Hay Fever, or what your doctor will call Allergic Rhinitis, can be a very disabling condition. Thankfully, there are a number of excellent treatments and medications to relieve suffering from this seasonal condition.
WHAT IS IT?
Allergic rhinitis literally means "allergic nose disease": rhino means "to do with the nose" and the ending -itis simply refers to disease.
This condition can either be seasonal or year-round. Seasonal allergic rhinitis is also commonly known as "hay fever." In most people, a single allergen - something that triggers an allergy - sets their symptoms off at about the same time each year. Spring attacks are usually due to tree pollen, while grass pollens dominate in the summer and weed pollens in the autumn.
Perennial allergic rhinitis often appears year-round. This condition isn't always caused by an allergy, but it's most common in people with allergies to things that are present all year. Naturally, people who are allergic to house dust mites or to their own pets tend to suffer no matter the season.
WHAT HAPPENS?
Hay fever is so common that almost everyone recognizes the basic symptoms: runny nose, sneezing, itching and congestion. Other symptoms of this seasonal form of allergic rhinitis can also include tearing of the eyes, coughing, and headache.
You can usually tell hay fever from perennial rhinitis by the fact that it appears regularly at the same time each year. Another difference is that, while hay fever often causes red eyes, perennial rhinitis tends to leave the eyes alone. It can also cause minor blockage of the ears, particularly in children.
WHY DOES IT HAPPEN?
Hay fever is an atopic disease like asthma, meaning that the body tends to overreact to certain types of outside substances. One way it overreacts is by releasing histamine, a chemical present in almost every cell. Histamine widens the blood vessels, slowing blood flow and reducing blood pressure. It can help in guarding against infections by keeping them from spreading throughout the body. When it's released in the nasal passages or the airways, however, it narrows them, allowing less air to enter. It can also cause muscle spasms that show up as sneezing and coughing.
Hay fever, like asthma, can be inherited, but you probably don't inherit particular allergies, such as to cat dander or ragweed. Instead, you just inherit the tendency to be allergic. Whatever you're most exposed to will probably become the allergen that bothers you.
DIAGNOSING
The important thing to remember about in hay fever is exactly when the rhinitis appears and disappears. Knowing these dates will give a doctor or an allergist vital clues as to what's provoking the symptoms, and makes diagnosis easier.
By getting the details of where you live and work and when you suffer most, a doctor or an allergist can make a very short list of possible causes. Allergists use small, standardized doses of all the most common allergens to narrow down the diagnosis. They test for allergy by gently scraping the skin with each of these until they get a small rash. Most of these tests are nearly painless.
If none of the skin tests produce results, it's probably some other kind of rhinitis. These other conditions can be confused with hay fever:
Vasomotor rhinitis:the nasal mucous membrane swells up with increased blood flow, causing runny nose and congestion, but typically no itching. There's no specific cause - patients aren't allergic to anything - although smoke, dry air, temperature change (such as coming in from the cold), and odours can trigger symptoms.
Chronic rhinitis: may be prolonged symptoms of a common cold or another disease, for example syphilis or tuberculosis.
Rhinitis medicamentosa: caused by overusing nasal spray decongestants, which actually increase congestion if used for more than about 10 days. Cocaine users are also vulnerable to this form of rhinitis.
TREATMENT AND PREVENTION
Treating and preventing hay fever are often the same thing - the best way to cure the symptoms is to avoid the allergen. This may mean changing your habits, or even giving away a pet or moving to another house if the symptoms are unbearable and don't respond to drugs. If the allergen is something you can't completely avoid, like dust mites, here are some steps you can take to make your home a haven:
· Remove furniture that collects dust, for example carpets, draperies, and stuffed chairs.
· Put plastic covers on mattresses.
· Wash floors frequently with a wet mop.
· Reduce air humidity with a dehumidifier.
· Install a high-efficiency air filter, called a HEPA filter.
If these measures prove insufficient, most people fortunately do respond to drugs. The therapy of choice is antihistamines taken orally or as a spray. If your antihistamine makes you drowsy, there's usually another one that won't. For really bad seasonal allergy attacks, you may be given a corticosteroid spray if antihistamines aren't working. Corticosteroids sprays are preferred if rhinitis symptoms are chronic.
Desensitization - If antihistamines aren't helping, and you can't avoid the allergen, you're left with the option of desensitization, sometimes called hyposensitization or allergen immunotherapy. Small amounts of the allergen are injected regularly, slowly increasing the dosage with the hope of getting the body "used to it." The immune reaction eventually gets weaker and weaker, even disappearing in some people. The injections are needed every 4-6 weeks, and the treatment works best if used year-round.
Desensitization is not risk-free. Very occasionally, the patient has a system-wide immune reaction called anaphylactic shock, which can kill. You'll usually have to wait around for half an hour after each shot to make sure you don't have this reaction. Since people with pollen allergies are most vulnerable to large doses, it's often best to reduce the dose during pollen season. For these people, the best time to start desensitization is at the end of their annual allergic period.
