Case Study Seasonal Allergies

CASE STUDY: Seasonal Allergies

SUBMITTED BY: Katie Donnelly

PATIENT: Male, 11 years old

INITIAL PRESENTATION:

Client has been experiencing ongoing irritation causing a shallow, dry cough and subconscious throat clearance. He has known allergies to pollen, often initiated by seasonal change. Symptoms include watery and stinging eyes, sneezing, and typically sinus congestion. The client also has diagnosed asthma and takes preventor medication. He experiences dry, itchy eczema, more frequently over cooler months.

Current symptoms of dry cough and throat clearance have been ongoing for the past three months. The client’s mother describes periods of coughing that can last up to 30 minutes and are repeated multiple times per day. No phlegm is described. No nasal congestion is currently present. Some watering of the eyes.

Throat clearance is described as ‘constant’. The client has said it feels as though something is in his throat and he can’t move it. Feels as though he must clear it, even though nothing happens when he does. The general practitioner has advised there are no structural concerns. He has no shortness of breath, no chest pain or discomfort, and no tightness. There is no temperature, malaise, or sign of infection, and no pallor. Nail signs show all moons present with potential zinc spots but may be trauma spots. Mild tongue tremor and describes ‘growing pains’ in his legs that occur sporadically.

Prior to this, client experienced viral infection that resulted in three weeks of severe illness and low energy. Fatigue continued for one month post infection. Sensitivity to pollen has notably increased since experiencing illness.

Strep throat was identified two weeks prior to consultation, although, this case was asymptomatic. Testing resulted after a family member was unwell. The client was prescribed a course of antibiotics lasting 10 days, which was completed. No digestive discomfort was noted and no change to bowel movements described. Client was embarrassed to discussed bowel movements, so provided information on ideal form and regularity.

His diet includes a wide variety of fruits, vegetables, and proteins, and the family only cook with olive or coconut oil. The mother advised that he had a dairy sensitivity as an infant, but he had outgrown that sensitivity. No other allergies noted. The home has an air filtration system, and anti-dust mite pillows and bedding is used. Eco and sensitive products are used for washing and cleaning.

Client is otherwise happy and healthy. He is involved in sports five days a week and is very active.

HERBAL TREATMENTS

Herbal Formula (100mL)

Matricaria officinalis chamomile 30mL

Astragalus membranaceous astragalus 30mL

Echinacea purpurea/angustifolia echinacea 30mL

Blackcurrant concentrate 10mL

2.5mL twice daily with juice

ADDITIONAL TREATMENT RECOMMENDATIONS

Elimination diet to remove all dairy and gluten containing products for two weeks. Alternative food options have been provided. Guidance provided for a reintroduction and assessment of how his body responds.

Probiotics – take one sachet per day

Magnesium and B vitamin support – take one scoop per day

Omega 3 support – take one capsule per day

This is an intensive focus to remove any potential irritants and focus on improving gut and microbiome integrity and lower overall inflammation.

Supplementation is to be used for one month, and then reassessed as needed.

FOLLOW UP TWO WEEKS

Client’s mother advised that eczema disappeared within days of elimination diet. We will continue to monitor this as the weather changes, as it is typically exacerbated by cooler temperatures.

She also noted that within the first week she realised he hadn’t been coughing. On asking the client, he said coughing has reduced to ‘one or two’ single coughs per day. Throat clearance is significantly reduced. Energy has improved and tongue tremor has ceased. No other symptoms have presented.

Client has adapted well to dietary changes but has occasionally snuck the odd item of food. Reiterated the importance of this being a short-term change to establish how his body copes, to avoid any potential issues with disordered eating patterns or hiding food.