Health

Friday 19 September 2014

Doctor's orders: Hay fever is nothing to be sniffed at

Nearly a third of the population suffer during pollen season, and taking early action is a must

Pollen is a torment to hay fever sufferers
Sneeze

If you're reading this through bleary eyes and a stuffed up nose, chances are you, like almost 30 per cent of the Irish population, are starting to feel the effects of the pollen season. Hay fever – or allergic rhinitis, as clever medical types like me call it – is a bit of a misnomer, as it has little to do with hay but is an allergic reaction to environmental triggers such as pollen, dust, animal dander, smoke, foods and other stuff too. Personally, I sneeze like one of Snow White's dwarfs after drinking mineral water.

Sufferers get a runny nose, nasal, facial or sinus congestion and sometimes itchy watering eyes. And the severity ranges from pretty mild through to debilitating misery – where your swollen face is all you can think about and it makes everyday activities almost impossible. You may also feel generally tired and irritable – understandably, I think.

We have, through a combination of factors, one of the highest rates of hay fever – and its sister conditions asthma and eczema – in the world. And in the majority of cases it's poorly controlled.

I know one long-standing sufferer who only faced the fact that she could no longer eat dairy with impunity after a very important business meeting, where she had no tissues and her nose ran down her face like a proverbial tap.

And often people only seek help for their symptoms when they have progressed from allergic rhinitis into a sinus infection. Sinusitis is often the end result of untreated hay fever in the same way that a chest infection is often the end result of untreated asthma.

So, to avoid ending up on antibiotics and being generally miserable – getting your hay fever symptoms under control is important.

So what can you do? Well, avoidance, where it's practical, is a start. If you're a highly allergic, atopic type, don't go buying a long haired Abyssinian cat for example. If dust is your Achilles heel, ditch a home decor style heavy with curtain swags and fluffy carpets.

Or, if you, like 90 per cent of hay fever sufferers, are allergic to pollen – maybe pay little Johnny next door to cut your grass in the summer months. Equally, if it's your Friday vindaloo that sets you off, maybe stick to a chicken korma.

Then there's prevention and maintenance therapy. Daily use of antihistamines and topical steroid nasal sprays work well to keep symptoms under control. Saline sprays can also be useful for congestion. But, if you're someone who's prone to recurrent sinusitis, a sinus rinse – whilst unpleasant to use – is a must for preventing that painful bunged up feeling and the scourge of recurrent infections.

All of these things need to be used on a regular basis for best effect.

Over the counter decongestants containing pseudoephedrine should not be used for more than a couple of days, as they can cause rebound congestion on discontinuation that can be worse than the original condition.

And there's some benefit in sprays containing sodium cromoglycate – for those who find the topical steroids hard to tolerate.

In extremely severe cases – which do occur – oral steroids may be required occasionally with your antihistamines. But using preventative therapy will generally avoid the need for them. And that's the key. Most people take medication while they're suffering and ditch it once they've settled, instead of taking medications while well, as prevention. It's important to remember that hay fever is part of your make up, so we aren't aiming for 'cure' with treatment, we're aiming for management.

So, at a minimum, get yourself some anti-histamines and a steroid spray – use them – and get yourself a life this summer.

Dr Ciara Kelly is a GP in Greystones, Co. Wicklow.

Sunday Indo Living

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