Allergic disorders are not uncommon in highly urbanized countries, especially allergic rhinitis which is presumed to be the most common form of respiratory allergy. Allergic rhinitis is the inflammation of the mucous membrane lining the nose brought about by the inhalation of allergens in the air. It affects about 10 to 20% of the American population, 20-30% of which are adolescents. Allergic rhinitis runs in families and can develop at any age. People with other types of allergy are more likely to suffer from this condition and there is a higher incidence among women.

Hay fever is an allergic rhinitis demonstrating a seasonal variation—induced by airborne pollens. Each change of season brings its own brand of irritants, and varies according to location:

• Early spring: tree pollen (oak, elm, poplar, olive)
• Early summer: rose pollen, grass pollen
• Early fall: weed pollen

Mechanisms of the Reaction

The inhalation of an antigen causes the production of antibodies that initiate a series of cellular reactions and in turn triggers the release of chemicals such as histamine, leukotrienes, and eosinophil chemotactic factor. Histamine is the major mediator of allergic reactions in the nose. As a result the mucous membrane of the nose reacts by generating excessive amount of mucus, itchiness, and swelling.

Typical symptoms include:

• clear, watery nasal discharge
• nasal congestion
• postnasal drip
• sneezing
• itchiness in the eyes, nose, and palate
• conjunctivitis in some instances

Headache, sinusitis, and nose bleeding can accompany allergic rhinitis. The severity depends on environmental exposure and responsiveness of the immune system. Symptoms are usually persistent and demonstrate a seasonal variation. Pollens and pollutants are rampant in spring and summer respectively, which gradually tapers off and disappear by the first frost.

What Your Doctor Can Do For You

Diagnosis of seasonal allergic rhinitis is mostly based on history and physical assessment. Tests include nasal smears, skin testing, and blood counts (Radioallegosorbent test)—a rise in IgE and eosinophil levels are indicative of an allergic reaction.

Treatment of allergic rhinitis is primarily aimed at its symptoms. Avoidance of the alleged allergen should be maintained. In cases that this couldn’t be done, medications such as antihistamines, adrenergic agents, corticosteroids, and mast cell stabilizers are prescribed by a board-certified allergist. Another method that can be used is allergen desensitization or immunotherapy. It is a gradual desensitization of the offending agent—increasing doses of specific allergens are administered over a long period of time. This is performed at a physician’s clinic because the administered agent can produce systemic side effects. It is also used in conjunction with the medications. However, there is no assurance that the hypersensitivity disorder is cured.

What You Can Do

As much as possible, avoid the allergens that cause an allergic attack. Environmental modifications involve simple measures that include the use of air conditioners and humidifiers, and a smoke-free environment. The home must also be kept clean free from dust, lint, and mites. And remember to cover the nose when sweeping the floor, dusting furniture, and changing linens.