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Allergic Rhinitis (Nasal Allergies, Hay Fever)

Allergic rhinitis, commonly known as hay fever, is the most common allergic disorder affecting approximately 20% to 25% of the population. The most frequent symptoms are nasal congestion, itchy runny nose, itchy runny eyes, and fits of sneezing. Other frequently accompanying symptoms are headache around the eye area, drainage in the throat, fatigue, and lack of energy. There can also be intense itching of the throat and deep in the ears. The term hay fever is really a misnomer in that it is rarely due to hay, and there is no fever associated with it even though patients feel feverish as the result of the effects of histamine on the blood vessels causing them to dilate and feel warm.

Allergic respiratory symptoms are a result of histamine release along with other chemicals that are either preformed or formed in allergy cells as a result of an antigen antibody interaction.

The job of the allergist is to determine whether the above symptoms are due to allergies or not. Allergic rhinitis is typically classified as seasonal (intermittent) or perennial (persistent), or both. Frequent triggers of true hay fever symptoms include the pollens from grass, tree, and weeds, house dust mite, mold spores, and animal dander. If the above described symptoms are triggered by cleaning one’s home, playing with pets, mowing the grass, etc., then there is high likelihood that symptoms are due to allergies. If your doctor cannot make a correlation of your symptoms with the above triggers, then you need to start thinking outside the allergy box.

The correct diagnostic term for nasal symptoms not due to allergies is non-allergic or vasomotor rhinitis. We don’t understand the mechanism of this condition totally. As the name applies, it is not on an allergic basis, that is to say an antigen antibody interaction. Triggers of non-allergic rhinitis include irritants such as tobacco smoke, chemical odors, cold air, strong perfumes, etc.

Other conditions to consider in people with symptoms of a stuffy nose are hypothyroidism (low thyroid), nasal polyps, tumors (cancer), foreign bodies, infection, and deviated nasal septum. There is also another condition that goes by the acronym N.A.R.E.S. which stands for nonallergic rhinitis with eosinophilia. This means that a person can have all of the symptoms of allergies but are skin test negative, and yet paradoxically have an abundance of allergy cells called eosinophils in their nasal mucus. This condition responds nicely to intranasal steroid sprays.

The nose is the center of the universe to an allergist. If a person does not describe classic nasal symptoms, and for instance only complains that ears or eyes bother them, then the likelihood of symptoms being due to allergies is lessened.

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Grass Pollen Allergy

If the smells of freshly cut lawns make you sneeze, you may have a grass pollen allergy. Grass pollen is a common cause of allergy. Every spring and summer, plants release tiny pollen grains to fertilize same species plants. Grass pollen can trigger allergic reactions.

If you are experiencing these symptoms, grass pollen may be the trigger:

  • Runny nose
  • Sneezing
  • Itchy nose, eyes, ears and mouth
  • Stuffy nose (nasal congestion)
  • Red and watery eyes
  • Swelling round the eyes

 Since grass pollen grains may not be visible to the eye, your body may react even to tiny amounts of pollen in the air. With Oklahoma’s strong winds, pollen is distributed across the state.

Also known as hay fever, allergists refer to pollen allergy as seasonal allergic rhinitis.

What grasses cause allergy symptoms?

Fortunately, only a few grasses cause allergic symptoms. Where you live also plays a factor in grass allergy.

The most common grasses causing allergies are:

  • Bermuda
  • Johnson
  • Kentucky
  • Orchard
  • Rye
  • Sweet Vernal
  • Timothy

Living in Oklahoma, grass can pollinate through most of the year. Tiny, light and dry – grass pollen grains can travel for hundreds of miles.

“The first step is to get tested and diagnosed,” said OAAC Allergist Dr. Bret Haymore. “Once your allergist knows what specific allergens causing your symptoms, then we can work with you to create a treatment plan.”

Options for treatment include over-the-counter medicines, liquids or nasal sprays and prescription pills (also known as antihistamines, decongestants and nasal steroids). These can help reduce or prevent grass allergy symptoms.

“Grass allergy pollen medicines work best when you start taking them before pollen season begins,” said Dr. Haymore. “This will allow the medicines to prevent your body from releasing histamine and other chemicals that cause your symptoms.”

Another option if those medicines are no longer helping, may be immunotherapy or allergy shots. There are two types of grass allergy immunotherapy – allergy shots and allergy tablets. 

“Immunotherapy is a long-term course of treatment that can reduce or even prevent the severity of allergic reactions,” he said. “Allergy shots usually take a one-to-three-year commitment and can modify the body’s immune response to allergens.”

Allergy shots or subcutaneous immunotherapy (SCIT) are given at the OAAC clinics. Patients are monitored for any type of reaction to the shot. Most common side effects include local reactions at the injection site – redness, itching, swelling, tenderness, and pain. Less common reactions may include generalized redness, hives, itching, swelling, wheezing and low blood pressure.

Allergy tablets or sublingual immunotherapy (SLIT) can be done at home. This therapy involves placing a tablet containing the allergen under the tongue for one to two minutes and then swallowing it. Treatment must begin before grass allergy season and continues throughout grass allergy season. Taking the daily tablets may reduce grass allergy symptoms. There can be some side effects, and some can be serious. Please discuss with SLIT therapy with your OAAC provider about treatment options.

The post Grass Pollen Allergy appeared first on Oklahoma Allergy and Asthma Clinic.

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