Environmental allergens, which can cause symptoms of allergic rhinitis, affect an estimated 40-50 million people in the United States. This ends up being about 20-25% of the general population. Some allergies may interfere with day-to-day activities or lessen the quality of life.
"Hay fever" is a century-old term that has come to describe the symptoms of allergic rhinitis, especially when it occurs in the late summer. However, the symptoms are not caused by hay (ragweed is one of the main culprits) and are not accompanied by fever. So, the term "allergic rhinitis" is more accurate.
Rhinitis is a term describing the symptoms produced by nasal irritation or inflammation. Symptoms of rhinitis include: runny nose, increase post nasal drainage down the back of the throat, itching, sneezing, and/or stuffy nose due to blockage or congestion. They are often associated with itching of the eyes. Sometimes the sinuses can be affected also, causing sinus pressure, sinus headaches, or sinus infections.
Allergic rhinitis takes two different forms:
• Seasonal: Symptoms of seasonal allergic rhinitis occur in spring, summer and/or early fall. They are usually caused by allergic sensitivity to pollens from trees, grasses or weeds.
• Perennial: People with perennial allergic rhinitis experience symptoms year-round. It is generally caused by sensitivity to house dust mites, animal dander, cockroaches and/or mold spores.
Some people may experience both types of rhinitis, with perennial symptoms getting worse during specific pollen seasons. There are also non-allergic causes for rhinitis, such as chemical and irritant exposures to cigarette smoke, cleaning products, and perfumes; temperature changes; and infections, just to name a few.
When a sensitive person inhales an allergen (allergy-causing substance) like ragweed pollen, the body's immune system reacts abnormally. The allergen binds to allergic antibodies (immunoglobulin E, or IgE) that are attached to cells that produce histamine and other chemicals. The pollen "triggers" these cells in the nasal membranes, causing them to release histamine and the other chemicals. Histamine dilates the small blood vessels of the nose making fluids leak out into other tissues. This causes runny noses, watery eyes, itching, swelling and other allergy symptoms. Antibodies circulate in the blood stream, and collect in the tissues of the nose and in the skin. This makes it possible to show the presence of these antibodies by skin testing, or less commonly, by a special IgE allergy blood test. A positive skin test mirrors the type of reaction going on in the nose.
Sometimes several conditions can coexist in an allergic individual. Allergic rhinitis can be complicated by non-allergic rhinitis, septal deviation (curvature of the bone and cartilage that separate the two sides of the nose) or nasal polyps (abnormal growths inside the nose and sinuses). Any of these conditions will be made worse by catching a cold.
You may decide to see an allergist since he/she has received specialized training and expertise in managing allergies, allergic rhinitis and asthma. The allergist will begin by taking a detailed history, looking for clues in your lifestyle that will help pinpoint the cause of your symptoms. You'll be asked about the frequency and severity of your symptoms, your work and home environments, your eating habits, your family's medical history, and miscellaneous matters, such as if you have pets. Your allergist may use skin testing, in which small amounts of suspected allergen are introduced into the skin. In rare cases, it also may be necessary to do a special IgE allergy blood test for specific allergens. Allergists can help you develop a plan for your rhinitis treatment. The goal will be to enable you to lead a life that is as normal and symptom-free as possible.
Once allergic rhinitis is diagnosed, treatment options include: education, avoidance, medication and immunotherapy (allergy shots).
While it's difficult to escape pollen and molds, here are some ways to lessen exposure.
• Keep windows closed and use air-conditioning in the summer, if possible. Automobile air conditioners help, too.
• Don't hang clothing outdoors to dry. Pollen may cling to towels and sheets.
• The outdoor air usually is most heavily saturated with pollen and mold between 5 a.m. and 10 a.m., so early morning is a good time to limit outdoor activities.
• Wear a pollen mask (such as a NIOSH rated 95 filter mask) when mowing the lawn, raking leaves or gardening, and take appropriate medication beforehand.
• A common question from allergic rhinitis sufferers is: Can I move someplace where my allergies will go away? Some allergens are tough to escape. Ragweed, which affects 75 percent of allergic rhinitis sufferers, blankets most of the United States. Less ragweed is found in a band along the West Coast, the southern-most tip of Florida and northern Maine, but it is still present. Even parts of Alaska and Hawaii have a little ragweed.
• Allergists seldom recommend moving to another locale as a cure for allergies. A person may escape one allergy to ragweed, for example, only to develop sensitivity to grasses or other allergens in the new location. Since moving can have a disrupting effect on a family financially and emotionally, relocation should be considered only in an extreme situation and only after consultation with an allergist.
When avoidance measures don't control symptoms, medication may be the answer. Medications help to reduce nasal congestion, runny nose, sneezing and itching. They are available in many forms, including tablets, nasal sprays, eye drops and liquids. Some medications may cause side effects, so it is best to consult your allergist regarding your treatment plan.
You may also be a candidate for Immunotherapy. The lower your tolerance to allergens, the more strongly they react. This in turn causes more symptoms, which may require more medications to control symptoms. The immune tolerance can be raised by immunotherapy.
Allergies are a common disease in people. Effective treatment exists for most people. Speak with your physician if you have questions about the disease or the treatment options.
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