Healthy Living

What You Need to Know About Hay Fever (Allergic Rhinitis)

What is Hay Fever?

What You Need to Know About Hay Fever (Allergic Rhinitis)

Seasonal allergic rhinitis is most commonly caused by:

  • Pollens and spores.
  • Flowering shrub and tree pollens are most common in the spring.
  • Flowering plants and grasses in the summer
  • Ragweed and molds in the fall.
  • Dust, household mites, air pollution, and pet dander may produce year-round symptoms.
Healthy Living

What You Need to Know About Hay Fever (Allergic Rhinitis)

Symptoms

Pollen is a common allergen.

Allergic rhinitis is caused by exposure to a specific allergen in a predisposed individual.  This leads to activation of inflammatory cells that release inflammatory mediators causing the symptoms.

 Symptoms

Symptoms of hay fever are similar to those of viral rhinitis but are usually persistent and may show seasonal variation.

  • Sneezing, nasal discharge, itching, nasal congestion and obstruction.
  • Transverse nasal crease may appear as people may wipe their nose in an upward motion.
  • Nasal symptoms are often accompanied by eye symptoms such as irritation, pruritus, conjunctival redness, and tearing.
  • A positive family history of atopy or allergy may be present.
  • Patients may have troubling nasal discharge in response to numerous nasal stimuli, including warm or cold air and odors.
  • Complications of allergic rhinitis include otitis media and sinusitis.
Healthy Living

What You Need to Know About Hay Fever (Allergic Rhinitis)

Things You Can Do to Prevent Attacks

Things You Can Do to Prevent Attacks

Conservative treatment

Avoiding or reducing exposure to airborne allergens is the most effective means of alleviating symptoms of allergic rhinitis, but this can be extremely difficult.

  • Covering pillows and mattresses with plastic covers.
  • Substituting synthetic materials (foam mattress, acrylics) for animal products (wool, horsehair), and removing dust-collecting household fixtures (carpets, drapes, bedspreads, wicker).
  • Air purifiers and dust filters may also aid in maintaining an allergen-free environment.
  • Nasal saline irrigations are a useful adjunct in the treatment of allergic rhinitis to mechanically flush the allergens from the nasal cavity. 
Healthy Living

What You Need to Know About Hay Fever (Allergic Rhinitis)

Antihistamines

Antihistamines
  • Antihistamines offer temporary, but immediate, control of many of the most troubling symptoms of allergic rhinitis.
  • Topical nasal sprays are particularly useful in patients who experience side effects of oral antihistamines, mostly xerostomia and sedation.
  • Antihistamine tolerance seems to develop and alternating effective antihistamines periodically can control symptoms over the long term.
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What You Need to Know About Hay Fever (Allergic Rhinitis)

Intranasal Corticosteroids

Intranasal Corticosteroids
  • More effective and less expensive than nonsedating antihistamines.
  • There may be a delay in onset of relief of 2 or more weeks.
  • Corticosteroid sprays may also shrink hypertrophic nasal mucosa and nasal polyps, thereby providing an improved nasal airway and good drainage.
Healthy Living

What You Need to Know About Hay Fever (Allergic Rhinitis)

Other Treatments

Other Treatments
  • Using antileukotriene medications such as montelukast.
  • Cromolyn sodium and sodium nedocromil are also useful adjunct agents for allergic rhinitis.
  • Intranasal anticholinergic agents, such as ipratropium bromide is helpful if rhinorrhea is a major symptom.
  • In some cases, allergic rhinitis symptoms are inadequately relieved by medication and avoidance measures. Immunotherapy (desensitization by immunotherapy injection) has been proven to reduce circulating IgE levels in patients with allergic rhinitis and reduce the need for allergy medications.