Diagnosis and Management of Seasonal and Year Round Allergies

This is a recording of “Diagnosis & Management of Seasonal and Year Round Allergies with Dr. John Saryan,” a Zoom meeting held on May 6, 2021, sponsored by Dinno Health.

Dr. John Saryan, MD is an Allergy & Immunology Specialist with over 44 years of experience in the medical field. Dr. Saryan has extensive knowledge and experience with environmental allergies . He graduated from Johns Hopkins University School of Medicine in 1977. He is Chairman Emeritus of the Division of Allergy and Immunology at Lahey Hospital and Medical Center. Dr. Saryan recently retired in December 2020 from clinical practice.

The host, Saad Dinno, is a pharmacist and co-owner of Acton Pharmacy, Keyes Drug in Newton, Theatre Pharmacy in Lexington and West Concord Pharmacy.

Below is an excerpt:

Saad Dinno: 

I have known Dr. Saryan for many years because he took care of my son for many years. So Dr. Saryan, the floor is all yours. Thank you so much for joining us. We will take questions at the end.

Dr. Saryan:

As Mr. Dinno said I retired recently but I bring tonight 44 years of experience as a physician and most of that as an allergist. We’re going to talk today about the diagnosis and management of seasonal and year-round allergies and it’s a very apropos topic given that we are literally right in the midst of the peak of the spring pollen season in New England. 

So in our discussion of environmental allergies, I’ll give you some background information and a definition. We’ll talk about signs and symptoms of allergies, the causes, how to make the diagnosis and then various treatment options – as you can see, environmental measures, medications, and immunotherapy or allergy treatment, specific allergy treatments like shots.  

Allergic diseases, including asthma, have been increasing in prevalence in western society for somewhere between 20 and 50 years. Twenty to 25% of the population has allergic rhinitis or conjunctivitis, which is another term for environmental allergies. You may hear me referring to allergies and what I’m talking about is the same thing, environmental allergies or allergic rhinitis and conjunctivitis. The conjunctivitis is the inflammation of the lining of the eyes. The two go hand in hand. We see people with year-round and or seasonal allergies. Many patients have both. It is the most common chronic disease. Thankfully it’s not a disease that threatens our survival but it certainly impacts on the quality of an individual’s life. Most people who happen to have asthma also have nasal problems or rhinitis as well. 

So what is allergic rhinitis? Well, it’s allergic inflammation of the nose and sinuses and as well the lining of the eyes, and you know, we often refer to allergic rhinitis but it’s really allergic rhinitis and conjunctivitis or allergic rhinoconjunctivitis and I’ll be referring to the two together for the most part. 

In the case of most people with allergies, there’s exposure to an allergen, something that will trigger the allergy symptoms such as pollen. It gets absorbed through the lining of the nasal passage or lands on the eyes and gets absorbed that way. Then the proteins from that allergen, like the pollen, combine with something called IgE. Now that’s an allergic antibody that the person’s immune system has already been making from prior exposure so you won’t have allergies unless you have these allergic antibodies and they find themselves on the mast cells. Proteins from the pollen combine with the IgE on the surface of that mast cell so then the mast cell opens these holes which then allow the contents, which are histamines and other natural chemicals made by the body, and they get loose. They go into the nasal membranes and they cause the symptoms. Now as long as those histamines and other substances like leukotrienes and prostaglandins, etc. stay inside the mast cell, everything is fine. Once they get loose, now you’ve got a problem and you end up with the symptoms: the sneezing, runny nose, itching, congestion and other symptoms as well.

Watch the video to get more information on:

1. Understanding the differences between allergies and something else
2. Different types of allergies and management care
3. Allergies and the different treatment options