Allergic rhinitis in spring

Allergic rhinitis, or hay fever, is an allergic response to specific allergens, occurs when your immune system overreacts to particles in the air that you breathe. Your immune system attacks the particles in your body, causing symptoms such as sneezing and a runny nose. People with allergies usually have symptoms for many years. They may have symptoms often during the year, or just at certain times. Over time, allergens may begin to affect you less, and your symptoms may not be as severe as they had been.
Causes of allergic rhinitis
When your body comes into contact with an allergen, it releases histamine, which is a natural chemical that defends your body from the allergen. This chemical can cause allergic rhinitis and its symptoms, including a runny nose, sneezing, and itchy eyes. Pollen is the most common allergen in seasonal allergic rhinitis. Grasses and weeds produce more pollen in the spring and fall Pollens from trees, grasses, and weeds cause allergic rhinitis. These are allergy symptoms that occur with the change of seasons. In addition to tree pollen, other common allergens include, grass pollen, dust mites, animal dander, which is old skin, cat saliva, mold.

Things such as cereal grain, wood dust, chemicals, or lab animals, can also cause allergic rhinitis. If you are allergic to pollens, you may have symptoms only at certain times of the year. If you are allergic to dust mites and indoor allergens, you may have symptoms all the time.
Symptoms of allergic rhinitis
Common symptoms of allergic rhinitis include,    sneezing, runny nose, stuffy nose, itchy nose, coughing, sore or scratchy throat, itchy eyes, watery eyes, frequent headaches, eczema-type symptoms, such as having extremely dry, itchy skin that can blister and weep, hives,excessive fatigue.

Someone feels one or more of these symptoms immediately after coming into contact with an allergen. Some symptoms, such as recurrent headaches and fatigue, may only happen after long-term exposure to allergens. Fever isn't a symptom of hay fever.
Types of allergic rhinitis
The two types of allergic rhinitis are seasonal and perennial. Seasonal allergies usually occur during the spring and fall season and are typically in response to outdoor allergens like pollen. Perennial allergies can occur year round, or at any time during the year in response to indoor substances, like dust mites and pet dander.
Risk factors for allergic rhinitis
Allergies can affect anyone, but you're more likely to develop allergic rhinitis if there is a history of allergies in your family. Having asthma or atopic eczema can also increase your risk of allergic rhinitis.
Some external factors can trigger or worsen this condition, including cigarette smoke, chemicals, cold temperatures, humidity, wind, air pollution, hairspray, perfumes , wood smoke, fumes.
Diagnosis

To find out if you have allergies, your doctor will ask about your symptoms and examine you. Knowing what symptoms you have, when you get them and what makes them worse or better can help your doctor know whether you have allergies or another problem.
If you have severe symptoms, you may need to have allergy tests to find out what you are allergic to.
v    Your doctor may do a skin test. In this test your doctor puts a small amount of an allergen into your skin to see if it causes an allergic reaction.
v    Your doctor may order lab tests. These tests look for substances that put you at risk for allergies.
v    A blood test, or radioallergosorbent test (RAST), is also common. It  measures the amount of immunoglobulin E antibodies to particular allergens in your blood.
 If you have minor allergies, you'll probably only need a physical exam. However, your doctor may perform certain tests to figure out the best treatment and prevention plan for you.
Treatments
There is no cure for allergic rhinitis. One of the best things you can do is to avoid the things that cause your allergies. You may need to clean your house often to get rid of dust, animal dander, or molds. Or you may need to stay indoors when pollen counts are high.
Unless you have another health problem, such as asthma, you may take over-the-counter medicines to treat your symptoms at home. Talk to your doctor before starting a regimen of any allergy treatment to make sure you are taking the best medications for your symptoms. You doctor can also help you determine which products are made for short-term use and which are designed for long-term management.
Antihistamines
You can take antihistamines to treat allergies. They work by stopping your body from making histamine. Some popular over-the-counter (OTC) antihistamines include: fexofenadine, diphenhydramine , desloratadine, loratadine, levocetirizine, cetirizine etc.
Decongestants
You can use decongestants over a short period, usually no longer than three days, to relieve a stuffy nose and sinus pressure.
Eye drops and nasal sprays
Eye drops and nasal sprays can help relieve itchiness and other allergy-related symptoms for a short time. However, depending on the product, you may need to avoid long-term use. Like decongestants, overusing certain eye drops and nose drops can also cause a rebound effect.
Corticosteroids can help with inflammation and immune responses. These do not cause a rebound effect. Steroid nasal sprays are commonly recommended as a long-term, useful way to manage allergy symptoms. They are available both over the counter and by prescription. You should talk to your doctor before starting a new medication. Make sure that a new allergy medication won't interfere with other medications or medical conditions.Your doctor may.

Complications of allergic rhinitis
Unfortunately, allergic rhinitis itself can't be prevented. Treatment and management are keys to achieving a good quality of life with allergies. Some complications that can arise from hay fever include:
v    inability to sleep from symptoms keeping you up at night
v    development or worsening of asthma symptoms
v    frequent ear infections
v    sinusitis or frequent sinus infections
v    absences from school or work because of reduced productivity
v    frequent headaches
Complications can also arise from antihistamine side effects. Most commonly, drowsiness can occur. Other side effects include headache, anxiety, and insomnia.
Prevention
The best way to prevent allergy symptoms is to manage your allergies before your body has a chance to respond to substances adversely. Consider the following preventive measures:
v    Stay indoors when pollen counts are high.
v    Avoid exercising outdoors early in the morning.
v    Take showers immediately after being outside.
v    Keep your windows and doors shut as frequently as possible during allergy season.
v    Keep your mouth and nose covered while performing yard work.
v    Try not to rake leaves or mow the lawn.
v    Bathe your dog at least twice per week to minimize dander.
v    Remove carpeting from your bedroom if you're concerned about dust mites.


Dr Nazma Akter
Resident Physician
Department of Medicine
MARKS Medical College & Hospital, Mirpur-14, Dhaka.