date: 8/12/2005
Allergy triggers and symptoms: Keys to diagnosis
Accurate diagnosis of common symptoms can help determine what provokes them, and allow you to make the best decision about your own treatment options.
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Because any allergy increases the chance of developing another, more serious one, it's especially important to spot them early—but that's not easy. Both patients and doctors often overlook eczema and hives or attribute them to other causes. Food allergies can be confused with food intolerances, a milder problem. And some forms of hay fever, sinusitis, and asthma stem from nonallergic causes. The table below describes the most common or prominent symptoms and triggers for several similar allergic and nonallergic disorders. That can help you decide when to see your doctor and to provide a clear, targeted description of your symptoms and what provokes them.

LOCATION ALLERGY NOT AN ALLERGY
Disorder and symptoms Cause Disorder and symptoms Cause
Nose and eyes Seasonal rhinitis (hay fever): Sneezing, congestion with clear discharge, teary eyes, in spring or fall. Usually outdoor allergens, notably tree, grass, or weed pollen. Infectious rhinitis: Congestion, sometimes with mild fever and colored nasal discharge, lasting two weeks or less. Usually a virus, such as those that cause the common cold.
Chronic allergic rhinitis: Congestion, sometimes with sinusitis symptoms: clear nasal drainage, cough, headache, and facial pain. Usually pet dander, dust mites, or cockroach droppings. Chronic nonallergic rhinitis: Sneezing, runny nose, or congestion. Airborne irritants, such as strong smells or pollution; changes in temperature, humidity, or air pressure; hormonal changes during pregnancy or menstrual cycle.
Food- or drug-linked rhinitis: Sneezing and itchy, runny nose and eyes for several hours or days. Food or drug allergy, which can also cause other symptoms (see below and accompanying box). Other rhinitis: Acute or chronic congestion, sometimes with sinusitis symptoms. Certain topical medications, especially excessive decongestant use; structural defects in nose.
Lungs Allergic asthma: Chronic or seasonal wheezing, shortness of breath, and coughing, especially at night (often worsened by exercise). Same outdoor or indoor allergens that cause allergic rhinitis and sinusitis. Nonallergic asthma: Symptoms similar to allergic asthma, but usually chronic. Same airborne irritants that cause nonallergic rhinitis. Occasionally caused by exercise alone, certain drugs (especially aspirin), or gastroesophageal reflux.

Emphysema or chronic bronchitis: Symptoms similar to allergic asthma, but usually chronic and slowly worsening. Smoking or second-hand smoke;occasionally dust, pollutants, or other airborne irritants.
Heart failure: Symptoms similar to allergic asthma, but often worst when lying down; often accompanied by fatigue, swollen ankles, weight gain. Heart weakness caused by heart attack, smoking, heavy drinking, high blood pressure or cholesterol, diabetes, heart-valve disorders, overactive thyroid.
Skin Eczema: Itchy, red, scaly patches on face, elbows, or knees. Overheating, sweating, or exposure to allergens such as pet dander or cockroach droppings. Contact or irritant dermatitis: Painful, red, but not itchy rashes appearing soon after contact with offending substance, only where it touched skin. Irritating or caustic substances in soaps and other products.

Fungal infection: Itchy rashes in groin, on feet, or under breast in women. Fungus on skin.
Psoriasis: Silvery, scaly patches that sometimes itch. Autoimmune disorder.
Dry skin: Itching without rash. Aging, cold weather.
Hives: Itchy, pale-red, small or large bumps anywhere on body. Food, drug, or insect-sting allergy or, in children, viruses.
Gastroin-
testinal tract
Food-linked allergy: Vomiting, diarrhea, abdominal cramping, and sometimes itching and swelling of lips, mouth, and throat, usually right after eating the food. Food allergy. Food intolerances: Gas, bloating, sometimes nausea, usually two to six hours after eating certain foods. Usually inability to properly digest high-fiber foods, such as bran, beans, cruciferous vegetables (broccoli, brussels sprouts, cabbage, cauliflower, kale) or dairy products (lactose intolerance).
Celiac disease: Severe abdominal cramping, nausea, and other GI symptoms plus malnutrition. Allergy to gluten, a protein mainly in wheat, rye, oats, and barley. Bowel disorders: Abdominal pain or discomfort lasting months or years. Irritable bowel syndrome, bowel infection, or ulcerative colitis, colon cancer, or Crohn's disease.


If you suspect you are suffering from allergies, make an appointment with your doctor soon. Prompt, proper treatment can control symptoms and restore your quality of life. With many drug and non-drug options available, having up-to-date, unbiased information is crucial.


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