Allergic Rhinitis (Hay Fever)

Allergic rhinitis refers to a number of symptoms occurring in the nose due to allergy. Hay fever, as it is commonly known, occurs when our body is sensitive to any particle in air. Pollen is the most common particle causing allergy. The symptoms are similar to cold with sneezing, runny nose and watering of eyes, being the main ones. The diagnosis requires a skin test. More importantly, allergic rhinitis needs to be diagnosed early in children so that we can prevent asthma.

overview

Girl having allergic rhinitis

It is said that one in every five persons suffers from allergy! Allergy is more prevalent in people of developed than developing countries. As countries develop, their children get less exposed to dirt and microbes.

Consequently they don’t develop immunity to these. Eventually as they grow and get exposed to these allergens, they develop allergy. The theory is known as hygiene hypothesis.

symptoms and types

The most common symptoms of allergy are sneezing, runny nose, watering of eyes, itching of eyes and nose, scratchy throat and nose block. In addition to that, a few show cough, breathing trouble, hives and headache. Allergies can disturb your sleep and daily routine making you tired and less active.

The symptoms may occur seasonally or over the whole year. And based on this we classify hay fever into Seasonal and Perennial Allergic Rhinitis.

WHAT CAUSES ALLERGY? WHAT ARE ALLERGENS?

Allergens are airborne particles which cause allergy in sensitive individuals. In fact, they are termed aeroallergens in medical parlance. Pollen grains, household molds, animal dander and house dust mites are the most important ones. When a person with allergic rhinitis inhales air ridden with these, certain chemicals are released in body which produce the symptoms. The most noteworthy among these chemicals is histamine.

seasonal allergic rhinitis

These occur during same time of the year. Grass and tree pollen cause allergies in summer months, whereas, weed during autumn. Molds cause during the middle of the year.

perennial allergic rhinitis

Animal dander (cat or dogs), house dust mites and fungal spores (molds) produce symptoms year round. These are indoor allergens. They cause significant suffering.

risk factors

If allergy runs in your family, you are likely to develop it too. However, the risk is less in people of lower income countries, where there is overcrowding. Some external factors that can worsen or trigger the condition are-

  1. Wind
  2. Humidity
  3. Cold temperatures
  4. Smoking
  5. Pollution
  6. Chemicals and fumes
  7. Hairsprays
  8. Perfumes
Girl with runny nose
Girl on bed having runny nose

allergic rhinitis in children

Allergy in kids indicates sensitivity. They may develop asthma and respiratory difficulties at a later age. As a result, world over, we try to diagnose hay fever as early as possible to halt its progression to asthma. In addition to that, kids having allergies perform less at school and have sleeping difficulties. They are inattentive and irritable due to lack of sleep.

Asthma is another symptom of hypersensitivity. The same allergens causing hay fever, cause asthma as well. Therefore, allergy and asthma are inter-related. Asthma is more serious because the breathing difficulty can become life threatening if untreated.

when to consult a doctor? which specialist deals with allergies?

When symptoms are bothersome, take help from a specialist. These reduce your performance at work and school. Allergies cause sinusitis, bad breath and disturbed sleep as well. Above all, contact your physician if your kid has allergies. Early diagnosis and treatment of allergies in kids will prevent asthma.

ENT specialists, pediatricians, respiratory physicians and clinical allergists deal with patients of allergy. Allergic rhinitis is a purview of ENT specialists. One of the doctors in our panel, Dr. Shyam Kalyan N, is extremely passionate about allergy diagnosis and treatment. He has done an exhaustive study on the prevalence of allergy in sinusitis patients in New Delhi.

Do you suffer from symptoms of allergy? Are you unsure what to do? Talk to the experts in World ENT Care and find out what is the best treatment for you.

how do we diagnose allergic rhinitis?

After taking a thorough history your doctor may ask for a skin test. In this test, you place multiple allergens on separate sites on forearm and prick each of them. Thereafter, we wait for 10-15 minutes. A wheal and flare reaction occurs on the site of prick if you are allergic to that substance.

The skin prick test is performed in allergy labs by doctors trained in allergy diagnosis. The allergens used in the test must be prevalent locally. Another test for diagnosing allergy is RAST where we withdraw a blood sample and check for allergens in it. However, the skin test is more accurate.

how are allergies treated?

Antihistamines and steroids are the mainstay of treatment. First, antihistamines are drugs which counteract the effects of histamine in our body. Fexofenadine (Allegra), loratidine (Claritin) and cetrizine (Zyrtec) are the common antihistamines, for instance. Secondly, steroid nasal sprays suppress inflammation in nasal cavities. Steroid sprays can be used for months together. To relieve nasal blockage, decongestant drops are given for short terms. Thirdly, decongestant tablets like sudafed or phenylephrine are helpfu. However, they should be used under the doctor’s guidance because they are harmful in hypertensives. Lastly, for long term sufferers we suggest immunotherapy.

what is immunotherapy (allergy shots)?

In immunotherapy, we inject increasing amounts of allergen into the blood stream. Gradually the patient becomes immune to the allergen and doesn’t develop allergy symptoms when exposed. But this requires a long term commitment. And, you must visit your doctor once every few weeks for many months to a few years. The allergy shots offer a long term solution, though.

Allergy shot for allergic rhinitis

Immunotherapy can be given via skin injections (subcutaneous) and via a tablet placed under the tongue (sub-lingual). The sub-lingual method is becoming more common because it is more comfortable.

What is dupixent?

Dupixent (duplimab) is a special drug that is used in severe cases of allergies and chronic sinusitis. Talk to one of our experts to help you chalk out a plan.

what if i leave it untreated?

Not treating allergies in children leads to asthma. Asthma and allergy are due to sensitivity of the same airway. Allergic rhinitis manifests in nose, whereas asthma in the chest. Above all, that asthma is not as simple as hay fever. It can be life-threatening. Long term allergies cause sinusitis and ear infections. Recurrent attacks hamper professional and school performance. Finally, the sufferers have a very poor quality of life.

can i prevent allergies? are there home remedies?

Avoidance of allergens is the best remedy. Firstly, find out ways to prevent the entry of pollen inside the house. Keep windows closed and use an air conditioner. Remember to keep the filters of the A/C clean. Nextly, use a dehumidifier if humidity inside goes up. High-energy particulate air-filter (HEPA) attached to vacuum cleaners and A/Cs removes allergens. Thirdly, if you are allergic keep your pets in a separate area outside the house. Best is to not have animal around. At least give them a biweekly bath. Fourth, keep furry toys away from bedrooms. Clean curtains, carpets and bedding regularly. Lastly, saline nasal irrigation removes soot particles and allergens from the nose.

pollen causes allergic rhinitis
Boy playing with dandelion
  1. Maintain a pollen calendar
  2. Start allergy medicines before the attack
  3. Stay indoors when the pollen count is high
  4. Take a shower when you come home from outside
  1. Wear a mask when outside
  2. Keep windows and doors shut as much as possible
  3. Don’t exercise outside in early mornings
  4. Remove thick curtains and carpets from bedroom
  5. Immerse them in heated water before washing

We wish our readers find this article useful.

We at World ENT Care believe in reducing your sufferings from ENT ailments. With this aim we have brought to you an article on allergic rhinitis. Please mail in your comments and feedback to feedback@worldentcare.com

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