Hay Fever (Allergic Rhinitis) : Symptoms And Treatment

Hay fever is an allergic inflammation of the nasal mucosa caused by plant pollen. It is the most common allergy of all and occurs seasonally between spring and autumn when pollen from trees, grasses and herbs is in the air.

Typical symptoms are sneezing attacks, runny nose and itching in the mouth and throat. Hay fever is usually accompanied by an allergic disease of the conjunctiva and eyelids (allergic rhinoconjunctivitis). If the symptoms migrate towards the lungs and allergic asthma develops, there has been a change in levels from the upper to the lower airways.

Hay Fever (Allergic Rhinitis) Symptoms

Do you have sneezing attacks?

Is it itchy nose, mouth and throat?

 

Hay fever

 

These symptoms are typical of an allergic cold (allergic rhinitis) caused by flying pollen. Sneezing attacks, runny nose, stuffy nose and itching in the mouth and throat - sometimes also in the ears - are among the symptoms of hay fever. There is also fatigue and a general feeling of illness. The eyes are usually itchy and watery, they are red and sensitive to light, and even the eyelids can be swollen (allergic conjunctivitis). When symptoms in the nose and eyes occur at the same time, doctors speak of rhinoconjunctivitis. The symptoms can be so disturbing that a peaceful and restful sleep is unthinkable.

If, in addition to the hay fever symptoms described, there are also complaints such as coughing and wheezing, rattling breath, possibly combined with shortness of breath, it may be allergic asthma. The allergy has traveled down from the upper airways to the lungs. The doctors call this shifting of the symptoms a change of floors.

Sometimes cold symptoms don't stop even though the flowering and pollen season is long gone. Sneezing attacks, a runny nose or sore eyes persist all year round. The triggers for such a permanent allergic cold can usually be found within the house. It's mainly pets and dust mites, sometimes mold.

When is it hay fever and when is it a cold?

Many of the symptoms are similar to those of a cold, but there are differences. Colds usually announce themselves with a headache or a scratchy throat, an allergy begins suddenly with sneezing attacks. The itching in the nose, eyes and mouth associated with hay fever is often absent when you have a cold. In addition, the nasal secretion is very viscous in the case of an infection, and thin in the case of allergies. And the most important point of difference: hay fever only occurs when pollen is flying.

What happens in the body when you have hay fever?

Why do some people react with unpleasant symptoms to otherwise harmless substances such as pollen? This is because the human immune system has an important job to do. It is designed to protect the body from attackers. If he ingests a foreign substance through his nose, skin or gastrointestinal tract, his immune system begins to check it. Is the foreign substance harmless or dangerous? If the immune system detects danger, such as bacteria and viruses, it is its job to start a defense reaction. In allergy sufferers, the immune system is not always able to distinguish between harmful and harmless environmental substances. It classifies some harmless substances, such as pollen, as dangerous. As soon as it comes into contact with it, it forms antibodies called immunoglobulins of class E (IgE). This phase is called sensitization, because the allergic symptoms are still absent. The defense work, which involves sneezing and sniffling, only begins when the suspected attacker comes into contact again. Only when a person comes into contact with pollen for the second time do the IgE antibodies cause so-called mast cells to act. They release inflammatory messengers. The best known is histamine. Within a few minutes, but after two hours at the latest, histamine causes the typical symptoms of itchy eyes and sniffles. This means that hay fever belongs to the immediate allergic type (type I reaction).

Cross allergies

Many hay fever patients also suffer from food allergies. If you eat certain foods, your lips and mouth tingle and itch, you get stomach pains and flatulence. Luck in misfortune is: you do not have two allergies at the same time, but a pollen-associated food allergy. This is due to cross-reactions between the pollen and the food, because both have allergens that are the same or similar. For example, those who react to early bloomers such as birch often have problems biting an apple. People who are allergic to mugwort often cannot tolerate celery, pepperoni or raw carrots. The cross allergies do not always have to occur, they can be limited to the time of the respective pollen flight.

Hay fever in children

• Does your child sniffle all the time?
• Does it keep rubbing its nose for weeks?
• Does it walk around with its mouth open?
• Do you snore when you sleep because your nose is blocked?

Children suffering from allergic rhinitis suffer greatly. So if children have a stuffy nose for an unusually long period of time, their eyes are sticky, they cough in their sleep and wake up thirsty in the morning, these are indications of a possible allergy. Some children also suffer from body aches and fever. The symptoms usually begin from the age of three, often not until school age. If the symptoms persist all year round, pollen is not necessarily the cause, but animal hair, house dust mites or mold.

Hay Fever (Allergic Rhinitis) Treatment

Many people still take hay fever lightly. They don't go to the doctor even though they have been suffering from symptoms for years. There is a risk that the immune system will react allergically to more and more substances. Allergic asthma can also develop from hay fever. The disease travels from the upper airways down to the lungs, also known as the change of floors. Changing floors can possibly be avoided if allergic colds are treated in good time.

In order to diagnose a pollen allergy, the first thing to do is to talk to an allergist. He will ask under what circumstances the symptoms occur and how long they last. When are they performing? Rather in the morning or in the evening? At home or in nature? Are they seasonal, meaning only spring, summer, or fall? An allergy diary helps the doctor with the diagnosis. Once the preliminary talk (anamnesis) is over, the allergist will probably next carry out a skin test, a so-called skin prick test. He drips various allergens onto his forearm. The skin below the drops is then superficially scratched or punctured with a fine lancet or needle, which is generally painless. If itchy wheals or redness form in certain marked areas, the allergist can see which sensitizations have taken place.

In the case of small children, the specialists dispense with these skin tests and carry out a blood test straight away. Blood tests provide information about the presence of category E antibodies (immunoglobulin E, IgE). The total amount of IgE antibodies (RIST test) can be determined. Since the total amount of IgE antibodies is increased not only in allergies but also in other diseases, its value serves only as a guide. In a second blood test (RAST test), the blood can be examined for specific antibodies that have been formed against certain pollen.

If the diagnosis is difficult, there is the possibility of carrying out a provocation test. The doctor tries to provoke an allergic reaction under supervision in a practice or clinic. The allergen is dropped onto the nasal mucosa, for example.

If the tests are successful and the pollen that causes hay fever is identified, countermeasures can be taken. The therapy is based on several pillars: avoidance (pollen abstinence), treatment of the symptoms with medication and specific immunotherapy. In addition to conventional medicine, there are also alternative healing methods.

Avoiding pollen is hardly feasible. When trees, grass or grain are in bloom, the pollen flies for miles over town and country. That is why many pollen allergy sufferers would prefer to lock themselves in the apartment with the windows closed because they believe that there is no other way to get rid of the symptoms.

Medication

Many symptoms can be relieved with medication. Most preparations use the messenger substances histamine and leukotriene. These messenger substances are released by the so-called mast cells during allergic reactions and are responsible for the hay fever symptoms. The drugs have two options for intervening in the allergic process: either they prevent the mast cells from releasing the messenger substances, or they prevent the messenger substances from developing their effect.

• Antihistamines (histamine receptor blockers, histamine receptor antagonists) can be used both for local therapy and systemically for the whole body. Typical hay fever symptoms in the nose and eyes respond quickly to antihistamine sprays and drops. Both nasal sprays and eye drops often contain preservatives that can also trigger allergies. Without preservatives, eye drops often only last four weeks. Practical alternatives are single-dose preparations. Antihistamines in pill form combat symptoms throughout the body via the bloodstream. Therefore, they not only help with hay fever, but also alleviate symptoms such as allergic asthma or food allergies. Modern antihistamines such as cetirizine or loratadine hardly have any side effects such as tiredness and drowsiness. However, users react very differently. It is therefore advisable to try out the means before taking part in road traffic. To be on the safe side, they should also be taken before bed, as their effects generally last for 24 hours. Older antihistamines make you tired, which can be desirable in children, for example before going to bed.
• Mast cell stabilizers (cromones, e.g. cromoglicic acid) prevent the mast cells from releasing histamine or other messenger substances. To do this, the drugs need a certain lead time, which means that they do not work immediately, but with a delay. The use of these nasal sprays or eye drops should therefore be started at least a week before the expected pollen count.
• Glucocorticoids (e.g. cortisone) are active ingredients that are chemically derived from the hormones of the adrenal cortex. They have a strong anti-inflammatory effect. That is why they are only used for severe symptoms, especially when antihistamines and mast cell stabilizers are too weak. As a nasal spray, they take a few days to develop their full effect. There are now also low-dose nasal sprays that do not require a prescription. However, these should only be used over a longer period of time with professional advice.
• Alpha sympathomimetics (e.g. oxymetazoline, xylometazoline) are used as an active ingredient in nasal sprays that decongest the mucous membranes. These nasal sprays should not be used for more than seven days as they dry out the nasal mucous membranes and lead to permanent nasal congestion.
• Beta-2 sympathomimetics (e.g. salbutamol, fenoterol, salmeterol) dilate the bronchi. They are contained in asthma sprays against acute attacks or in longer-acting agents for long-term therapy.
• Leukotriene antagonists (e.g. montelukast) block the docking sites of the leukotrienes so that they can no longer work. Leukotrienes are among the inflammatory messengers that are mainly responsible for allergic asthma, but also for hay fever. Leutriene antagonists are taken as tablets or chewable tablets and require a prescription.

Alternate Methods

Many alternative healing methods are said to help with hay fever. Acupuncture is intended to alleviate acute symptoms and achieve a kind of desensitization in the long term. Few controlled studies have shown a modest effect on hay fever. In the field of homeopathy, too, there have been individual successes in the treatment of allergies to certain types of pollen. Methods such as bioresonance, autohemotherapy or electroacupuncture are considered unsuitable or useless for the treatment of pollen allergies.