 |
Beauty and the Beast…
When Nature Reeks Havoc on Allergy Sufferers
‘Tis the season of blossoming trees, singing birds, and wildflowers exploding on California hillsides. Along with the spring’s floral bounty comes those itchy, watery eyes, wheezing coughs and runny noses -- that have struck nasal allergy sufferers with a vengeance.
Why are you suffering so much this season? In a word: pollen. Billions of those pesky microscopic particles produced by the trees, grasses, and plants gleefully fly through the air – sometimes as far away as 400 miles on a windy day – reproducing more vegetation of the same species, which emits more pollen the following year. The heavy rains have also produced healthier trees and vegetation, which in turn produce more pollen… and the cycle continues.
According to the American Academy of Allergy, Asthma & Immunology, symptoms of allergic rhinitis, or nasal allergies, affect 30 to 40 percent of children. The number of people affected decreases with age to one in five adult Americans, with eighty percent of allergy sufferers experiencing symptoms by age 20.
Exposure to pollen is inevitable because it is airborne. We all come into contact with it, getting it on our hands and unwittingly rubbing our eyes, nose and mouth, or simply breathing it into our nasal passages. Some people have the misfortune of being born with highly reactive immune systems that recognize pollen as a foreign allergen.
For these individuals, contact with pollen triggers an aggressive cascade response of the immune system, stimulating IgE antibodies attached to mast cells, which in turn release histamine. Histamine then stimulates other cells to produce more inflammatory chemicals, which further stimulates the immune system to “fight” the allergen. The result is burning, itching, watery eyes, increased mucous and nasal congestion.
Unfortunately, complications from allergy symptoms are not uncommon. Nasal lining congestion and inflammation can cause obstruction of the normal aeration of the sinuses, resulting in trapping of mucous within those sinuses, which can lead to infection known as sinusitis. Symptoms can be significant, including yellow nasal discharge, post-nasal drip, nighttime coughing, facial pain, tooth pain, and headaches.
Antibiotics are often required to clear these infections. If antibiotics are not effective, then further evaluation by an Ear, Nose, & Throat specialist (Otolaryngologist) may be necessary to examine the nasal lining with a special fiberoptic scope to rule out nasal polyps or anatomic abnormalities. A special x-ray of the sinuses (CT scan) may also be needed.
Ear infections can also occur because of restricted airflow through the eustacian tube (which allows air to travel between the nose and ear). Bronchospasm, which is a narrowing of the lung bronchi can also result, causing the wheezing and difficult breathing commonly seen in asthma.
To treat symptoms, the pharmacy aisle has hundreds of medications to choose from, but upon closer inspection there are only a few “active ingredients” on the label that are particularly useful. The most helpful of these are non-sedating antihistamines and decongestants.
Treatment considerations:
- Taking non-sedating antihistamines as the spring season approaches, before the body comes in contact with pollen, is the best way to block the effects of histamine and onset of symptoms. The active ingredient Loratidine (Brand: Claritin, Alavert) is a non-sedating antihistamine.
- Decongestants cause the blood vessels to constrict in the nose, thereby decreasing the swelling in the nasal lining, allowing for more comfortable nasal breathing. Pseudoephedrine (Sudafed®) and Phenylephrine belong in this class.
- Decongestant nasal sprays, which contain Oxymetazoline (Afrin®), work temporarily and should not be used for more than four days continuously. Otherwise the nasal symptoms may worsen because the nasal passages may become more congested. Also decongestants can increase your blood pressure so be sure to speak to your doctor before taking them.
If these medications fail, then your physician may prescribe a nasal steroid, a nasal antihistamine, anti-histamine eye drops, a different oral antihistamine, or another type of anti-inflammatory medication.
Although there is no cure for allergic rhinitis, there is hope. Researchers at Johns Hopkins University are working on a vaccine that could make allergy sufferers immune to the effects of pollen for many years. Alas, there is a long way to go from research to product. In the meantime, remember to avoid gardening on a windy day!
Bassem Said, M.D., specializes in Otolaryngology (Ear, Nose and Throat), including head and neck surgery. He is a member of the Sutter Delta Medical Group.
|
