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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 particularly 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, it depends on the severity and depth.  Doctors often don’t close a wound if it’s on the hand or foot, because they heal quickly.

Also, if bleeding stops quickly or easily, closing a wound is less important.  If you do get a dog or cat bit, 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 and if it works?  I believe that I might have an allergy to gluten and wondered if this test would show true results?

Now that is a good question. This is a test for over 200 allergies and sensitivities. First off, this is an incredibly expensive test (over $1000 for some panels) for someone to purchase without medical guidance. It is being directly marketed to consumers based on poor quality research. Most of the ‘papers’ on the research section of the 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, it is an entirely different question which ones are important to the way you feel and your overall health.  It is clear that food allergies are becoming quite popular and that popularity has something to do with the ease of testing, the profitability of testing, and popular notion of food allergies.

For example, 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 have 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 on your own and buying this expensive panel of tests.

HOUSE Calls is a weekly column by Dr. Cristy Page, Dr. Adam Zolotor, and Dr. Adam Goldstein on behalf of YOUR HEALTH and the UNC Department of Family Medicine.

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