Allergic Rhinitis or Seasonal Allergies

At certain times of the year plants are blooming with growth phase of certain types occurring at different times of the year. This fact makes allergies very tough on susceptible patients. Pollens, grasses, trees and weeds are seasonal and occur at certain times of the year which will affect people differently depending on their specific allergen. Perennial or year round indoor allergens such as dust mites, mold and animal dander can cause problems at any time.

With exposure to the pollens or irritants in the environment the nasal mucosa or lining becomes swollen and congested, fluids are formed to rid the body of the irritant. This fluid drainage with gravity and anatomy moves forward presenting as a runny nose or backward into the nasopharynx and down into the back of the throat irritating the throat making it sore. The person is congested, runny nose, sneezing, itchy eyes, and the patient feels miserable and his or her nose becomes raw due to continued attention with tissues and blowing of the nose.  This process is an immune IgE mediated inflammation of the nasal mucosa following exposure to the allergen in the immediate environment. The pollen or allergen causes the body to respond with the inflammatory reaction, certain chemicals such as histamine are released from cells in the body which cause the symptoms of fluid release and swelling. Risk factors for development are a family history atopy or eczematous skin lesions, food allergies, asthma, higher socioeconomic status and exposure to tobacco smoke (Barros, Medeiros and Ho, 2012)
Medical physical examination with an otoscope reveals a pale boggy nasal mucosa with swelling, irritated red throat, runny nose with clear watery drainage, normal fever, sneezing, watery eyes with some redness in the blood vessels, post nasal drainage seen in the posterior pharynx or back of the throat and  and oropharyngeal lymphatic tissue (tonsil, adenoids)  hypertrophy or enlargement. One can look at the patients face and nose and see transverse nasal creases on the end of nose from repetitive pushing upward on the end of the nose with the hand, especially in children, red nose around the nostrils from continuous blowing, and allergic shiners (bags under eyes).

The treatment of allergic rhinitis and allergies depends on the severity. It starts with oral antihistamines, intranasal antihistamines, leukotriene receptor antagonists, for intermittent mild symptoms. Persistent mild or intermittent moderate to severe symptoms are treated with allergen avoidance if possible, oral antihistamines, oral or intranasal decongestants, and oral corticosteroids. Severe symptoms are treated with allergen avoidance, intranasal cortiocosteroids, intranasal ipratropium, oral or intranasal antihistamines, decongestants and oral corticosteroids.  If the usual therapy is ineffective very expensive but effective subcutaneous immunotherapy and allergen avoidance usually with the guidance of an allergist is recommended (Epocrates, 2012).

Most of these medications are prescription strength but some are over the counter. The better and more effective treatments are prescriptions and they are usually less sedating. The most sedating drugs are effective but they put one to sleep and make it hard to function and maybe even dangerous depending on what that person may be doing, driving, working in hazardous conditions etc.

Complications of allergic rhinitis are secondary infections such as otitis media (ear ache), sinusitis, epistaxis (nose bleeds), tonsil and adenoid enlargement, asthma, facial changes and sleep difficulties (Barros, Medeiros, Ho, 2012). It is wise to treat it early and far more comfortable to avoid the potential complications.

If you or a family member, coworker, friend, relative or other colleague have allergies, call our office and we will do an examination to determine the cause. We will then figure out the best most cost effective treatment plan based on the latest research in medicine and prescribe those medications so you can function better and not be so miserable. We want to help you. Call us at 817-274-2343 and we will get you in for an immediate appointment and relief will be moments away. Many of the treatments are quickly effective. Don’t suffer needlessly from aggravating allergies.

References

  1. The 5 Minnute Clinical Consult 2012, Michael C. Barros, Colleen F. Medeiros, Vu Ho. pp 1150-1151.
  2. Epocrates Medicine (epocrates.com).