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House Calls, March 15, 2012

Practicing family physicians from the UNC Department of Family Medicine have teamed up with The Carrboro Citizen to bring you a weekly feature responding to your questions about health and medicine. Send your questions or comments to yourhealth@unc.edu

This week we respond to questions about dog bites and allergy testing.

Dear HOUSE Calls, My dog bit my nephew and left a deep wound, but for some reason the doctor didn’t close it with stitches. Why not?

Bites are a little bit confusing. We do not sew up human bites or cat bites because they tend to get infected, and we don’t want to trap the infection in. Dog bites are sometimes sewn up and sometimes not, depending on the severity and depth. Doctors often don’t close a wound if it’s on the hand or foot, because those wounds tend to heal quickly. Also, if bleeding stops quickly or easily, closing a wound is less important. If you do get a dog or cat bite, be certain the animal has had a rabies vaccine, and try to keep this from happening again.

Dear HOUSE Calls, Do you believe in the ALCAT test? I believe that I might have an allergy to gluten and wondered if this test would show true results.

First off, this is an incredibly expensive test (more than $1,000 for some panels) for someone to purchase without medical guidance. This is a test for more than 200 allergies and sensitivities. It is being directly marketed to consumers based on poor-quality research. Most of the “papers” on the research section of the test’s website are reports that have not been subjected to peer review, use very small samples and have no comparison group. If we test for enough allergens in a test tube, we will undoubtedly find some that you are sensitive to. However, which ones are important to the way you feel and your overall health is an entirely different question. It is clear food allergies are becoming quite popular and that popularity has something to do with the ease of testing, the profitability of testing and the popular notion of food allergies. Gluten sensitivity used to be under-diagnosed, but with the development of highly accurate blood tests, many more people can be tested quite accurately for celiac disease. It is probably now over-diagnosed. There was a recent “quack” report about ALCAT testing. The American Society for Allergies and Immunology has said that ALCAT is not a reliable test. It is very important to talk to your doctor about symptoms and potential causes before going it alone and buying this expensive panel of tests.

House Calls is a weekly column by Dr. Adam Goldstein, Dr. Cristy Page and Dr. Adam Zolotor on behalf of Your Health and the UNC Department of Family Medicine.

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