Fall Allergy

Fall is approaching. About 20-30% of people suffer from allergic rhinitis also known as hay fever. If you are one of them, please read on! There is evidence that allergic diseases are on the rise globally. Exact reasons for this are not clear. Allergic rhinitis can have a significant impact on the quality of your life in addition to placing an enormous economic burden on the society due to treatment costs and missed days of work.

How are allergies caused?

People like you with allergies have developed specific allergic IgE antibodies to allergens such as pollen, mold, dander, dust and dust mites. These IgE antibodies get fixed to the surface of mast cells present in the lining of respiratory passages. The mast cells produce and store various chemicals such as histamine. When you inhale the allergen, it combines with the IgE on the mast cell surface and causes liberation of histamine and other chemicals. This results in an allergic reaction.

Initially, you experience the symptoms during spring or fall. Subsequently the symptoms become perennial. There are two types of allergic rhinitis sufferers: Runners- get predominantly sneezing, itching, runny nose and postnasal drainage and Blockers-get mostly stuffiness and congestion of the nostrils. Which type do you belong? Do not be surprised if you have both!

Allergic rhinitis can be complicated by the development of sinusitis, asthma, ear infections and even by snoring and sleep apnea. Optimal management of allergic rhinitis often results in their improvement. In one study, regular treatment with prescription nasal sprays reduced the incidence of ER attendance due to acute asthma exacerbation by 50% in adult patients with asthma and allergic rhinitis.

What are the triggers?

Besides cold and allergies, there are other causes for rhinitis. Irritants such as smoke, pollution, newsprint, new paint and strongly scented skin and body care products can cause rhinitis symptoms in many patients. Similarly, changes in temperature, humidity and atmospheric pressure and ingestion of alcohol and spicy food could also result in similar symptoms. Occasionally rhinitis can be caused by medications such as aspirin, NSAIDs, birth control pills, hormones, certain blood pressure medications and others, poorly controlled hypothyroidism, abuse of certain over-the-counter nasal sprays such as Afrin, sniffing cocaine, and pregnancy (due to the effect of hormones the baby makes). In dry climates, nasal stuffiness could be the predominant symptom resulting from dryness of the nasal mucosa.

How are allergies diagnosed and treated?

Allergic rhinitis is often diagnosed by your physician who takes a careful history and does an allergy-focused physical examination. Allergy skin tests or blood tests help to confirm or rule out the diagnosis. Allergy skin tests are preferred over blood tests as they are slightly more accurate, not painful (contrary to popular belief), and the results are available 20 minutes after the test.

Three methods treat rhinitis: 1- Avoidance of triggers, 2- Medications and 3- Allergy injections. Avoidance of triggers is perhaps the most important and often neglected of the treatment options. It is best used in combination with the other two options. Allergic triggers, as well as non-allergic triggers, should be avoided. Exact triggers to be avoided depend on your allergic history and allergy skin or blood test results. Medications–Antihistamines with or without decongestants and prescription nasal sprays are two commonly used drugs. While antihistamines are good at relieving sneezing, itching and runny nose and itchy, red and watery eyes, prescription nasal sprays are more effective in relieving nasal congestion and stuffiness. The nasal sprays do not work immediately. They have to be regularly used to get relief. They do not cause addiction. Decongestant medications have the potential to cause insomnia, palpitations, worsening of glaucoma, high blood pressure and problems with urination. Older antihistamines such as Benadryl or Chlor-Trimeton may cause significant sedation and fatigue. Patients who take such medications should not drive or operate heavy machinery. Newer antihistamines such as Allegra, Claritin or Clarinex usually do not cause such problems. Allergy injections- They have several advantages over medications: They eventually reduce the need for medications, prevent complications associated with allergic rhinitis, improve the quality of life, prevent development of new allergies and may even prevent development of asthma in children who have allergic rhinitis. Millions of allergy sufferers all over the world have benefited from them since 1911.

Conclusions

While nasal allergies are not severe enough to take you to an emergency room, they can make your life miserable and affect your sleep, work or education significantly. In this modern day and age, there is no reason for you to suffer from the dreaded allergies! Please talk to your doctor about it!

If you have questions, please call our office for clarification at 928-681-5800