This month we continue our conversation with Dr. Viktória Kovács, a FirstMed Ear, Nose and Throat (ENT) specialist, about allergies. We’ll start off by discussing tips for coping with allergic rhinitis, or hay fever as it is more commonly known, including therapy and medications.
Just to recap, allergic rhinitis is a type of inflammation in the nose caused by the immune system overreacting to allergens in the air. There are two basic types, seasonal and perennial, with seasonal strongest during pollen seasons. The pollen doesn’t come from insect-pollinated plants, such as flowers, as this type of pollen is far too large to stay airborne for any length of time. Perennial allergies occur through the year and most commonly affect children.
What advice is there for those who suffer most from allergic rhinitis?
If you have hay fever it is very important to try to avoid coming into contact with allergens, or at least to decrease the concentration. To do this it is recommended to follow these tips:
- Try to spend less time outside during allergy season.
- Wearing eyeglasses, or sunglasses, helps to prevent pollens becoming stuck in your conjunctiva, which is a membrane that covers the front of the eye and lines the inside of the eyelids.
- If you start feeling symptoms of contact with pollen, wash your face, hands and hair more often, and start rinsing your nose with a nasal irrigator such as a neti pot.
- Understand that long hair, mustaches and beards are excellent places for pollens to collect.
- Keep your windows closed in allergy season or when weather is warm and windy. Do not sleep with windows open.
- When travelling by train, keep windows closed. Find a seat in the first car after the engine, sitting in the middle of the carriage.
- When driving keep the windows closed and change your pollen filters often.
- Dust or change your clothes before entering your home and do your best not to bring your outdoor clothes into your bedroom.
- Do not keep flowerpots in the house, to reduce airborne pollen.
- Avoid honey and desserts made with honey or propolis. Skip herbal teas because drinking them might raise your allergic symptoms.
- Choose your holiday wisely. Avoid travel in the period of the allergy season when you suffer from the worst symptoms.
- When you’re taking medication and symptoms start to improve, do not stop your therapy before the end of the course because you might get even worse in the presence of allergens.
Reactions between the pollens and certain foods (OAS: oral allergy syndrome):
Some foodstuffs, mostly vegetables, fruits and herbs, are just like pollens. When normally consumed, a slight allergic reaction may be experienced but not enough to warrant exclusion from the diet. When eating them during pollen season, the immune system recognizes the pollen and similar proteins in the food and directs an allergic response to them. Fortunately, people affected can usually eat the same fruits or vegetables if they have been cooked because the proteins are distorted by cooking so that the immune system no longer recognizes the food.
There is a connection between these foods and allergens: (Pollen: Food)
- Ragweed pollen: banana, sunflower seeds, melons, cucumber, zucchini
- Grass pollen: melons, tomatoes, oranges, celery, peach
- Birch pollen: apple, almond, carrot, celery, cherry, cumin, dill, hazelnut, kiwi, peach, pear, plum
- Dust mites: shellfish
Many people have no idea that they suffer from oral allergy syndrome, or OAS. When swelling, tingling or pain develops while eating certain foods, then it is wise to see a professional such as an Ear, Nose and Throat or allergy specialist. Before testing begins it is suggested keeping a food log or diary so the physician can then perform an allergy test and avoid random testing. The diagnosis of OAS usually involves skin-prick tests and blood tests to determine the cause of the reaction.
Can allergic rhinitis be cured?
Currently it cannot be cured because we are still unclear we even have allergies in the first place. Fortunately, symptoms can be reduced with medications. Another form of relief could come from allergen immunotherapy, also known as allergy shots, a long-term treatment that decreases symptoms for sufferers from allergic asthma, eye allergy or stinging insect allergy. Allergy shots work much like a vaccine. With gradually increased doses of a specific allergen, the body responds by developing immunity or tolerance, reducing the original reaction. While they don’t cure allergies, eventually your symptoms will get better and you may experience allergic reactions less often.
What are the most common medications for allergic rhinitis?
Treatment is always customized for the patient by the specialist. The very first step is to avoid allergens, then use nose sprays and eye drops, and finally take oral medications. The most important components of this complex treatment are the following:
- Antihistamines: a drug that inhibits the effects of histamine, which are chemicals produced during an allergic response. When an allergen triggers the immune system, histamines are released as part of the inflammatory immune reaction. It’s this inflammation that gives you puffy, swollen eyes or a blistery skin rash.
- Corticosteroids: they are used to provide relief for inflamed areas of the body often in the form of a nose spray or an eye drop. Corticosteroids lessen swelling, redness, itching and allergic reactions.
- Decongestant nasal sprays and drops: decongestant sprays shrink swollen blood vessels and tissues in your nose that cause congestion. It is not advised to use them more than three days because this can cause permanent damage in your nose.
Other complications from allergic rhinitis?
If you have allergic rhinitis, there’s a risk you could develop further problems. A blocked or runny nose can result in difficulty sleeping, drowsiness during the daytime, irritability and problems with concentration. Allergic rhinitis can also make symptoms of asthma worse. The inflammation associated with allergic rhinitis can sometimes lead to other conditions, such as nasal polyps, sinusitis and middle-ear infections. For these reasons it is advisable to speak with an ENT professional, who may refer you to a pulmonologist or allergy specialist.
We thank Dr. Viktória Kovács, ENT, for her time discussing this topic with us, as I think everyone knows someone who suffers from hay fever or some other type of allergic reaction. If you would like to know more about what steps you could take to uncover the causes of symptoms you are experiencing due to the environment around you, feel free to contact her or any of FirstMed’s ENTs to schedule a consultation.