Allergic Rhinitis – Tis the Season!
By Susan Biegel M.D.
Do you ever experience post-nasal drip and find yourself having to clear your throat on and off all day? Or, do you have cold symptoms such as sore throat and cough that have lasted for two to three weeks off and on without letting up? There would be no problem for you to try over the counter Claritin or Allegra to see if it works. If Claritin or Allegra do help, you have likely made your diagnosis. Allergies can be seasonal, or all year long. Seasonal allergic rhinitis flares when certain trees or grasses are blooming or growing; or when we get rainfall that encourages the growth of grasses, molds, or spores.
The root cause: Allergens of all types, including pollens and dog or cat dander land on the nasal mucosal lining, causing the mast cells there to release a chemical cascade which leads to the swelling, itching, sneezing, and dripping that is so common with allergy sufferers. This is why using a Netty pot or at least a nasal rinse to wash the nasal passages of pollens will help control or eliminate a lot of the allergy flare ups.
Turn your bedroom into an allergy free zone. Some of us need to look no further than our own bedroom to discover the source of allergy symptoms. Dust mites that live in mattresses and pillows, and dog and cat dander can encourage annoying symptoms of allergies all year long. Using mattress and pillow covers, and removing dogs and cats from the bedroom can make a world of difference. Especially, but not only in the bedroom, replacing carpet that can hold in dust and allergens with laminate, hard wood or tile can eliminate a large reservoir of allergies. And, removing clothes that may be saturated with allergens from the day, as well as showering before bed, can help remove allergens. Keeping our sleeping areas free of allergens probably pays off the most since we spend eight or more hours per day in our bedroom.
Help! Ask your family doctor or Internist to take a look at your symptoms.
Most allergy sufferers can experience relief from just one dose of a non-sedating antihistamine (Fexofenadine or Loratadine) per day. Adding a nasal steroid spray daily to this regimen may be necessary for better control of symptoms from time to time, depending on the season. Nasal steroids such as Fluticasone or other nasal sprays such as Azelastine can also be used as the primary treatment. These can be a good option for the patients who can’t or won’t swallow pills. Loratadine also comes in a minty, orally disintegrating wafer for those who don’t like to swallow tablets. Pilots beware: sedating antihistamines such as Benadryl may cause drowsiness that can impair pilot functioning. Make sure that your drug of choice is FAA approved!
Take control. The good news is you can get relief with these simple measures. However, if you experience unsatisfactory relief of symptoms, it’s probably time to go to the doctor. Your family doctor, Internist, or “primary care physician” will be your best first appointment. Your primary doctor will listen to your symptoms and develop a customized treatment plan just for you. Your doctor may find it useful to order allergy testing through a blood sample called Immunocap testing. Most patients will not require this as part of their evaluation, however. Likewise, most allergy sufferers will never need to go to an allergy doctor (Allergist/ Immunologist). However, if needed, they can be helpful. There, allergy skin testing can be done which can pinpoint the specific allergen that you react to. Sometimes, at that point, the doctor finds that you really are allergic to nothing and the cause of all your suffering is vasomotor rhinitis, a condition where the vessels in the nose dilate and congest causing a very similar picture to allergic rhinitis. Patients who have uncontrollable allergic rhinitis or asthma on top of allergic rhinitis may greatly benefit from a trip to the Allergist/Immunologist office.
But doc, it’s just a little sniffle… The importance of controlling allergy symptoms sometimes goes further than just treating the symptoms of allergic rhinitis. If allergies are out of control, the patient may experience undue fatigue, or headache and the immune barriers can be broken down making us more susceptible to upper respiratory infections. Also, many times allergic rhinitis causes asthma to flare up, leading to severe symptoms of shortness of breath and to hospitalization.
In summary, allergic rhinitis is a very common condition, able to be treated with over the counter drugs, but the consequences can be serious. Just be very careful to choose only non-sedating antihistamines or other medications that are approved by the FAA.
Have a prosperous, satisfying, and healthy new year!
Doctor Susan Biegel can we reached at 909/985-1908 or visit www.susanbiegelmd.com.
