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Hay fever

5 tips for effective treatment

If something has little to do with hay or fever, why is it called hay fever?

If you suffer from itchy eyes, runny nose and post-nasal drainage in the summer months, you know what hay fever feels like, even if you never call it that. Nowadays, doctors call hay fever "seasonal allergic rhinitis". In addition to the above symptoms, some patients experience cough, fatigue, or wheezing. In more than 25 years of medicine, I have never seen anyone who has a fever, at least not in the traditional sense of overheating. Perhaps it was originally called "fever" because until the last century the difference between infection and allergy was not well understood.

In terms of the allergic component, people can certainly be allergic to hay, but most of us aren't around hay every day. However, we are close to grass and weeds and may be allergic to one or the other. Every spring, tree pollen is the first trigger for environmental allergies, followed by grass and weeds. Ragweed is one of the most common weeds that cause symptoms in mid or late summer.

Here are 5 suggestions from your doctor about how to effectively treat hay fever:

1. Stay indoors in an air conditioner. For some allergy sufferers in summer, this is the number one option. It definitely works, but I don't recommend avoiding fresh air and exercise. If you go outside, try at a time when nobody is mowing the grass nearby. You may also find that certain times of the day are better or worse for your symptoms.

2. Take a shower after spending time outside. When breathing, pollen and other plant allergens not only get into the eyes and nose, but also onto the skin, hair and clothing. A simple shower and a change of clothes reduce the burden of allergies and relieve your symptoms.

3. Use an over-the-counter antihistamine. Over-the-counter antihistamines are ideal for preventing itching, runny nose and post-nasal drainage. Claritin, Benadryl and Zyrtec were not so long ago prescription drugs and are now all available in inexpensive generic drugs. They can all be used to prevent and treat symptoms.

4. Use pseudoephedrine to overload. Due to methamphetamine production and abuse problems, most over-the-counter allergy medications switched from pseudoephedrine to less effective decongestants a few years ago. However, real pseudoephedrine is still available at the pharmacy with your signature. Some patients, including yours, consider it the most effective medication for congestion and sometimes for itching and drainage.

5. Use topical eye drops and a nasal spray. If your symptoms are limited to your eyes, you should try a topical antihistamine or anti-inflammatory nasal spray like Zaditor. To prevent nasal symptoms, NasalCrom is an effective drug that was previously only available on prescription. It works much like prescription nasal sprays (but a lot cheaper).

If the suggestions above don't help, contact your doctor. You may have an infection rather than an allergy, or you may benefit from a short-term steroid or inhaler, or you may need an allergy test. However, the majority of patients will find adequate relief with one or a combination of these over-the-counter treatments.

Copyright 2010 Cynthia J. Koelker, M.D.

Allergic rhinitis (hay fever) - manage it today!

Allergic rhinitis is an allergic inflammation of the nasal passages that causes symptoms such as runny nose, nasal congestion and sneezing. These symptoms are very familiar to most of us and are most commonly caused by infections (such as colds, flu, or bacterial rhinosinusitis) or allergies (such as allergic rhinitis discussed in this article).

Allergic rhinitis is also known as "hay fever" in the West. Hay fever is actually a misnomer because hay is not the common cause and there is no fever associated with the disease. Hence the preferred and more specific term is "allergic rhinitis".

SYMPTOMS Problem Description

Symptoms of allergic rhinitis include nasal congestion, runny nose, sneezing, itchy nose and eyes, and watery eyes. Sometimes post-nasal decline can occur, which can lead to coughing, especially at night and when lying down.

Loss of smell occurs frequently and can be accompanied by loss of taste. With severe nasal symptoms, the superficial blood vessels in the "small zone" can sometimes burst and lead to nosebleeds (see article on "Epistaxis").

Allergic rhinitis is often associated with other "allergic" conditions such as asthma, allergic conjunctivitis and eczema. There is also usually a family history of atopy (allergies).

THE CAUSE

An allergic reaction occurs when the body's immune system attacks a generally harmless substance (known as an "antigen") that the body comes into contact with. Genetic and environmental factors can contribute to the predisposition to allergies.

When an antigen presents itself to the body's immune system, it is treated as a foreign "invasive force" and the body builds up its defense to protect itself. The immune system produces a substance known as immunoglobulin E (or IgE for short) to ward off intruders. In an allergic person, this immune response is somewhat exaggerated, producing an excessive amount of IgE.

As in most battles, innocent viewers are unwittingly targeted. And in this case, the innocent bystanders are the body's mast cells, which ultimately hurt themselves. Injury to these so-called mast cells leads to the release of chemicals such as histamine. These are the chemicals that cause itching, swelling, and fluid leakage from the cells. They are also responsible for the contraction of the smooth muscles that line the airways, causing shortness of breath and wheezing in asthma.

Common allergens are:

  • Dust mites
  • Parts of cockroaches
  • Animal hair
  • Mold
  • Pollen

MANAGEMENT

Allergic rhinitis is treated like most other allergic diseases. Identify and avoid the disruptive allergens and alleviate the symptoms. The most effective way to relieve the symptoms of allergic rhinitis is to completely avoid allergens. However, this can often be difficult.

A person with symptoms of allergic rhinitis should consult their doctor / specialist. Sometimes doctors can identify possible allergens based on a detailed medical history. Since the identification of allergens is important and not always easy, skin tests are often required to identify the specific substance that causes the allergy.

1. Tips for avoiding allergens:

Mites:

Dust mites are a universal allergen. While there isn't a single method that is most effective, the following steps in combination can help reduce exposure to dust mite allergens.

  • Changing pads, mattresses etc. with anti-allergenic mite protection covers.
  • Wash bedding and plush toys once a week in hot water (over 60 degrees Celsius).
  • Avoid carpets, thick curtains and soft toys if possible.
  • Use a vacuum cleaner with integrated HEPA filters.
  • Keep all clothing in the drawers / cupboards to reduce dust accumulation.
  • Clean all surfaces regularly with a damp cloth.
  • Replace the air conditioning system filters regularly and clean them.
  • Keep the dimensions under control.

Animal hair:

Avoid keeping animals that lose their fur. Animal hair is a well-known trigger for allergic rhinitis. If you already have an animal or would like to keep an animal, remove it from your litter box and bathe it regularly.

Air pollution:

Most studies show a link between air pollutants and the worsening of allergic conditions. In periods of haze, allergy sufferers should avoid unnecessary outdoor activities.

Smoking:

Avoid smoking and expose yourself to second-hand smoke.

Insect control:

Many homes have cockroaches and other insects that can potentially cause allergic rhinitis.

  • Use bait and cockroach traps.
  • Insecticides can be used, but not in the presence of allergy sufferers. Before entering, make sure the rooms are well ventilated.

Professional triggers:

The range of professional sensitizers is very wide and complex and requires an assessment by a specialist.

Food and food additives:

Real food allergies are rare and extensive testing of food allergies is generally impractical.

2. Medicine:

Antihistamines - These drugs do not block the release of histamine, but the effect of histamine on the tissues. First generation antihistamines (such as chlorpheniramine) are effective but have the side effects of dry mouth and drowsiness. 2nd generation antihistamines (such as loratadine, cetirizine) work slower, work longer and are more expensive. They have the advantage of being less or not soothing.

Decongestants - shrink swollen nasal mucosa and make breathing easier. These can be in the form of oral preparations or in the form of nasal sprays. Decreases cause the so-called "rebound effect" if taken too long. This rebound effect refers to the worsening of symptoms when stopping the drug and occurs due to the dependence of the tissue on the drug.

Steroids - these are available in oral form or as a nasal spray. Oral steroids such as prednisolone start quickly, but are limited by their short duration of action and the side effects of prolonged corticosteroid therapy. Steroid nasal sprays, on the other hand, are safe and effective, but must be used regularly over time for their therapeutic effects to develop. An improvement in the symptoms of allergic rhinitis is usually seen only after about a week or two of regular use of steroid nasal sprays. Steroids are very effective because they stop the formation of inflammatory chemicals that are produced by the body's immune system.

Sometimes Cromolyn and Ipratropium nasal sprays are also prescribed to control symptoms.

Montelukast (Singulair) is a leukotriene receptor antagonist that blocks the action of leukotrienes, another chemical involved in allergic reactions. It has been approved for use in asthma and allergic rhinitis.

Immunotherapy - Immunotherapy, also known as allergy desensitization, treats the root cause of the problem, the hypersensitivity of the body's immune system to a particular antigen. This is done by stimulating the immune system by gradually increasing the doses of the known allergen. It works by gradually "desensitizing" the body by reducing the strength of IgE and its effects on mast cells. Immunotherapy for allergies usually requires frequent treatments in the specialist clinic and takes several months to a year before it becomes effective.

3. Surgery:

Surgery does not cure allergic rhinitis, but it is sometimes required to correct a physical defect in the nose or sinuses that complicates the treatment of allergic rhinitis. This is considered a treatment option if the medical treatments have failed.

Operations include removing the nasal polyps and correcting a distracted nasal septum. Surgery may also be needed to treat the complications that sometimes occur with allergic rhinitis. This would include the outflow of fluid from the middle ear and the outflow from the sinuses.

Although surgery does not cure allergic rhinitis, you may need it to repair a physical defect in your nose or sinuses. Such problems can complicate the treatment of allergic rhinitis. You and your doctor should not consider surgery unless other treatments have failed.

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