Allergic rhinitis (hay fever, rose fever) is an inflammatory condition involving the mucous membranes of the eyes, ears, nose, throat and sinuses. It is triggered by inhaling airborne allergens. It is the most common allergic disorder affecting over 60 million people in the United States alone. Examples of allergens include mold spores, house dust mites, tree, grass and ragweed pollens and proteins from the skin and saliva of animals such as cats and dogs. For allergic rhinitis to occur, a person must first be sensitized to a particular allergen, a process, which may take months, or years. Sensitization results in the production of the allergic antibody, IgE, which is made specifically in response to each allergen.
Allergic symptoms may include a runny nose, sneezing and itching of the eyes, ears, nose or throat. Other associated symptoms may include tearing of the eyes, nasal swelling which may cause blockage of the sinus openings into the nose resulting in sinus headaches and bacterial sinus infection.
Allergic rhinitis symptoms are “seasonal” if associated with specific time periods related to pollination during the spring, summer or fall and are perennial if they occur on a year round basis. In Ohio, tree pollens are encountered in early March through May, grass pollens from mid-May through July and ragweed pollens from early August through the first frost. Some allergens responsible for perennial (year round) rhinitis include dust mites, molds and animal proteins.
The evaluation and diagnosis of allergic rhinitis begins with a careful history and physical examination by your doctor. The history is directed toward the nature of the symptoms, what time of year they are worse and what triggers the symptoms. Skin testing with allergen solutions is often required to confirm the suspected allergic factors. These tests will be explained and administered by a trained allergy nurse. Local swelling and itching at the skin test site usually indicates that an allergic antibody is present to the substances being tested.
The treatment of allergic rhinitis includes avoidance measures, drug therapy and allergy injections. If it is determined that substances such as dust mite and animals are responsible for your allergic rhinitis, one of our doctors may instruct you on avoidance measures. Drug therapy for allergic rhinitis consists of antihistamines and decongestant preparations available over the counter or by prescription. Also available are nasal cromolyn (Nasalcrom), nasal antihistamines (Astepro and Patanase) and nasal topical corticosteroids (Flonase, Nasarel, Nasacort, Nasonex, Omnaris, Rhinocort, Veramyst). These have been proven very effective in relieving allergic rhinitis symptoms if used under the appropriate circumstances. A suitable drug regimen will be recommended for you according to the severity of your symptoms while minimizing adverse side effects.
When avoidance and medication treatment prove ineffective, allergy injections may be an effective means for decreasing allergic symptoms and medication requirements. Allergy shots represent the only potential curative treatment for allergic rhinitis. The treatment involves receiving a series of injections under the skin to extracts or solutions of the allergens. On each injection visit to the office, the allergen dose is increased until a high dose or maintenance level is achieved. Approximately 85% of patients who achieve “maintenance” doses have significant improvement in their symptoms. Allergy shots require a time commitment on the patient’s part to attain the maximum therapeutic response. Details about scheduling and frequency of injections will be discussed with you if allergy shots are recommended.