what causes bronchospasm?

Dr. Kamil Bar:

Allergic diseases are autoimmune in origin. The body begins to react against itself. Untreated, chronic inflammation in the airways itself provokes bronchospasm.

If we only treat the symptoms and not the disease itself, the patient may feel better, but the inflammatory process continues.

[00:06:40] Can allergies appear at any age?

Dariusz Litera:

Do we suffer from allergies from childhood, or can allergies appear at any age?

Dr. Kamil Bar:

We can wake up with allergies every day. Food allergies are more common in children – with up to 4–8% occurring in them. In adults, the figure is around 1–2%. However, children can outgrow many allergies over time.

[00:07:19] Allergy diagnostics – not just skin tests

Dariusz Litera:

How do we diagnose allergies?

Dr. Kamil Bar:

Skin testing and specific IgE antibody testing only detect IgE-dependent allergies. However, there are many other allergic mechanisms.

We also use patch tests, especially in the diagnosis of contact allergies, and provocation tests, which are a very valuable diagnostic tool.

[00:08:44] Provocation tests – when and how?

Dr. Kamil Bar:

If an allergy is suspected, we expose the patient to the allergen under controlled conditions and observe the reaction. In some cases, after medical evaluation, provocation tests can even be performed at home. However, this should always be discussed with a doctor.

[00:10:15] Elimination Diet – Common Pitfalls

Dr. Kamil Bar:

After eliminating the suspect product, the symptoms often disappear, but without a provocation test we cannot be sure whether it was actually the allergen.

Excessively long and unnecessary elimination diets can lead to nutritional problems, especially in children. If the patient's condition allows, we try to reintroduce the products and train the immune system to tolerate them.

[00:11:59] Can allergies be cured?

Dariusz Litera:

Can allergies be completely cured?

Dr. Kamil Bar:

The only way to treat the cause of allergies is through specific immunotherapy, also known as desensitization. A standard course lasts 3 to 5 years.

Before starting it, we must be sure that we are actually dealing with an allergy to a given allergen and that such therapy makes sense.

[00:13:45] Allergen avoidance as a form of treatment

Dr. Kamil Bar:

The second course of action is to avoid the allergen if possible.

[00:14:07] Practical tips for allergy sufferers

Dr. Kamil Bar:

In food allergies, the basis is the elimination of harmful products or their appropriate heat treatment if the allergen is heat-labile.

In inhalant allergies, it's important to distinguish between seasonal and perennial allergens. It's helpful to use pollen calendars, limit exposure during periods of peak allergen concentration, and initiate treatment early.

For example, nasal steroids begin to work optimally after 2–3 weeks of regular use.

[00:17:03] Ending

Dariusz Litera:

Kamil Bar, MD, said in the podcast WHAT YOUR DOCTOR SAYS. Doctor, thank you very much.

Dr. Kamil Bar:

Thank you too.

Key takeaways for patients:

• An allergy is an excessive reaction of the immune system to harmless factors.
• Both genes and the environment influence the development of allergies.
• The severity of symptoms does not always correlate with the results of allergy tests.
• Not every allergic disease is associated with a detectable allergy (e.g. asthma).
• Allergy diagnosis involves various methods, including provocation tests.
• Specific immunotherapy is the only method of treating the cause of allergy, but it requires time and qualifications.
• Proper management and treatment can significantly improve patients' quality of life.

Information about the authors:

Kamil Bar, MD, PhD: physician, doctor of medical sciences, specialist in pediatrics, currently specializing in allergology, dealing with the diagnosis and treatment of allergic diseases in children and adults.

Dariusz Litera: medical editor and podcast host WHAT DOES YOUR DOCTOR SAY?, dealing with health communication and patient education.

Attention!

This material is for informational and educational purposes only. It does not replace an individual medical consultation or medical advice tailored to a specific patient. If you experience any disturbing symptoms or have concerns about your health, please contact us. consult a doctor.