Gentowa

How the allergy is diagnosed by the doctor

The diagnosis procedure is not easy. The clinical symptoms of the different origin illness are often similar. For instance the symptoms of the allergic fever – red stuffy nose, sneezing, nose secretion are the same as while having the cold (it is usually caused by a simple viral inflammation). But the treatment approach is different. Therefore the diagnosis procedure requires besides the judgement of the current health conditions further information, too.

The basis of all allergic examination is the detailed anamnesis. It is actually the list of all factors, which relate (sometimes only seemingly for the patients) to the illnesses.

The family anamnesis is an information on the illnesses appeared in the patient family. Naturally, the blood relations, not he wife or the brother-in-law, are important. The allergic reaction, their ancestors – father, grandmother, siblings or children-suffered from, indicates the relation to the current illness of the patient. The allergy predisposition is inherited. While the child of the parents, who do not suffer any allergy, inclines to the allergy at the odds of approximately 20%, the odds of the allergy increases up to 50% concerning the child of at least one allergic parent. If the mother suffers any allergy, the odds will increase even more and in the case of both allergic parents, it is almost 100% certain, that their child will suffer the allergy (especially if both parents are allergic to the same allergens).

Personal anamnesis includes the facts, which precedes the particular current illness. In the anamnesis, all the previous illnesses, we have undergone, are listened. The eczemas in the childhood, serious allergic reaction suffered years ago, or the repeated infections – all these are information, which indicate the possible immune system disorder or direct the allergic “before-period”. Concerning the women the important information is the number of the deliveries and

the development of the pregnancy, concerning the children, the time until they were nursed,

when they started to eat the baby food, is of the greatest importance.

The working anamnesis is the information on the surroundings, where we spend the main part of our day. The important facts refer not only to conditions of the building (cleanness, humidity, thermo regime) but also all things we come into contact with – the production, administration, special operations and chemicals. The significant information are the protection regime against the potential harmful chemicals at the workplace and our approach to it. The information about how we spend our spare time – our hobbies, the sport, etc, places where we have the chance of the contact with the factors initiating or starting the allergy, should be a part of this analysis, too.

The current illness – its description is the most important part of the “testimony” and no basic information can be omitted in it.

● illness start and description

● your own symptoms descriptions

● seasonal presence of the clinical effects (per year, during the summer, etc)

● allergic (not allergic) initiating factor – if we know it or if it seems to be assumed

● lifestyle influence

* the symptoms occurrence frequency and the seriousness symptoms

* influence on the occupation ( study)

* extra working activities (sport, hobby)

* sleep

● environmental allergens – surroundings allergens – (at home, work)

● existing treatment – ( if already treated)

* effect (little, significant; stopped to be effective after a period of time)

* side-effects

* satisfaction and the willingness to undergo this type of treatment.

The information on the further potential illnesses we have, especially on medications we take, is important. Many can influence not only the diagnosis, but also the particular allergic reaction itself – and not only in the negative sense – worsen of the clinical condition or on the contrary- covering of the particular typical symptoms.

The physical examination is the basis in all cases. The doctor examines all systems. He or she examines the skin al over the body, where the symptoms – even not the most serious and hence hidden, which the patient himself does not have to notice – inflammation, reaction to any mechanic irritation, dryness or wetness of the skin, nails, hair, are looked for. The oral cavity reveals the potential inflammation- infectious, but allergic, as well.

The nasal mucosa swelling and congestion, nasal discharge, red skin around the nostrils caused by the mechanic irritation are the symptoms of the common cold. The patients with the nasal congestion breathe through the mouth, which are open all the time. The nasal congestion As far as the children are concerned, the nasal congestion is revealed by the line on the top, especially the so called allergic salute (greeting), it is started with. It is a “gesture” of pushing the top of the nose up with the palm, while the nasal cavity is being released.

The auscultatory examination – examination with the phonendoscope – enables to hear the breathing sound. Unlike the healthy lungs, the patients with the clinical asthma make crunching, bubbling or whistling sounds while breathing. They do not have to be loud so that only the experienced ear of the doctor can hear and identify them. The palpating and percussing of the rib cage and the abdomen provides further information.

The entire examination, especially the first visit to the specialised doctor is necessary. Therefore even while examining the patients, who are think that they have “only” a common cold, we should expect the complex examination.