Allergic Rhinitis1

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Most likely you or someone you know

has allergies. The telltale itchy, puffy,watery eyes and red, stuffy nose signalchanges in the seasons. What thesepeople suffer from is

allergic rhinitis or hay fever

The medical name for this conditionrefers to stuffy and itchy nose ("rhin-"),the most common symptom.


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Hay fever is an allergic reaction. It is your

immune system's response to foreign

material in the air you breathe. Hay feverusually refers to allergies to outdoor, airborne

materials such as pollens and molds.

About 15-20% of the population of the

United States has some degree of hay fever.

It is found equally in both men and women.

Usually hay fever is seasonal, but it can lastall year long if the allergen stays throughout

the year. Spring and fall are the main hay

fever seasons.


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A process called sensitization, your immune

system mistakenly identifies a harmless airbornesubstance as something harmful. Your immune

system then starts producing antibodies to this

harmless substance. The next time you come in

contact with the substance, these antibodiesrecognize it and signal your immune system to

release chemicals, such as histamine, into your

bloodstream. These immune system chemicals

cause a reaction that leads to the irritating

signs and symptoms of hay fever.


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Seasonal hay fever triggers include:

Tree pollen, common in the springGrass pollen, common in the late spring and

summer

Ragweed pollen, common in the fall

Spores from fungi and molds, which can beworse during warm-weather months

Year-round hay fever triggers include:

Dust mites or cockroaches

Dander (dried skin flakes and saliva) from pets,

such as cats, dogs or birds

Spores from indoor and outdoor fungi and molds


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Sneezing

Runny nose (clear, thin discharge)

Congested ("stuffy") nose

Postnasal dripSensation of plugged ear(s)

Watery, bloodshot eyes

Itching of nose, soft palate, ear canal,

eyes, and/or skinFatigue

Trouble sleeping


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Reduced quality of life. Hay fever can interfere with yourenjoyment of activities and cause you to be lessproductive. For many people, hay fever symptoms leadto absences from work or school.Poor sleep. Hay fever symptoms can keep you awake ormake it hard to stay asleep.

Worsening asthma. If you have asthma, hay fever canworsen signs and symptoms, such as coughing andwheezing.Sinusitis. Prolonged sinus congestion due to hay fever

may increase your susceptibility to sinusitis

aninfection or inflammation of the membrane that lines thesinuses.Ear infection. In children, hay fever often is a factor inmiddle ear infection (otitis media).


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Family medical history

physical examinationSkin prick test. During skin testing, small amounts of material

that can trigger allergies are pricked into the skin of your arm or

upper back and you're observed for signs of an allergic

reaction. If you're allergic, you develop a raised bump (hive) at

the test location on your skin. Allergy specialists usually are bestequipped to perform allergy skin tests.

Allergy blood test. A blood test, sometimes called the

radioallergosorbent test (RAST), can measure your immune

system's response to a specific allergen. The test measures the

amount of allergy-causing antibodies in your bloodstream,

known as immunoglobulin E (IgE) antibodies. A blood sample is

sent to a medical laboratory, where it can be tested for

evidence of sensitivity to possible allergens.


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1. Nasal corticosteroids

These prescription nasal sprays help prevent and treatthe nasal inflammation, nasal itching and runny nosecaused by hay fever. For many people they're the mosteffective hay fever medications, and they're often the

first type of medication prescribed.Examples include fluticasone propionate (Flonase),triamcinolone (Nasacort AQ), mometasone (Nasonex)and budesonide (Rhinocort).Nasal corticosteroids are a safe long-term treatmentfor most people.Side effects can include an unpleasant smell or tasteand nose irritation. Steroid side effects are rare.


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2. AntihistaminesThese preparations are usually given as pills.

However, there are also antihistamine nasal spraysand eyedrops. Antihistamines can help with itching, sneezing andrunny nose but have less effect on congestion. Theywork by blocking histamine, a symptom-causingchemical released by your immune system during anallergic reaction.Older over-the-counter antihistamines such asdiphenhydramine (Benadryl) work as well as newer

ones.Antihistamine eyedrops help relieve eye itchinessand eye irritation caused by hay fever.


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3. Decongestants.

These medications are available in over-the-counter and

prescription liquids, tablets and nasal sprays.

Over-the-counter oral decongestants include Sudafed andDrixoral. Nasal sprays include phenylephrine (Neo-

Synephrine) and oxymetazoline (Afrin).

side effects, including increased blood pressure, insomnia,

irritability and headache.

4. Cromolyn sodium.

This medication is available as an over-the-counter nasal

spray that must be used several times a day. It's also

available in eyedrop form with a prescription (Crolom).

It helps relieve hay fever symptoms by preventing therelease of histamine.

Cromolyn sodium doesn't have serious side effects, and it's

most effective when you begin using it before your

symptoms start.


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5. Leukotriene modifier.

Montelukast (Singulair) is a prescription tablet taken to block

the action of leukotrienes immune system chemicals that

cause allergy symptoms such as excess mucus production.

It's especially effective in treating allergy-induced asthma. It's

often used when nasal sprays can't be tolerated, or when you

have mild asthma.

6. Nasal ipratropium.Available in a prescription nasal spray, ipratropium (Atrovent)

helps relieve a severe runny nose by preventing the glands in

your nose from producing excess fluid.

Mild side effects include nasal dryness, nosebleeds and sore

throat.

7. Oral corticosteroids.

Corticosteroid medications in pill form, such as prednisone,

are sometimes used to relieve severe allergy symptoms.


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8. Rinsing your sinuses.

Rinsing your nasal passages with distilled, sterile saline

(nasal irrigation) is a quick, inexpensive and very effective

way to relieve nasal congestion.

Rinsing directly flushes out mucus and allergens from your

nose. Look for a squeeze bottle or a neti pot a small

container with a spout designed for nose rinsing

at yourpharmacy or health food store.

Use water that's distilled, sterile, previously boiled and

cooled, or filtered using a filter with an absolute pore size

of 1 micron or smaller to make up the saline irrigation

solution.


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Pollen or molds

Close doors and windows during pollen season.Don't hang laundry outside pollen can stick to sheets and towels.Avoid outdoor activity in the early morning when pollen counts arehighest.Stay indoors on dry, windy days.Use a high-efficiency particulate air (HEPA) filter in your bedroom.

Avoid mowing the lawn or raking leaves, which stirs up pollen andmolds.Wear a dust mask when doing outdoor activities such as gardening.

Dust mites

Use allergy-proof covers on mattresses, box springs and pillows.Wash sheets and blankets in water heated to at least 130 F (54 C).Vacuum carpets weekly with a vacuum cleaner equipped with asmall-particle or HEPA filter.Consider removing carpeting, especially where you sleep, if you're

highly sensitive to dust mites.


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CockroachesBlock cracks and crevices where roaches can enter.

Fix leaky faucets and pipes.

Wash dishes and empty garbage daily.

Sweep food crumbs from counters and floors.

Store food, in sealed containers.

Pet dander

Remove pets from the house, if possible.

Bathe your pets on a weekly basis, if possible. Using

wipes designed to reduce dander also may help.Keep your pets out of the bedroom.

Allergic Rhinitis1

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