How Can I Manage My Allergies?
 

By Debbie Midyette, PA-C

Nasal congestion, runny nose, sneezing, itchy eyes; as well as itchy nose and throat are symptoms associated with allergies.  Allergic Rhinitis is the medical diagnosis used for these symptoms.  Fever and achiness are not associated with allergies.  Having a parent with allergies increases the risk of having them, since there is a genetic basis for them.

Allergic Rhinitis can be seasonal or perennial.  Seasonal allergies are associated pollen and mold spores that occur during certain months when levels are high, commonly Spring and Fall.  Perennial allergies are usually caused by dust mites, insects, animal dander, and mold spores.  Symptoms of this show little or no seasonal variation.

Allergies to things such as mold spores, pet dander, and pollen trigger an immune response.  The immune system produces the antibody IgE in response to that trigger.  IgE binds to mast cells which release histamines along with other substances.  These substances cause the symptoms mentioned previously. 

Allergic Rhinitis can result in missed days at work or school and result in decreased quality of life.  Treatment can prevent sinus and ear infections, nasal polyps, and decrease the chance of asthma. 

The best way to prevent symptoms is to avoid allergens.  Stay indoors as much as possible and keep windows closed to avoid pollen.  Cover pillows and mattresses in protected covering to prevent dust mites.  If certain animals cause symptoms, then at least keep them out of the bedroom.  If these ideas don’t help, over-the-counter (OTC) and prescription medications can be used.

Antihistamines block histamines and therefore prevent itching, sneezing, and runny nose.  OTC examples include Benadryl and Chlor-Trimeton, first-generation antihistamines that prevent the symptoms, but can cause drowsiness.  Second and third-generation medications are less prone to cause drowsiness; examples of these are Claritin, Clarinex, Zyrtec, and Allegra.  Claritin is now available OTC, as is Alavert.  The others can only be obtained by prescription.

Decongestants shrink blood vessels, reducing fluid leakage into nasal tissue.  This decreases nasal congestion but can cause sleeplessness or jitteriness.  These should be avoided in certain patients, such as those with high blood pressure.  OTC oral decongestants include Sudafed PE and Claritin-D (Claritin with a decongestant added).  Allegra-D and Zyrtec-D are available by prescription.  Afrin, an OTC nasal spray, is available but should be used only for two-three days, or worsening congestion can result. 

Nasal steroids have an anti-inflammatory effect action.  They relieve nasal symptoms of congestion, runny nose, nasal itch, and sneezing.  These do not work immediately and may take up to three weeks for full effect.  Flonase and Nasonex are examples of nasal steroids and are available by prescription.

When avoidance of allergens fails and medication proves ineffective, Immunotherapy, or allergy injections, can be tried.  Injections of increasing amounts of allergen are given at five to seven-day intervals until symptoms are relieved.  A maintenance dose is administered every two to four weeks and continued until symptoms have been controlled for three to five years.