They’re back! Those nasty outdoor pollens, mold spores, animal dander and dust mites. It is estimated that 40 to 50 million people in the United States alone suffer from allergies.
In Western countries as a whole, 10 to 25 percent of people are affected annually by allergic rhinitis. Their allergies may be severe enough to impact daily activities or just uncomfortable enough to lessen a good quality of life.
The medical term for “hay fever” is allergic rhinitis. Rhinitis is a term which describes inflammation of the nasal passages. Think Rhinoceros. Typical symptoms include a runny nose, itching, sneezing and nasal stuffiness. The nose is meant to produce mucous in order to trap unwanted substances from reaching the respiratory tract, like dust, pollen, pollution, bacteria and viruses. Mucous generally flows from the front to the back of the nose, then down the throat. When too much mucous is made, a person will experience either a runny nose from the front or excessive post nasal drip in the back. Coughing is the natural response to clearing the throat.
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Dark circles can appear under the eyes from dilation of blood vessels in that area or nasal congestion. Examination of the inside of the nose will reveal the mucous tissue to be swollen and boggy. The whites of the eyes can appear reddened with excessive tear production. The neck may have lymph node enlargement, the lungs may be wheezing and the skin may have rashes.
The causes of allergic rhinitis are varied, depending if the symptoms are seasonal, perennial (year round) or sporadic. Grass pollens, weed pollens and outdoor molds generally cause seasonal rhinitis. House dust mites and pets will contribute to perennial rhinitis. Certain foods, allergens to which the individual is not usually exposed and occupational exposures may cause sporadic allergies.
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Treatment consists mainly of trying to avoid the allergen. This may consist of staying indoors as much as possible during hay fever season, closing windows and doors to prevent wind borne pollen from entering the house or office and using air conditioning as an effective filter. Specialized pollen filters are available to detoxify the air.
Reasonable non prescription treatments may consist of saline nasal spray or a “Nettie Pot” which can be purchased at any pharmacy. The Nettie Pot is a teapot looking instrument which one fills with normal saline and is used to wash out the sinuses.
Medications include antihistamines, such as over the counter Claritin, Zyrtec or Benadryl. Pseudofed, a decongestant, is also available over the counter. Steroids are available only by prescription. Some patients have such severe symptoms that they must undergo desensitization with either allergy immunotherapy such as allergy shots, or removal of nasal tissue (e.g. nasal polyps) or sinuses.
Think twice before pet sitting your friend’s English Sheepdog if you’re prone to sneezing and wheezing around fido. It would probably cost you a week’s salary to feed him anyway.
Dr. Ballard is a Board Certified Internist and Geriatrician with a special interest in Women’s Health. She practices in Enumclaw, 360-825-1389. Dr. Ballard’s comments are informational only and not to be construed as medical advice. Consult your personal physician for any medical issues.
