Hay Fever

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Hay Fever

Definition

Hayfever, also known as 'seasonal allergic rhinitis' is an allergic reaction to pollen which causes inflammation and irritation to the lining of the eyes, nose and throat.

Description

Hayfever results when nasal passages are exposed to an allergy-causing substance (allergen). The membranes release large amounts of histamine, which causes swelling and inflammation in the area and an increased production of mucus. Pollen from trees and grass is a common allergen carried by the wind and easily breathed into the nose. As plants flower at different times a pollen allergy often occurs at a specific time of year.

Allergy to grass pollen is the most common cause of Hayfever, however if there is also an allergy to a tree pollen then the Hayfever season is very prolonged. The incidence of Hayfever can vary widely depending on the plants present in a particular geographical location. Symptoms disappear when the offending plant is not producing spores or pollen, usually during the colder months of the year. Hayfever-like symptoms that occur all year round are usually caused by indoor allergens such as house dust mites, pets and possibly indoor molds. In this case the condition is known as perennial allergic rhinitis.

Signs and Symptoms

Hayfever symptoms will vary from person to person. Symptoms often first appear in childhood and adolescence. Studies have shown that Hayfever severely affects quality of life. It disturbs sleep, impairs daytime concentration and work performance and is a significant cause of absenteeism from school and work. Common Hayfever symptoms include;

  • a runny, sometimes streaming, nose
  • a strong sensation of tickling in the nose, throat, ears and roof of the mouth
  • frequent sneezing
  • blocked nostrils, on one or both sides
  • 'nasal' voice (like trying to talk through a pinched nose)
  • inability to taste or smell food
  • reddened, puffy, watering, itchy eyes
  • irritating cough
  • discomfort from swallowing large amounts of mucus which may lead to nausea at times

In addition, people with Hayfever may find it difficult to concentrate and may become listless and irritable. Hayfever can cause asthma symptoms such as wheeze or breathlessness to worsen especially if the person is particularly sensitive and is exposed to high levels of allergen. Some people have asthma symptoms only during the Hayfever season.

HAYFEVER AND SINUSITIS

Hayfever can cause chronic inflammation of the sinus and mucus linings. This inflammation prevents the usual clearance of bacteria from the sinus cavity, increasing the chances of developing secondary bacterial sinusitis. If you experience the following symptoms, consult your GP for an accurate diagnosis and treatment;

  • Thick, green or yellow coloured mucus from the nose or down the back of the throat
  • Temperature or shivers (fever)
  • Facial congestion (a feeling of fullness) and pain
  • Headache/toothache

Treatment Options

As with all medical conditions your Doctor should be consulted for an accurate diagnosis and treatment. There are a number of treatment options for managing hayfever. It is important to be clear about the dosage instructions for hayfever medicine and how they may interact with other medicine you are taking. If you have any questions, ask your Pharmacist for advice. Care must be taken to  not overuse decongestants as this type of medication can excessively dry the lining of the nose, which can lead to further swelling and congestion. It is important to clearly follow the instructions when using nasal decongestants.

It is impossible to avoid pollen altogether however, symptoms tend to be less severe if you can reduce your exposure. The amount of pollen in the air tends to be highest on warm, dry, and breezy mornings and lowest on rainy, cool days. The pollen count is often given with TV, radio, internet, or newspaper weather forecasts. The following may help when the pollen count is high;

  • Stay indoors as much as possible, and keep windows and doors shut.
  • Avoid freshly cut grass, large grassy places, and camping.
  • Shower and wash your hair after being outdoors, especially after going to the countryside.
  • Wear wrap-around sunglasses when you are out.
  • Keep car windows closed, and consider buying a pollen filter for the air vents in your car.
  • Avoid line-drying clothes and bedding when pollen counts are high.

Your GP may recommended that you use a corticosteroid nasal spray. If used regularly as directed, this may help to reduce the inflammation in the nose, which is the cause of nasal blockage and other symptoms. A corticosteroid nasal spray works best if you take it before your symptoms start and then on a daily basis throughout the hay fever season. They are available over-the-counter from your local Pharmacy and your GP can also prescribe stronger nasal sprays.

Your Doctor may recommend that you take a non-sedating antihistamine medication to help control hayfever symptoms. These may be useful to control sneezing and itching, but are not as effective as sprays to control a severely blocked or runny nose. Ask your GP or Pharmacist for advice if you are breastfeeding, as some medications can cause breastfed babies to become irritable and restless.

Decongestant nasal sprays or nasal drops can provide fast, temporary relief from a runny or blocked nose. However, these medicines should only be used for a few days at a time. Regular use may damage the lining of the nose and can lead to rebound congestion where the spray actually causes a blocked nose. If your symptoms have not improved after three days, talk to your GP or Pharmacist.

Immunotherapy (desensitisation) is a treatment that involves a series of injections to 'desensitise' the immune system. As immunotherapy is so intensive and time consuming, it is usually only given to people who have not responded to other treatments.

Side Effects 

CORTICOSTEROID NASAL SPRAY

It is important that you carefully read the instructions that come with your medication as applying the drops or the spray incorrectly can increase your risk of side effects, such as;

  • irritation and dryness of your nose
  • nose bleed
  • unpleasant taste in your mouth
  • itchy skin rash around the nose

ANTIHISTAMINES

Unlike older antihistamines, the newer types should not cause drowsiness, although this can occasionally occur in some people. If drowsiness does occur then avoid driving or using tools or machinery. Also contact your Pharmacist or GP as there may be an alternative antihistamine you can take.

NASAL DECONGESTANTS

Rebound congestion is a worsening of congestion symptoms that occurs after you stop using a nasal decongestant. This can occur if you use a nasal decongestant for longer than 5 days (or at higher than the recommended dose). Your symptoms may take weeks to improve. To avoid rebound congestion, avoid using nasal decongestants for longer than 4 or 5 days, and only use the recommended dose.

Diet Hints

  • A clinical study has found that eating a Mediterranean diet helps to reduce the symptoms of Hayfever in adults and children. This type of diet is high in fresh fruits and vegetables, e.g. grapes, oranges, apples, and fresh tomatoes. See the Mediterranean diet topic for more information.
  • If you feel that a certain type of food leads to a worsening of symptoms it is best to avoid that food. Some people report an increase in mucus production after eating dairy foods e.g milk, cheese, cream etc. Dairy foods are high in calcium, an important mineral for strong teeth and growing bones. If it does become necessary to eliminate milk and other dairy products from your diet, ensure you substitute with other calcium containing foods and drinks, or take a calcium supplement.
  • If you suffer from Hayfever and also experience an itching or tingling sensation in your mouth when you eat certain fruit or vegetables, ask your Pharmacist about oral allergy syndrome.
  • Fluids are needed to prevent dehydration. Try to drink 8 glasses of water each day.

Vitamins/Minerals/Herbs

Vitamins and minerals may only be of assistance if dietary intake is inadequate. There is evidence that antioxidant levels are low in people with allergies, particularly those with asthma.

  • Vitamin C with bioflavonoids and vitamin E are antioxidants that are available as nutritional supplements.
  • Zinc and magnesium help to support the immune system and may help to alleviate severity of Hayfever symptoms
  • Garlic and horseradish are herbs with a long history of traditional use in the management of Hayfever. These two herbs are commonly found in herbal and nutritional preparations for Hayfever.

Aromatherapy

The listed essential oils are suggested for the health management of Hayfever. The most specific oils are shown in capitals. ANISEED, LAVENDER.

VAPORISATION: Add 5 drops (total) single listed essential oil or combination of both essential oils listed to water in oil burner.

Notes 

If you know when your Hayfever is likely to start each year, you should start taking your treatment shortly before your symptoms normally begin. It is more difficult to control symptoms that are already well established.

Pharmacist’s Advice

Ask your Wizard Pharmacist for advice;

  • Monitor pollen forecasts daily and stay indoors wherever possible when the count is high.
  • Antihistamines are often prescribed to help control the symptoms of Hayfever. There are many types available e.g., nasal sprays, tablets, eye drops or syrups. Ask your Pharmacist for a suitable product.
  • Corticosteroid nasal sprays are a treatment option for Hayfever. Ask your Pharmacist for advice concerning the long-term use of corticosteroids.
  • Face masks can be used to reduce exposure to allergens, particularly when outdoors. Your Pharmacist can supply these.
  • Applying an ointment around the edge of each nostril or using a gel nasal spray can act as a barrier to trap pollens. Ask your Pharmacist for advice.
  • To help with irritating nasal symptoms, it may help to rinse your nose with salt water. Use a saline nasal spray from your Pharmacy.
  • Eyedrops may help to relieve red and irritated eyes. If you wear contact lenses ask your Pharmacist to recommend suitable eyedrops.
  • If your eyes are irritated choose hypo-allergenic eye make-up, especially mascara, available from your Pharmacy.