Hay Fever

What is hay fever?

Hay fever, otherwise known as seasonal allergic rhinitis, is an allergic reaction to airborne substances such as pollen that get into the upper respiratory passages - the nose, sinus, throat - and also the eyes. Different microscopic substances get into the nose and cause the body to produce antibodies and release histamine. Histamine irritates the upper respiratory passages, making them swell and producing the typical hay fever symptoms.

A tendency to suffer from allergies is often hereditary. The most common causes of hay fever are:

  • Tree pollen such as elder, elm, hazel and especially birch (spring hay fever)
  • Grass pollen (summer hay fever)
  • Ragweed and mugwort (autumn hay fever)
  • House dust mites and mold fungus - particularly associated with perennial allergic rhinitis
  • Animal saliva, urine and dander-Cats and dogs are most common, but people can be allergic to mice, rats, gerbils, guinea pigs, hamsters, rabbits, horses and even ferrets! Allergies to these animals can be perennial if they are pets or episodic upon exposure as in the case of horses or when visiting homes where these animals are present. You can even react to the presence of dander on someone’s clothes!

What are the symptoms of hay fever?

  • Itchy and watery eyes
  • Itching on the roof of the mouth
  • Coughing
  • Wheezing or a burning sensation in the throat

How is hay fever (allergic rhinitis) diagnosed?

History and physical along with specific allergy testing will be performed during your visit. Allergy testing can be used to confirm the antigen causing allergic symptoms. Hay fever sufferers are more vulnerable to other allergic respiratory diseases, eg. asthma, and sleeping difficulties that can lead to chronic fatigue (because of blocked nasal passages and snoring). Proper identification of allergen can help guide treatment.

How is allergic rhinitis treated?

The most common treatment recommendation is to have the patient avoid the allergens causing the allergic sensitivity. This may be feasible if the allergen is cat, dog or dust but is difficult when symptoms are due to pollen .Symptoms may be controlled with nasal saline irrigations, nasal steroid sprays, and/or antihistamines. Allergy hyposensitization with immunotherapy may be considered in patients that are refractory to treamtent or patients who cannot tolerate medications/prefer not to take medications.

Immunotherapy is a process in which an allergic patient can become desensitized to those pollens and inhalants that trigger allergic rhinitis (nasal congestion), allergic conjunctivitis, asthma and insect reactions. Small doses of the actual allergic substance are injected weekly. Each week the dose is increased. Gradually a protective antibody, also known as Immunoglobulin G, is formed to block the allergic reaction. When someone has allergy, they have high levels of the allergic antibody, Immunoglobulin E (IgE), in their blood. This IgE is activated by the allergen (dust mites, ragweed, cat, etc), and it attaches itself to “mast” cells that release histamine. The histamine causes a release of a fluid that causes swelling and congestion. It can cause a tightening of the airways to create asthma.

The change induced by immunotherapy is gradual. Many patients notice an improvement within six (6) months at which time the patient should schedule a 6-month evaluation appointment. Progress is evaluated every six (6) months to one (1) year. Immunotherapy does not work in about 5% of patients who were correctly diagnosed to have significant allergies.

Patients with pollen sensitivities benefit most from this treatment. IT is also effective in reducing the onset of pollen-induced asthma. After your visit we can determine your allergen sensitization and discuss the best options for you.

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