Q: I have been suffering from perennial cold and cough. Initially, I ignored it but it’s becoming very problematic. I am having a blocked nose all day. It is especially severe during morning hours. Based on doctor’s recommendation, I got a blood test done. It also included a serum IgE test. The level of serum IgE was found to be extremely high. Based on the reports, the doctor told me that it is just an indication of allergy and nothing is serious to have long term implication but at the same time the disease is incurable. The only method is avoidance of allergy causing substances. I'd like to know if I need to take any further tests to figure out the root cause of my perennial cold. If it is due to serum IgE, does it have along term solution? What other tests/medicines should I take to prevent/cure it?

A:Allergy is the result of an individuals genetic predisposition, some environmental trigger(s) and an allergen present locally. A family history of allergy predisposes the individual to it. Environmental factors like dust, pollens, cigarette smoke, seasons, certain foods, medicines etc. are all implicated in causing allergy. IgE is a type of antibody (immunoglobulin) found in blood and some tissues, which is responsible for mediating allergic reactions. People suffering from allergy have high levels of it. However, the levels may also be raised in smokers, those consuming alcohol regularly, infections caused by parasites and some diseases (immune disorders, cancers etc.). Its levels are also affected by the site of allergy, being higher in skin disorders as compared to rhino-nasal problems. Treatment is greatly assisted if the allergen can be identified as then measures to avoid or reduce it can be taken. A variety of tests are available to type the allergen causing the symptoms but these are available at only specialised centres. Your symptoms are likely due to an inhaled aeroallergen, which could be both a seasonal outdoor allergen like spore or pollen from trees/grasses/weeds or perennial indoor allergen derived from dust mites, molds, cockroaches or pets. Some general measures that can help include the use of impermeable covers on pillows and mattresses composed of either vinyl or tightly woven fabric that serve as effective barriers to dust mites. Removal of carpets/rugs, heavy curtains and upholstered furniture decreases mite exposure as also the removal of other articles that collect dust like (stuffed toys or books) from the bedroom. The use of a vacuum cleaner, regular washing of linen in hot water, closing windows and preventing dampness in the house can all help. Besides this, symptomatic treatment includes nasal decongestants, antihistaminic, steroids and mast-cell stabilizers. If all this fails, immunotherapy can be tried. Please consult an ENT specialist who will be able to explain and treat you appropriately.