Hay fever, also called allergic rhinitis, is due to inflammation of the membrane lining the nose, throat and eyes. This inflammation is the result of an allergic reaction to specific airborne substances known as allergens.
Allergic rhinitis may occur only during the spring and summer, in which case it is known as seasonal allergic rhinitis or hay fever and is due to inhaled pollen. If it occurs all year round it’s called perennial rhinitis and is most commonly due to an allergy to house dust. Allergic rhinitis is more common in people who have other allergic disorders, such as asthma, eczema or migraine; that is, they have atopy.
Causes of Hay Fever
Flowers, trees and grasses release pollen or spores in vast numbers. Each has its own protein fingerprint, which causes an allergic reaction in the nose, throat and lungs. They are called allergens – something that provokes allergy. Animals are another source of allergens, whether hairs or fragments of skin (dander).
Seasonal allergic rhinitis is usually due to grass, tree, flower or weed pollens; it occurs mostly in the spring and summer when pollen counts are high. The most common allergens that provoke perennial allergic rhinitis include house dust and dust mites, animal fur and dander, feathers and mould spores.
In hot weather, car fumes and pollution may combine to cause a chemical effect that imitates the eyes and noses of those who do not normally suffer from hay fever. Different people are sensitive to different allergens: some have a general hypersensitivity to all allergens and thus have symptoms all year round – termed perennial rhinitis.
Symptoms of Hay Fever
Do not be tempted to exceed the recommended dose. The whole range of drugs used in asthma may also be used in severe hay fever, for example steroid sprays and substances to dilate the airways such as salbutamol and cromoglycate.
The most common symptoms are itchy eyes and sneezing. The red eyes stream with tears; the nose runs. There is often a tickle in the throat. In severe cases the lungs are affected; there is a persistent cough or wheezing, like asthma.
The symptoms of both forms of allergic rhinitis usually appear soon after contact with the allergen but tend to be more severe in hay fever. They include:
- itchy sensation in the nose » frequent sneezing
- blocked, runny nose
- itchy, red, watery eyes.
Some people may develop a headache. If the lining of the nose is severely inflamed, nosebleeds may occur.
There are all degrees of severity from mild nuisance to fighting a battle each summer against breathlessness and discomfort. Fortunately, there is a tendency to grow out of hay fever during adult life. After years of hay fever one nostril may feel constantly blocked. This may be due to a polyp, which is a harmless fleshy growth that can be surgically removed.
Treatment of Hay Fever
A selection of modem remedies is available for hay fever. Antihistamines are, for most people, the mainstay of treatment. They reduce the severity of the allergic response and a single tablet helps all the symptoms. Modern antihistamines such as astemizole or loratadine are taken just once or twice a day and rarely cause the drowsiness which the older types do. They are available in liquid form suitable for children.
Antiallergy eye drops contain substances that block the allergic response, for example cromoglycate. Extremely safe, they have to be applied several times a day for full effect.
Nasal sprays contain cither low doses of steroids, for example beclomethasone, or the same antiallergy substances used in eye drops. They are safe for long-term use because the steroids are absorbed within the nose itself and only negligible amounts arc absorbed into the body as a whole. Nevertheless,
General measures and surgery of Hay Fever
To reduce the impact of hay fever avoid bright sunlight; drive with car windows closed and try to keep windows at home shut in the heat of the day. Avoid animals you know you react against. While inconvenient, these measures are unavoidable if symptoms are not fully controlled by other methods.
Surgery is a possibility for those who arc not helped by standard remedies. The lining of the nose is removed, relieving the persistent stuffiness and discharge.
Desensitisation and allergy testing For Hay Fever
In practice allergy testing is rarely useful (see Asthma).
Desensitisation is done by giving stronger and stronger injections of whatever the individual is allergic to. There is a risk of provoking a serious allergic response, sudden collapse or even death, however, so it is no longer recommended, except in specialised clinics with full resuscitation facilities.
Complementary Treatment For Hay Fever
Bach flower remedies Rescue Remedy and crab apple diluted in water to bathe sore eyes. Shiatsu-do can help reduce sensitivity to allergens.
Diet – allergy to food and to pollen may be linked; consult a nutritional therapist or a naturopath for advice. Hypnotherapy can be used in conjunction with a desensitising programme.
Other therapies to try: Chinese and Western herbalism; tai chi/chi kung; chakra balancing; healing; homoeopathy.
What Might Be Done For Hay Fever?
- Your doctor may recognize allergic rhinitis from your symptoms, particularly if you can identify the substance that triggers a reaction, ♦ A skin prick test may be performed in order to identify the allergen that causes the allergic rhinitis. In some cases, the allergen cannot be found
- If you can avoid the allergens that affect you, your symptoms will subside.
- Oral antihistamines are often combined with decongestants to relieve inflammation and itching.
- Many anti-allergy drugs are available over the counter or by prescription. For example, allergies can be blocked by nasal sprays that contain cromolyn sodium.
- Alternatively, nasal corticosteroids in the form of a spray are effective for hay fever but may take a few days to work.
- Nasal sprays containing decongestants can relieve symptoms but should not be used regularly.
- Eyedrops may help relieve eye symptoms.
- Rarely, if symptoms are severe, your doctor may prescribe an oral corticosteroid.
The most specific treatment for allergic rhinitis is immunotherapy, in which you arc injected with gradually increasing doses of allergen with the aim of desensitizing the immune system. This treatment, which typically takes as long as 3-4 years, is not always successful.
Hey Fever Calendar
Coping with hay fever (allergic rhinitis)
Perennial allergic rhinitis
The measures listed below are all aimed at maintaining an allergen-free environment in your home in order to prevent perennial allergic rhinitis.
- Avoid keeping furry animals as pets if you are allergic to them.
- Replace pillows and quilts containing animal materials such as duck feathers with those containing synthetic stuffing.
- Cover mattresses with plastic.
- Remove dust-collecting items such as upholstered furniture and curtains if possible.
To help prevent the symptoms of hay fever, the following measures may be effective.
- Avoid areas with long grass or where grass is being cut.
In summer, keep doors and windows closed and spend as much time as possible in air-conditioned buildings.
- Try to stay inside during late morning and early evening when the pollen count is highest.
- Keep car windows shut while driving.
- Make sure your car is fitted with an effective pollen filter.
- When outside, wear sunglasses to help prevent eye irritation; sunglasses