7 Details about allergic rhinitis and hay fever
- It is not a disease that usually leads to serious consequences
- It greatly alters the quality of life of the patient
- It affects the ability to concentrate and study, being this important during school age.
- It requires an analysis of the causes in order to control it.
- It can be controlled in the vast majority of cases with appropriate treatment
- The side effects of treatment should be minimized.
- It is frequently associated with allergic asthma
Allergic rhinitis: Introduction.
NOTE: This article is intended to explain in a simple way and with understandable language for all patients the disease of allergic rhinitis, removing scientific terminology as much as possible.
When allergic rhinitis is caused by pollens, it is also called hay fever. Allergic rhinitis is a common disease in developed countries, globally affecting more than 500 million people in the world. However, despite being so frequent, institutions and mass media does not usually take it seriously enough, and this is so because allergic rhinitis almost never produces severe complications that endanger the life of the patient.
This fact means that, in turn, family or primary care doctors do not have the necessary training to treat it in all its depth until the total disappearance of the symptoms while avoiding the adverse effects of the medication. If you are reading this article, you may already be aware that the problem of this disease is in the alteration of the quality of life both at the level of leisure, studies, work, sleep, mood and, in short, having a life absolutely normal.
The disease is characterized by the presence of itching, sneezing, runny nose and nasal obstruction, which may or may not be accompanied by itching, tearing and redness of the eye. It is important to note that these mucus are of the watery type and not as occurs in rhinitis caused by infections. As a consequence of such a runny nose, when they fall backwards and not forwards, they can produce irritation that leads to an increase in coughing as well as a sensation of dryness in the throat, which is usually quite uncomfortable for the patient and in many cases not is treated correctly.
The nose and nasal cavities have an important number of functions such as smell, humidification of the air to enter the lungs, ventilation of the inner part of the ears, among others. In this way, allergic rhinitis can alter the normal function of the nose, influencing these functions.
Why do allergic rhinitis and hay fever occur?
The causes that lead to allergic rhinitis are really varied but they share a common characteristic and that is that it is produced by proteins that are capable of remaining floating for more or less time in the air, how pollens can be fungi molecules of dust mite molecules from cats dogs and other animals.
Explained in simple words, at some point in our lives our body’s defense system begins to recognize such molecules as harmful and therefore once it is back in contact with them, it sets in motion mechanisms to attack them. In other words, it is an error in our defensive system that leads us to have this disease.
How does allergic rhinitis and hay fever occur?
It is not the purpose of this article to explain in detail how the disease occurs. Explained so that every patient can understand, exposure to airborne protein in allergic patients will lead to the activation of a series of cells, most notably a so-called mast cell.
The patient must know that when said mast cell is activated, there are substances such as histamine that will be released in the first seconds or minutes while others will be released after several hours, being for this reason that there are initial symptoms produced by the protein called “histamine” and what consists of itching, sneezing and runny nose, and other later symptoms produced by the slow accumulation of inflammatory cells in the nasal region, these cells going to such a location thanks to the call of the activated mast cell.
How is allergic rhinitis and hay fever diagnosed?
The first thing to remember is that not all rhinitis is allergic and therefore your allergist should ask the appropriate questions and, if necessary, the corresponding tests to make sure that your allergy is the cause of it. It must also be taken into account that some patients may have both allergic and non-allergic rhinitis.
This diagnosis is important since it will determine if the treatment you need has been directed at the proteins and accumulation of cells that cause allergy, or on the contrary, it must be directed towards other mechanisms or even require the help of other specialists such as otolaryngologists. One sign that can give us an idea is that allergic rhinitis itches while non-allergic ones tend not to itch.
How is allergic rhinitis and hay fever treated?
The treatment of allergic rhinitis should be based on two aspects:
– Avoidance of the protein that causes rhinitis
– Correct use of drugs avoiding adverse effects
Avoidance of the protein that causes rhinitis
A correct diagnosis will help us to know if the protein causing your problem is a pollen, animal, fungus, mites that live in dust, or others. Once recognized, the easiest thing to do is avoid it but unfortunately this from a practical point of view is not really possible in all cases, because for example we cannot control nature in the case of pollens, or reduce house dust to zero. in the case of dust mites, or completely avoid contact with animals.
In addition, sometimes removing the protein that causes the problem may require strict measures at home and it is your allergist who can tell you if such measures are necessary. An example of the latter is that for a patient with mild allergic rhinitis due to dust mites, I would not recommend following all the strict measures such as frequent vacuuming of the house, removing carpets, sleeping with dust mite covers and placing of HEPA filters… while in a patient with severe rhinitis all these measures should be evaluated individually.
Correct use of drugs avoiding adverse effects
– Antihistamines: Above I have commented that histamine is produced in the first phase and causes itching, sneezing and a runny nose, therefore drugs that stop the effect of said protein will be useful for such symptoms and not very useful for other symptoms. These drugs often have side effects, including drowsiness, and your allergist can help you choose the drug that can solve the problem without creating side effects.
– Nasal spray with corticosteroids: Despite having corticosteroids, they are very safe since they are deposited in the nose and are barely absorbed by the rest of the body. As we said before, there is a late phase where an accumulation of cells occurs in the nose and it is for this accumulation of cells that nasal sprays with corticosteroids are effective
– Nasal washes: nasal washes with saline serum are a cheap remedy that helps to remove the proteins that cause a problem in the nose, being useful in patients with mild symptoms or as a complement to other therapies
– Allergy shots or immunotherapy: This treatment consists of the administration of progressive doses of the protein that gives you problems, being an effective treatment if used properly. It is indicated in those cases that do not respond to treatment with drugs and avoidance measures or individually in other patients.
– Others: there are other drugs that your allergist should evaluate their introduction, and these include anti-leukotrienes, & nbsp; nasal antihistamines, & nbsp; ipratropium bromide, or cromolyn among others. It should be noted the so-called nasal decongestants that are happily sold in pharmacies can produce very negative effects when the treatment lasts more than 5, highlighting the so-called drug rhinitis that produces a permanent nasal congestion very difficult to treat.
When should see an allergist to treat my rhinitis?
The reality is that if you have allergic rhinitis that you are able to control with your treatment in a total way, and by total I mean that it does not prevent you from any activities of your daily life, including work, sleep, leisure. … You would not benefit from an allergy consultation.
However, those people where their allergic rhinitis alters their quality of life or in those people where the drugs are insufficient or produce any type of adverse effect, would definitely benefit from a consultation with their allergist to have a life absolutely normal.
In addition, those of school age would also benefit, since in many cases allergic rhinitis affects their study performance without them being aware of it, since they have been having these symptoms for many years and they believe that it is normal to have them. In other words, he is like the child who cannot read the blackboard and it takes us years to realize that he needs glasses.
Every patient with accompanying asthma should also be seen by an allergist since asthma can cause very serious complications with relative frequency.
Those people who present complications such as frequent nose and ear infections, loss of smell, permanent obstruction should also be studied.
Scientific Publications on Allergic Rhinitis and Hay Fever:
By the author:
– Pollen counts stations in USA ( National Allergy Bureau ) : https://www.aaaai.org/global/nab-pollen-counts
– Latin American Society of Allergy, Asthma and Immunology: https://www.slaai.org/
– American Academy of Allergy Asthma and Immunology: https://www.aaaai.org/conditions -and-treatments / allergies