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Dr Eccles discusses:
What is Hay Fever?
Hay fever is medically known as ‘seasonal allergic rhinitis’; it causes an inflammation and irritation in the delicate linings of the nasal passage, throat and eyes. Hay fever commonly appears around the age 11-12, the symptoms usually peak in the 20's and early 30's then gradually disappear. However, more and more people are beginning to experience hay fever for the first time in their 30's. Although we still use the term ‘hay fever’, in fact a fever is not a symptom of the disease, nor is it due to hay. There are two types of allergic rhinitis, seasonal allergic rhinitis and perennial allergic rhinitis. Seasonal rhinitis is when you only experience symptoms during the spring and summer pollen season.
When the majority of people say they have hay fever, it usually means seasonal allergic rhinitis. Perennial rhinitis is when you experience symptoms all year around. Perennial rhinitis is usually caused by indoor allergens, such as house dust mites, moulds and animal fur. The symptoms are similar to those of hay fever though you may feel like you have a permanent cold and suffer with a blocked nose and sore throat.
Hay Fever affects 15 - 20% of the population in the United Kingdom and is the most common of allergic conditions. Those who suffer from hay fever may also have symptoms of asthma. Hay fever is caused by an allergic reaction to the allergen pollen. Pollens that are light enough to be wind-borne are what cause the problem for most hay-fever sufferers. Heavier pollens that are carried from plant to plant by bees and by other insects can also be allergens, but they cause trouble only when a person comes into direct contact with the plant. Airborne pollens can penetrate anywhere, indoors and out, and are most numerous at the height of the pollinating season for the particular plant.
When pollen particles are breathed in the body's immune system overreacts, as it believes it to be a harmful substance. The body then produces an antibody, immunoglobulin E (IgE) to fight it off. The IgE antibody stimulates the release of certain chemicals, in particular histamine, to flush the pollen out of the airways. It is this process, which causes the many symptoms associated with hay fever. If you tend to suffer your hay fever symptoms in early spring then it is most likely an allergy to tree pollens, if you suffer more in the summer then it is more likely to be a grass pollen allergy.
Hay fever is the commonest form of allergy in the UK affecting up to 20% of the population of the UK, which would be up to 10 million sufferers. It is an allergy to pollen. Whilst grass pollen is the most common culprit for producing hay fever symptoms, tree pollen, flower pollen, and fungal spores (the fungus equivalent of pollen) can also produce the same symptoms in sensitive people. An estimated 26.1 million Americans have hay fever symptoms annually resulting in 10 million lost days of school or work each year. 14.6 million Americans have asthma, which can often accompany hay fever.
Symptoms of Hay Fever?
Sneezing that is repeated and prolonged is the most common feature in the hay fever sufferer. A stuffy and watery nose is also a main sign of hay fever. Other symptoms include redness, swelling and itching of the eyes; itching of the nose, throat and mouth and itching of the ears, or other ear problems. Breathing difficulties at night due to obstruction of the nose may interfere with sleep. These symptoms differ in degree according to the individual, ranging from mild to severe. When severe, they are very uncomfortable, make it difficult to carry out daily tasks, and may cause loss of time from work and school. Health complications from repeated hay fever attacks, year after year, may be an even more serious problem.
Chronic sinusitis -- inflammation of the sinus cavities -- is one of these problems. Another is nasal polyps, or growths. In addition, significant percentages of people with hay fever have or develop asthma.
For Hay Fever The "hay fever season" can be a different time of year for different
people depending where in the world they live. In part, this is because trees,
grasses, and weeds produce pollens during different seasons. In the last few years
the weather in the United Kingdom has been much warmer than the long term average
so the flowering times for many plants have altered. For example, Birch trees
have flowered several weeks earlier in the last few years than they did several
decades ago. Hay fever subsides with the onset of cold weather.
For example, people in the eastern and Midwestern United States who are sensitive
to tree pollen may suffer in the early spring when trees such as elm, maple, birch
and poplar are producing pollen. People who are sensitive to pollens produced
by grasses may suffer in the late spring, and early summer, the time when most
grasses are pollinating. About half of all hay fever sufferers are sensitive to
grass pollens. Weeds flourish in most parts of the country from midsummer to late
fall. In the late fall, ragweed is the most common problem. In fact, ragweed is
the plant that causes the most hay fever.
Some people suffer all year round when they are allergic to things that are in
the air all year.
Sensitivity and How It Works
"Sensitivity" is the term used to describe the process by which you develop an allergy. Sensitivity is established when the tissues that form antibodies (lymphoid tissues) are stimulated to make specialized antibodies to otherwise harmless pollens, spores, etc. These antibodies fix to other specialized cells throughout the body that contain powerful defensive substances such as histamine. When the individual next is exposed to the pollen (as in the nose, for instance), the antibodies trigger the cells to secrete their defensive substances. This in turn causes the dilation of blood vessels, increased secretions of fluids, swelling of tissues, itching, sneezing, and other reactions that add up to hay fever.
The inflammation and other symptoms -- while real enough -- actually are not of the same destructive nature as those carried by more serious diseases. Removing the cause of the reaction results in immediate relief.
Control Hay Fever
Avoiding the substance that causes a reaction is the best way to control hay fever. Moving to a different part of the country is sometimes suggested, but taking this drastic and expensive step may prove useless if the person has or develops sensitivity to a substance common in the new location.
Using air conditioning and air purifying devices may help cut down on suffering during the hay fever season, so that normal sleep and work are possible. Dust masks should be used during outdoor work if the work cannot be avoided.
Antihistamines - drugs that counteract the histamine released by the allergen-antibody reaction usually serve to give relief from some symptoms.
Decongestants may help, as well. However, they don't affect the underlying sensitivity. Each individual has to depend on his or her doctor to find out what drug or combination of drugs works best.
Over-the-counter nose sprays are usually of limited value and their prolonged use may actually cause symptoms or make them worse.
Inhaled steroids are often effective and may be prescribed by a doctor. Specific desensitizing injections can also be used.
What Causes Allergic Rhinitis?
Chemical substances, such as histamine, are normally stored in mast cells in tissues of the body, including the nose and eyes. The allergic person forms antibodies against pollens and other allergens. These antibodies attach themselves to the mast cells, and when combined with the allergen the result is the release of histamine and other chemical substances from the mast cells. These chemical substances cause the allergic responses of itching, sneezing, congestion, and dripping.
Avoidance is the best treatment for any allergy whenever possible. Keeping doors and windows closed in the home and in your car and avoiding vigorous outside activity will help to lessen your exposure during times when the pollen count is high. Removing pets from the home and dust and mould control measures can significantly relieve symptoms due to perennial allergens. Antihistamines may relieve many hay fever symptoms by inhibiting the action of histamine on nasal and eye tissues. When a person first starts to take these medications they often cause drowsiness, but this usually goes away after a day or two of taking antihistamines on a regular basis.
More recently I have discovered Yamoa, a novel plant extract. I believe that one of the ways that this is having its positive effect in both asthma and hayfever is by an immune modulatory action leading to less allergic response and less inflammation in the airways. (See other sections on this website for more details and clinical experience with this product). There may be a genetic link in hayfever. You are more likely to develop it if your parents had hay fever, or if they suffered with other allergic conditions such as eczema or asthma. So if your brother or sister already suffers from hay fever, then you may well have inherited the same sensitivity from your parents. Similarly if you had eczema or asthma as a child this makes you more likely to develop hay fever, and this is often the pattern that shows itself for someone who suffers from allergies. The peak age for hay fever is late teens and twenties. After that it usually gets gradually better, but may always give you some symptoms, especially in years with high pollen counts. The way we live may have some effect on the development of hay fever. Our modern lifestyle could expose us to many allergy-triggering substances. This allergy overload causes more people to become allergic to something. This could explain the increase in hay fever over recent years.
How do you know if you have hay fever?
Due to the similarities between a common cold and hay fever it can sometimes be very difficult to differentiate between the two, especially when the symptoms are brief and irregular. The symptoms related to hay fever will come and go throughout the summer months and vary in severity. Itchy, watery eyes usually accompany hay fever but are not normally a cold symptom. You will also begin to notice a pattern in the times of year when you have the attacks. The symptoms of hay fever will disappear when the allergen is removed or a suitable treatment is used. Almost half of those who suffer from hay fever say their work is affected, the main causes being irritability and lack of concentration. During the hay fever season sufferers claim to feel unhappy and depressed. 10% of hay fever sufferers have taken time off from work as a result of the related symptoms. Many sufferers said they are self-conscious about the effects hay fever has on their appearance, therefore affecting their social lives.
Is there anything I can do to prevent hay fever?
To lessen symptoms you need to avoid contact with the allergens, which cause your symptoms. Apart from a trial of Yamoa the following may prove useful: Keep doors and windows shut at home and in your car on high pollen count days. Wear sunglasses or glasses when outdoors. Avoid mowing or weeding the lawn in the summer and avoid lying on freshly cut grass. Apply a thin layer of Vaseline™ just inside nostrils to trap pollen. Wash your clothes after going out, as pollen can stick to your garments. Keep your bedding clean. Shower or bathe before going to bed to wash off pollen in your hair and on your skin. Avoid going outdoors in the early evening when the pollen count is usually at its highest.
To prevent perennial allergic rhinitis symptoms try Yamoa but the following may help:
Dust and vacuum your house regularly to minimise the presence of dust and therefore the dust mite.
Use special bed and pillow coverings.
Hot wash all bedding at least once a week.
Avoid having pets but if you do, bathe them regularly, keep them outside and never allow them in the bedroom.
How is Hay fever (allergic rhinitis) diagnosed?
Allergic rhinitis is usually diagnosed from symptoms alone, especially in the case of hay fever. Perennial rhinitis is more difficult to diagnose, your doctor might suggest you keep a record of all your symptoms, when they occur and when they are at their worst. This might help identify what is triggering the symptoms to occur. Your doctor may suggest you have an allergy test to confirm exactly what you are allergic to.
Article ©2004-2010 Dr.Nyjon Eccles - reproduced with kind permission
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