Chapter 17
Medical Highlight: Allergic Rhinitis or Hay Fever
Hay fever affects one in every five Americans. Over one billion dollars are spent every year to treat this disorder. Hay Fever is a misnomer, since hay is not the usual cause, and it does not cause fever. Early descriptions of sneezing, nasal congestion, and eye irritation while harvesting hay promoted the popular term. Allergic rhinitis (or irritation of the nose) is the correct term to describe this condition.
Symptoms – Symptoms include nasal congestion, a clear runny nose, sneezing, nose and eye itching, and tearing eyes. Loss of smell is common, and loss of taste occurs occasionally. Observers of the person experiencing allergic rhinitis will commonly notice frequent rubbing of the nose using the index finger. This is called the “allergic salute.” Allergic rhinitis can also lead to sinusitis and asthma.
Cause - Allergic rhinitis is frequently caused by plant proteins. Many trees, plants, and flowers produce protein particles called pollen, which are smaller than the tip of a pin. This pollen is usually invisible in the air. Pollen is a potent stimulator of allergic responses as it lodges in the nasal lining and the respiratory tract. A person is programmed to be allergic by his or her genetic make-up, and is destined to be allergic from birth.
Occurrence - Symptoms occur when pollen is in the air. Trees pollinate in the spring, grasses pollinate in the spring and summer, and weeds usually pollinate in the late summer and fall.
Diagnosis - Diagnosis is made by using pinpoint skin testing to identify the specific substance causing the allergy.
Treatment
1. Control the environment by closing windows, using air conditioners, and opting for dryers rather than clotheslines.
2. Medicate with antihistamines; discuss with your doctor the best type of antihistamine to use.
3. Control allergy symptoms with decongestant nasal sprays. These medications shrink the swollen membranes and make it easier to breathe. Decongestant nasal spray should not be used for more than five days without a doctor’s advice. If taken too long, decongestant nasal sprays may cause a rebound effect. A rebound effect is the worsening of the symptom when the drug is discontinued. Recent studies suggest that a salt water spray may be as effective, without the rebound effect.
4. If antihistamines and nasal sprays are not effective, allergy desensitization or immunotherapy may be prescribed.
Simple strategies may include:
· Watch the clock - Seasonal symptoms typically peak early in the morning. A once-a-day medication taken just before bedtime ensures that the drug will be circulating in the system by morning.
· Protect the eyes - Sunglasses help to shield the eyes from airborne pollens and curb the tendency to touch or rub the eyes. Touching transfers pollen from fingers to the eyes.
· Cry - Crying relieves eye irritation. Try artificial tears if natural tears are insufficient in volume.
Ref. Hay fever-allergic rhinitis http://www.medicinenet.com/script/main/art.asp?articlekey=377&p
Navigator Health-Sneeze Guards – AARP The Magazine, May-June 2003, p 17.