Allergic Rhinitis (Hay Fever)

Allergic rhinitis is inflammation of the lining of the nose. It is swelling of that lining, not an infection.

It is classed by the allergen that causes it. Seasonal allergic rhinitis comes from pollens and some moulds. Perennial rhinitis lasts all year and comes from house dust mites, animal dander and hair, and some moulds. The two groups cannot always be separated.

What happens in the body

When the body meets an allergen, the immune system releases histamine, which is a natural chemical. The reaction starts once the allergen enters through the airway, the skin or the stomach and intestines.

If it enters through the airway, the nose itches, you sneeze, the nose blocks and runs, and you cough. Headache, loss of smell and conjunctivitis can come with it. If it enters through the stomach and intestines, abdominal pain and diarrhoea follow. On the skin it causes itching and redness.

Causes

• A sensitive immune system
• Chemical allergens
• House dust and mites
• Grass, tree and weed pollens
• Fungal spores and moulds
• Animal hair
• Food with additives
• Indoor plants
• Environmental factors: smoky places, chemicals, air pollution, strong smells and damp

What it feels like

• A blocked nose and a runny nose
• Sneezing and coughing
• Pain, itching and a stuck feeling in the throat
• Loss of smell and taste
• Fullness and blockage in the ear
• A dry cough
• Watering and itching eyes, and bags under the eyes
• In children, rubbing the nose with the hand again and again, which is called the allergic salute
• Tiredness, difficulty concentrating and broken sleep
• Sometimes wheezy breathing, a tickly cough and headache

How the doctor makes the diagnosis

• A detailed history and a physical examination
• The signs the patient has
• Whether the signs follow the seasons
• The state of the lining inside the nose
• Blood tests and tests on the nasal mucus
• Skin allergy tests

Even when the tests come back negative, the examination and the signs settle the diagnosis.

Treatment, in order

1. Stop contact with the allergen. Children should also stay away from coloured food and food with additives.
2. Medicines. Antihistamines and steroid sprays for the nose.
3. Immunotherapy. Treatment that lowers the sensitivity to the allergen.
4. Surgery. Used for enlarged turbinates that block the nose, for polyps inside the nose, and for long-standing sinusitis that does not answer treatment. It reduces the patient’s complaints.
5. Phototherapy (Rhinolight).

Phototherapy

Rhinolight is the newest technology used for allergic rhinitis. It delivers high intensity light of a specific composition to the lining of the nose.

The treatment is given in sessions of a few minutes and it is painless. Its effect starts to show after one or two treatments. In patients with seasonal and with year-round allergic rhinitis, it reduces or removes itching, a running nose, blockage and sneezing.

What to pay attention to

• Stay out of dusty places and away from pollen.
• Keep doors and windows closed in the pollen season.
• Add moisture to the air in a centrally heated home.
• Air the rooms at regular intervals.
• Do not keep animals or plants in the house.
• Choose synthetic blankets instead of woollen and fluffy ones.
• Do not use carpets and other things that hold dust on the floor.
• Stay away from perfume and the smell of bleach.
• Do not sit in air conditioning, or fit a pollen filter to it.
• Take outdoor exercise, and take it around midday.
• Do not use air fresheners in rooms or in the car.
• Stress, overwork and food with additives all make allergy worse.