S1 Ep 16 - Allergies and Sinusitis with Dr. Oliaei | Nourish MD Podcast

Summary

In this episode of Nourish MD, hosts Lauren Panos and Roman Brennan sit down with Dr. Oi, an ENT specialist from UC Irvine, to discuss allergies and sinusitis. The conversation covers how environmental allergies trigger immune responses, genetic and environmental factors affecting susceptibility, and effective management strategies including avoidance, medications, and immunotherapy. Dr. Oi explains allergy testing methods, distinguishes IgE from IgG responses, and explores the link between allergies and chronic sinusitis. Practical advice on saline irrigation, symptom recognition, and when to consult an ENT is provided, equipping listeners with actionable insights to better manage their nasal health and overall wellness.

Takeaways

• 😀 Allergies are an overreaction of the immune system to environmental substances, involving mast cells and lymphocytes that release histamines and cytokines.
• 😀 Genetics play a significant role in allergy susceptibility, with children from atopic families having a 50% chance of developing allergies.
• 😀 Environmental exposures, especially in early childhood, can influence allergy development and severity.
• 😀 Managing allergies involves a three-pronged approach: avoidance, pharmacotherapy (antihistamines and nasal steroids), and immunotherapy.
• 😀 Allergy testing can be done via skin prick tests (instant, sensitive) or IgE blood tests (slightly less sensitive, more comfortable).
• 😀 IgE tests detect immediate allergic reactions, while IgG responses are typically delayed and milder, mostly relevant for food allergies.
• 😀 Immunotherapy (allergy shots or sublingual drops) gradually builds tolerance to allergens, effective in both children and adults, usually over 3–5 years.
• 😀 Chronic or recurrent sinusitis can result from structural issues, allergies, immune suppression, improper prior treatments, or viral-bacterial interactions.
• 😀 Saline irrigation is highly recommended for prevention and symptom management, but must be done with correct salt-to-water ratios and distilled or boiled water.
• 😀 Misuse of antibiotics for viral infections can lead to resistant bacterial infections and ineffective treatment of sinusitis.
• 😀 Patients with facial pressure, discolored nasal discharge, or changes in smell should consult an ENT to determine if sinusitis, rather than allergies, is the cause.
• 😀 Resources for patients include UC Irvine ENT and Allergy websites, as well as educational videos on YouTube and Instagram for guidance on treatments and preventive care.

Q & A

What is the main focus of today's discussion in the Nourish MD podcast?

Today's discussion focuses on allergies and sinusitis, specifically how they are linked, the science behind allergies, testing options, and treatments such as immunotherapy and allergy shots.

Can you briefly describe how environmental allergies affect the body?

Environmental allergies occur when the body's immune system overreacts to non-harmful environmental substances like pollen, dust, or mold. White blood cells like mast cells and lymphocytes release chemicals such as histamines that cause typical allergy symptoms like sneezing, itching, and congestion.

What role does genetics play in someone’s susceptibility to allergies?

Genetics play a significant role in determining susceptibility to allergies. People born into 'atopic families' have a 50% chance of developing allergies, while those not born into these families have a 20% chance. This genetic makeup influences immune cells and the lining cells of the airways, making them more reactive to allergens.

What are the three main components of allergy treatment?

The three main components of allergy treatment are: 1) Avoidance of allergens (e.g., using dust mite covers), 2) Pharmacotherapy (e.g., antihistamines and nasal steroids), and 3) Immunotherapy (building tolerance to allergens through allergy shots or drops).

What types of allergy testing are available, and what are their differences?

The two primary types of allergy testing are skin testing and blood testing (IG-E testing). Skin testing provides immediate results and is often more sensitive, whereas blood testing takes a week or two for results but is less sensitive and more comfortable for some patients.

What is the difference between IGG and IGE testing in terms of food allergies?

IGE testing measures immediate allergic reactions to foods or environmental allergens and is commonly used in clinical settings. IGG testing, on the other hand, detects delayed immune responses and is less commonly used in clinical practice because it often doesn't correlate with allergy symptoms or severity.

What is immunotherapy, and how does it work in treating allergies?

Immunotherapy involves administering small amounts of allergens to gradually build tolerance in the body. Over time, the immune system learns to ignore the allergens, reducing allergic reactions. Immunotherapy can take several years to show full results and is offered in the form of allergy shots or sublingual drops.

Are there any risks associated with immunotherapy?

Immunotherapy can cause side effects such as mild allergic reactions at the injection site, or more severe reactions like anaphylaxis. However, the process is generally safe and effective, and the benefits of reduced allergy symptoms outweigh the risks for many patients.

How does sinusitis develop, and how is it related to allergies?

Sinusitis develops when the sinuses become inflamed due to infection, structural issues, or prolonged allergies. Allergies can trigger inflammation in the mucosal lining of the sinuses, which weakens the immune system and makes it harder to fight infections, increasing the risk of sinusitis.

What are some signs that sinusitis might be developing rather than just seasonal allergies?

Signs of sinusitis include sustained pressure or pain in the face and forehead, changes in smell, or discolored nasal discharge. If these symptoms last for more than a few days or worsen, it may indicate sinusitis rather than just seasonal allergies.

What role does saline irrigation play in treating allergies and sinusitis?

Saline irrigation helps to thin mucus, remove allergens and pollutants, and reduce inflammation in the sinuses. It is a useful tool for both preventing and treating sinusitis and allergy symptoms. For chronic sinusitis patients, it can be combined with topical therapies like steroids or antibiotics.

What should someone do if they experience increased congestion after using saline irrigation?

If increased congestion occurs, it may be due to an improper salt-to-water ratio or using unboiled tap water, which can lead to rare infections. If symptoms persist or worsen, it's important to consult an ENT specialist for further evaluation, as structural issues or other complications may be present.