Allergic Rhinitis – “Hay Fever”

Allergic rhinitis is caused by inflammation and irritation of the mucus membranes of the nose, sinuses, throat, eyes, and ears. This condition is caused by the interaction of allergens (allergy causing substances) with allergy cells lining the membranes of the respiratory tract. Allergic rhinitis is a very common condition, with data suggesting it effects 20% – 30% of the U.S. population. Common allergens include: tree, grass and ragweed pollen, mold, cat and dog dander, dust mites and cockroaches.

Symptoms of Allergic Rhinitis Include:

  • Sneezing, Often Occurring in Bouts
  • Clear, Watery Nasal Discharge
  • Scratchy Throat
  • Nasal Congestion
  • Itchy Nose
  • Cough
  • Itching, Watering and Red Eyes
  • Alteration of Sense of Smell and Taste
  • Itchy Ears
  • Dark Circles Under Eyes, “Allergic Shiners”
  • Facial Pain and Pressure

The tendency to develop allergies is both genetically and environmentally determined. When a susceptible person is exposed to an allergen, the body’s immune system reacts abnormally. Normally, the body encounters and “remembers” foreign substances such as bacteria and viruses and gets rid of them. Allergic reactions occur when the immune system mistakenly learns to “remember” innocent foreign substances and sees them as harmful. The immune system produces allergic antibodies that attach themselves to mast cells that line the nasal passages and upper respiratory tract.

When the allergen is inhaled again, the antibodies detect something that they recognize as an “enemy” and the mast cells release powerful chemicals such as histamine. This causes the blood vessels to swell and begin leaking fluid into the surrounding tissues causing allergy symptoms.

An allergic rhinitis diagnosis usually comes after taking a detailed history, looking for allergen exposures and typical symptoms. The history includes: discussion of the home and work environment; the type, frequency and severity of symptoms; when symptoms occur; family history; and information regarding pets.

Skin testing may be performed to identify the cause of the allergy symptoms. Occasionally, a special allergy blood test is ordered.

Once allergic rhinitis is diagnosed, treatment options include avoidance of allergens and taking medications for symptom control. Allergen immunotherapy (allergy shots, allergy drops or allergy tablets) may be recommended in instances where allergen exposure is unavoidable, medications are not sufficiently helpful, side effects are experienced from medications or allergens trigger asthma. Allergy shots and drops (immunotherapy) have been shown to be very effective in controlling allergic symptoms.