Allergic Rhinitis

Allergic rhinitis affects more than 40 million Americans.  It is a reaction to allergens…foreign substances, e.g. pollen, molds, and pollution that to most people are normally harmless, which trigger the release of a substance in the body called histamine, a potent inflammatory agent.  Simply put, body mechanisms are activated to try to eliminate the allergen(s) resulting in body responses such as sneezing, coughing, runny nose and “watery” eyes.

Seasonal allergic rhinitis (SAR) is often referred to as “hay fever,” but it seldom causes a fever and is rarely related to hay.  It is caused by a reaction to pollens from grass, trees, and/or weeds…any one or all of them.  It can occur anywhere from early spring through early fall.

SAR is different from a common cold, which exhibits similar symptoms, but which usually occurs from the end of one hay fever season until the start of the next.  Persons with SAR usually have no fever; the nasal secretions are clear and runny; and sneezes occur in rapid, multiple sequences.  It is often accompanied by itchiness in the nose, throat (especially on the roof of the mouth), ears, and eyes; and the symptoms last longer than those of the typical cold.

Because histamine release in the body is the culprit, it is logical to conclude that an antihistamine (AH) drug would be one form of treatment.  There are a number of older AH drugs available in generic form, which do not require a doctor’s prescription, that can provide low cost relief…probably less than the copay for a prescription AH drug.  One drawback for these products is that for some people they cause drowsiness.  A person should test out the product before operating machinery or driving.  Several newer, non-sedating AHs are available on prescription.

Current medical literature indicates that use of a cortico-steroid inhaled into the nose may be better than oral AHs.  These anti-inflammatory agents get right to the source of the irritated tissue and there are almost no side effects.  They do require a prescription.  You should ask your pharmacist to demonstrate the proper way to use the spray container because it is important to the effective and economic use of these products.  Doctors may supplement this form of treatment by also prescribing a non-sedating AH.

Hay fever attacks may be exhausting, but they cause no permanent damage.  However, if they persist and go unchecked, they can lead to sinusitis.  It is always best to check with your physician about choice of treatment.

July 2000

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