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NASAL CORTICOSTEROID SPRAYS: USE, CONTRAINDICATIONS AND SIDE EFFECTSUses For Nasal Corticosteroid SpraysNasal conditions in which nasal corticosteroid sprays are indicated include the following:- Seasonal allergic rhinitis- Perennial allergic rhinitis- Non-allergic rhinitis (vasomotor)- Nasal polyps (prevent recurrence of polyps following surgical removal)- Chemical rhinitis (the nose-drop or nose spray nose)
Contraindications For Corticosteroid Nasal SprayThere are two general contraindications to the use of corticosteroid nasal sprays:1. An allergic or hypersensitivity reaction to either the corticosteroid or one of the additives in the spray you plan to use, manifested by sneezing, congestion, generalized itching, coughing, wheezing, fainting, etc.2. An untreated but significant infection of the lining membrane of the nose.NOTE: If you are having pain in your nose and/or blowing copious amounts of pus, perhaps with blood intermixed, from your nose, talk to your doctor before you use one of these sprays.
Side Effects Of Corticosteroid Nasal SpraysThe side effects of corticosteroid nasal sprays are generally mild and limited to the nose. Systemic side effects are possible at higher-than-recommended doses.Common side effects include burning, stinging, and irritation of the lining of the nose.Less common side effects include aggravation of bronchial asthma (by accidentally inhaling the solution into the lungs during spraying), headache, light headedness, nausea, nose bleeding, and rebound nasal congestion (if your nasal congestion worsens with use rather than improves). Rare but possible side effects include a decrease in function of the adrenal glands, allergy to the product or an additive, glaucoma (alert doctor if you have a family history of glaucoma), injury of the nasal septum (the wall that divides the nose into right/left sides), sore throat, thrush, and watering of the eyes.*48/322/5*

Knowledge about food allergy is as old as history; the ancient Egyptians, the Chinese, the Jews, and the Greeks all demonstrated an instinctive understanding of these allergies. However, allergy to food was studied scientifically for the first time only fifty years ago by Schloss who observed that:(a) a boy had epidermoids-animal hair and scales from dogs, cats, horses, goats, rabbits, birds, sheep, rats and mice, roaches, silkworms dyes cosmetics insecticides poison ivy plant hives after eating eggs, almonds, and oatmeal; (b) the same boy had an inflammation in his skin when injected with extracts of those foods; (c) the boy manifested either an immediate reaction to a food (which showed itself a few minutes after eating it) or a delayed reaction (which showed itself hours or days after eating it). Schloss concluded that in immediate reactions to foods the allergen is the whole food, while in delayed reactions it is one of the broken down products of the food absorbed during digestion. He advised avoidance of complicated foods which might be incompletely digested and absorbed as such by the immature intestines of a baby.

The symptoms of food allergy are hives, nose stuffiness, asthma, eczema, vomiting, diarrhea, gas, or migraine headaches. We know through experience that fish, shellfish, berries, nuts, and chocolate frequently cause hives, while cereals, milk, egg, or meat more often cause nose stuffiness and asthma.

A food allergy is usually diagnosed clinically with a diet diary, an elimination diet, or a provocative diet. Skin testing has little value in diagnosing food allergy.

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Coeliac disease is not usually thought of as ‘food intolerance’, although it is an adverse reaction to food. In this disease, there is just one type of food at fault -wheat and related grains (rye, barley and oats). Moreover, the symptoms are very specific. In babies they consist of pale, foul-smelling stools, wind, bloating and poor growth. These symptoms usually develop a few weeks after cereals are introduced into the diet. In those infrequent cases where coeliac disease begins in an adult, the symptoms are diarrhoea, pain, bloating, weight loss, malaise and weakness. In rare cases, however, constipation may be the main symptom. When the lining of the small intestine is examined under a microscope, it shows clear signs of damage.

The offending element in wheat is the main protein, commonly known as gluten. In fact gluten is a mixture of dozens of different proteins, which fall into two main types, the glutenins and the gliadins. The part, or parts, of these proteins that produce coeliac disease have still not been identified.

Exactly what goes wrong in coeliac disease is not entirely clear, and the disease seems to be quite complex. There is definitely an inherited component because coeliac disease runs in families. And the immune system is involved in some way, as shown by the large numbers of immune cells found in the coeliac’s gut lining.

The most widely accepted theory at present is that one or more components of gluten are lectins and that they specifically bind to carbohydrate markers on cells in the gut wall of coeliacs. We all have these carbohydrate markers, and they are determined genetically. The theory is that coeliacs inherit a particular type of marker molecule on the surface of their cells, which happens to be bound by the lectins in gluten. The combination of lectin-and-marker looks like an unwelcome alien to the immune system, which then proceeds to make antibodies against it. In the relentless war against the bound lectin, the immune system causes severe damage to the gut lining, which is then unable to function properly. The available evidence suggests that this theory may be correct in broad outline, but the details still need to be filled in.

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