Hay fever – a year-round battle
Itchy red eyes are often a very distressing symptom
IT'S funny how certain terms creep into the English language and become part of our normal daily speech. Many of us Hoover instead of vacuum, use Kleenex instead of tissues, and Google instead of internet search.
Medicine is no different– lots of people refer to migraines when they really mean a headache, flu when they mean a cold and talk about having hay fever when referring to general sinus allergies.
Hay fever is in fact a misnomer because it doesn't necessarily have anything to do with hay and it doesn't cause a fever.
The medical term for symptoms such as runny or congested noses, itchy eyes and throat and constant sneezing is allergic rhinitis.
It is estimated that up to one in five people suffer from this condition.
For some the symptoms are seasonal, peaking in spring and summer but for others the symptoms may occur all year round (perennial).
The symptoms of allergic rhinitis are a response to the body's exposure to an irritant or allergen. The immune system responds by releasing histamine, a chemical which has a myriad of effects.
The most common allergens for seasonal sufferers are tree pollens (mainly in spring) grass pollens (peaking in summer), with weeds, moulds and fungi also playing a role.
For perennial sufferers other irritants such as house dust mites and pet dander play a role. Exposure to fumes and exhaust can often add to the problem and as a result many urban dwellers suffer more. Avoiding most of these substances is virtually impossible, so for many people finding a way of controlling their symptoms becomes an annual crusade.
There is no cure for allergic rhinitis but there are a number of treatments that can help. These are most effective if started before symptoms do.
For those who notice symptoms in spring to early summer that means starting treatment soon.
Anti-histamine tablets block the release of histamine and can be very helpful. The older ones can be very sedating. More recently some insurance companies have expressed concern about the effect some of these may have on ability to operate machinery so the newer, less sedating once-daily tablets are a better choice.
The next weapon in the medical armoury is a steroid nasal spray. People often worry when they hear steroids being mentioned but these sprays act mainly locally in the nasal passage and effects to the rest of the body are minimal.
They take a few days to kick in and are designed to be taken daily through the season. There are other non-steroid sprays available to decongest but most of these should only be used in the short-term. If used too long, when ceased a flare of symptoms often occurs.
The third treatment is eye drops. Itchy red eyes are often a very distressing symptom and the regular use of the correct drops can bring great relief. Lastly nasal rinses are now recommended to help reduce the presence of allergens in the nasal passages.
If symptoms are very severe a doctor may occasionally prescribe a short dose of steroid tablets to help improve the situation. Many patients looking for long-term relief of symptoms will have heard of a treatment called Kenalog. This injection, however, is a slow-release steroid that can cause many side effects and it is no longer recommended.
There is a relatively new treatment that shows great promise for sufferers. It is a type of immunotherapy that involves exposing oneself to small amounts of grass pollen allowing the body to become desensitised.
It has been shown in clinical trials to reduce symptoms of grass pollen allergy. This treatment can only be prescribed by doctors and should be started several months before symptoms begin.
Alternative remedies remain ever popular. Some of the common ones include local honey, camomile, nettle, eyebright and turmeric but I must stress that none of these have shown significant benefit in clinical trials.
Evidence does suggest that keeping stress levels to a minimum, having a varied healthy diet, and exercising regularly can help reduce severity of symptoms.
Other simple lifestyle suggestions include avoiding being outdoors in the early morning or on dry windy days when pollens spread easily; not using clothes lines which allow allergens to stick to clothes; having a vacuum cleaner with a Hepa filter to reduce circulating pet dander or house dust mites and considering removing carpets from the home.
The search for answers is on-going but hopefully in the meantime the correct combination of medication and lifestyle can help keep symptoms at bay.