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    Allergic rhinitis

    Hay fever; Nasal allergies; Seasonal allergy; Seasonal allergic rhinitis

    Allergic rhinitis is agroup of symptoms affecting the nose. These symptoms occur when you breathe in something you are allergic to, such as dust, animal dander, or pollen. Symptoms can also occur when you eat a food that you are allergic to.

    This article focuses on allergic rhinitis due toplant pollens. This type of allergic rhinitis is commonly called hay fever or seasonal allergy.

    Causes

    An allergen is something that triggers an allergy. When a person with allergic rhinitis breathes in an allergen such as pollen,mold, animal dander,or dust, the body releases chemicalsthat cause allergy symptoms.

    Hay fever involves an allergic reaction to pollen.

    Plants that cause hay fever are trees, grasses, and weeds. Their pollen is carried by the wind. (Flower pollen is carried by insects and does not cause hay fever.) Types of plants that cause hay fever vary from person to person and from area to area.

    The amount of pollen in the air can affectwhether hay fever symptoms develop.

    • Hot, dry, windy daysare more likely to havea lotof pollen in the air.
    • On cool, damp, rainy days, most pollen is washed to the ground.

    Hay fever and allergies often run in families. If both of your parents have hay fever or other allergies, you are likely to have hay fever and allergies, too. The chance is higher if your mother has allergies.

    Symptoms

    Symptoms that occur shortly after you come into contact with the substance you are allergic to may include:

    • Itchy nose, mouth, eyes, throat, skin, or any area
    • Problems with smell
    • Runny nose
    • Sneezing
    • Watery eyes

    Symptoms that may develop later include:

    • Stuffy nose (nasal congestion)
    • Coughing
    • Clogged ears and decreased sense of smell
    • Sore throat
    • Dark circles under the eyes
    • Puffiness under the eyes
    • Fatigue and irritability
    • Headache  

    Exams and Tests

    The health care provider will perform a physical exam and ask about your symptoms. You will be asked whether your symptoms vary by time of day or season, and exposure to pets or other allergens.

    Allergy testing may reveal the pollen or other substances that trigger your symptoms. Skin testing is the most common method of allergy testing.

    If your doctor determines you cannot have skin testing, special blood tests may help with the diagnosis. These tests, known as IgE RAST tests, can measure the levels of allergy-related substances.

    A complete blood count (CBC) test called the eosinophil count may also help diagnose allergies.

    Treatment

    LIFESTYLE AND AVOIDING ALLERGENS

    The best treatment is to avoid the pollens thatcause your symptoms. It may be impossible to avoid all pollen. But you can often take steps to reduce your exposure.

    You may be prescribed medicine to treat allergic rhinitis.The medicine your doctor prescribes depends onyour symptomsand how severe they are.Your age and whether you have other medical conditions, such as asthma, will also be considered.

    For mild allergic rhinitis, a nasal wash can help remove mucus from the nose. You can buy a saline solution at a drug store or make one at home using one cup of warm water, half a teaspoon of salt, and pinch of baking soda.

    Treatments for allergic rhinitis include:

    ANTIHISTAMINES

    Antihistamines work well for treating allergy symptoms. Theymay beused when symptoms do not happen often or do not last long. Be aware of the following:

    • Many antihistamines taken by mouth can be bought without a prescription.
    • Some can cause sleepiness.You should notdrive or operate machines after taking this medicine.
    • Otherscause little or no sleepiness.
    • Antihistamine nasal sprays work well for treating allergic rhinitis. Ask your doctor if you should try these medicinesfirst.

    CORTICOSTEROIDS

    • Nasal corticosteroid sprays are the most effective treatment for allergic rhinitis.
    • They work best when used nonstop, but they can also be helpful when used for shorter periods of time.
    • Many brands are available. You will need a prescription from your doctor.
    • Corticosteroid sprays are generally safe for children and adults.

    DECONGESTANTS

    • Decongestants may also be helpful for reducing symptoms such as nasal stuffiness.
    • Do not use nasal spray decongestants for more than 3 days.

    OTHER MEDICINES

    • Leukotriene inhibitors areprescription medicines that block leukotrienes. These are the chemicalsthat the body releases inresponse to an allergen that also trigger symptoms.

    ALLERGY SHOTS

    Allergy shots (immunotherapy) are sometimes recommended if you cannot avoid thepollen and your symptoms are hard to control. This includes regularshots of the pollen you are allergic to. Each dose is slightly larger than the dose before it, until you reach the dose that helps control your symptoms. Allergy shots may help your body adjust to thepollenthat is causing the reaction.

    Outlook (Prognosis)

    Most symptoms of allergic rhinitis can be treated. More severe cases need allergy shots.

    Some people, especially children, may outgrow an allergy as the immune system becomes less sensitive to the trigger. Butonce a substance, such as pollen,causes allergies, it often continues to have a long-term effect on the person.

    When to Contact a Medical Professional

    Call for an appointment with your health care provider if:

    • You have severe hay fever symptoms
    • Treatment that once worked for you no longer works
    • Your symptoms do not respond to treatment

    Prevention

    You can sometimes prevent symptoms by avoiding the pollen you are allergic to. During pollen season, you should stay indoors where it is air-conditioned, if possible.

    References

    Frew AJ. Allergen immunotherapy. J Allergy Clin Immunol. 2010 Feb;125(2 Suppl 2):S306-13.

    Greiner AN, Hellings PW, Rotiroti G, Scadding GK. Allergic rhinitis. Lancet. 2011;378(9809):2112-2122.

    Orban NT, Saleh H, Durham SR. Allergic and non-allergic rhinitis. In: Adkinson NF Jr., Bochner BS, Busse WW, et al., eds. In: Middleton’s Allergy Principles and Practice. 7th ed. Philadelphia, Pa.: Elsevier Mosby; 2008:chap 55.

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    • Allergies

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    • Allergic rhinitis

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    • Recognizing invader

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    • Allergies

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    • Allergy symptoms

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    • Allergic rhinitis

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    A Closer Look

    Talking to your MD

    Self Care

    Tests for Allergic rhinitis

      Review Date: 5/27/2013

      Reviewed By: Stuart I. Henochowicz, MD, FACP, Associate Clinical Professor of Medicine, Division of Allergy, Immunology, and Rheumatology, Georgetown University Medical School. Also reviewed by David Zieve, MD, MHA, Bethanne Black, and the A.D.A.M. Editorial team.

      The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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