With changing seasons comes different seasonal conditions such as allergies. If you find yourself sneezing and coughing during certain times of the year, or maybe even throughout the year, you may have to schedule a visit with your doctor or certified allergist. 


What are allergies? 

 

Allergies are a result of the immune system's reaction to a foreign substance such as pollen, dust, bee venom, or even food. These substances, called allergens, do not inherently cause a reaction in other people but cause a reaction in allergic people. During an allergic reaction, the body releases histamine which are substances that identify an allergen as harmful even when they are not. Essentially, the body is responding to a false alarm which results in the symptoms experienced by the patient. 


One of the most common types of allergy is nasal rhinitis or nasal allergies. This type of allergy can affect all age groups and may be experienced seasonally or year-round. The most common allergen associated with seasonal nasal rhinitis is pollen from trees and plants during spring and fall. On the other hand, dust, animal dander, perfumes, cigarette smoke, and mold among other things may cause nasal allergies throughout the year. 

 

Signs and Symptoms


Symptoms appear when there is exposure to or contact with allergens. The release of histamine causes inflammation of the nasal passages which results in the symptoms experienced by the patient. 


The common symptoms of nasal rhinitis are: 


  • Runny nose 
  • Post-nasal drip 
  • Sneezing 
  • Stuffiness or nasal congestion 
  • Throat clearing and cough 
  • Itching 


In some cases, eye allergies and hives/rashes may appear. Allergic rhinitis may also trigger an asthma attack in asthmatic patients. Avoiding or limiting exposure to allergens is critical in controlling these symptoms. 

 

Diagnosis


Generally, a physical exam conducted by a physician is enough to diagnose minor allergies. In such cases, the physician looks at the signs and symptoms present and figures out the best treatment and prevention plan for the patient. Additionally, a blood test called ImmunoCAP may be done to detect the presence of antibodies to major allergens. 

 

Treatment and Management

 

There are several ways to go about treating nasal rhinitis. These include allergen avoidance and different types of medications. However, it is important to consult with health professionals before trying any medication or treatment. 


Avoiding allergens 

 

As they say: prevention is better than a cure. Identifying and avoiding allergens are the first things patients must do to prevent an allergic reaction. For instance, vacuuming and changing sheets often will help patients allergic to dust. Wearing protective equipment such as masks will also help those allergic to chemicals or dust when they are working. Staying indoors with windows and doors closed when pollen is high outside will benefit patients allergic to pollen. A few lifestyle changes to avoid or limit exposure to allergens will go a long way. 


Antihistamines


For mild cases of nasal rhinitis, oral and nasal spray antihistamines are often used. These medications prevent the binding of histamine to receptors in the body hence stopping or preventing symptoms. However, it is important to note that these types of medication may cause drowsiness or sedation. Popular over-the-counter antihistamines include Cetirizine and Loratadine. However, prescription antihistamines for more advanced allergic cases are also available such as: 


  • Fexofenadine (Allegra) 
  • Desloratadine (Aerius, Clarinex) 
  • Levocetirizine (Xyzal) 
  • Azelastine (Astelin) 


Steroid Nasal Sprays


Nasal corticosteroids are usually the first line of medications prescribed to treat nasal rhinitis. They have an anti-inflammatory mechanism thus reducing congestion, runny nose, itching, and sneezing. They are also effective for reducing eye allergy symptoms such as redness and puffiness. Corticosteroids may be used continuously or as needed only, however; continuous use proves to be more effective. Some side effects of corticosteroids are local irritation of the nasal cavity, dryness or burning, or in severe instances, septum perforation. Fortunately, these side effects may be avoided with proper administration techniques. 


Some examples of prescription nasal corticosteroids are: 


  • Mometasone Nasal Sprays (Nasonex) 
  • Beclomethasone Aqueous Spray (Qvar) 
  • Fluticasone Nasal Spray (Flixotide, Flonase) 


Asthma and Allergy 


For some asthmatic patients, allergies and asthma attacks go hand in hand. Though asthma and allergies are treated differently, there are a few treatments that can help both. Leukotriene modifiers such as Montelukast (Singulair) are effective in reducing both asthma and allergy symptoms. Another treatment is immunotherapy in which the patient is injected with small amounts of the allergen for them to develop tolerance and diminish reactions. 


Of course, in situations where allergy leads to a severe asthma attack, different inhaled anti-inflammatory medications may be prescribed to control symptoms. These may include fast-acting medications for instant relief of long-acting medications for longer treatments. Examples of these medications include: 


  • Albuterol inhalers or tablets (Ventolin) 
  • Fluticasone and Salmeterol (Advair Diskus) 
  • Budesonide and Formoterol (Symbicort)


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