| Hay fever is the allergic reaction caused
when the immune system treats a harmless substance, such as
pollen, as an " enemy invader". The response causes
the body to produce defensive antibodies. When an allergen
and an antibody combine, the body releases histamine and other
chemicals into the bloodstream which then irritate and inflame
the mucous membranes that line the nose. Hay fever victims
suffer sneezing fits, runny noses, itchy eyes and have difficulty
breathing. Attacks can be triggered by tree, grass or weed
pollen, and peoples sensitivity can vary depending on the
type of allergen in a particular area.
Anti-histamine drugs can help relieve symptoms, and there
is a plethora of other over-the-counter remedies and alternative
therapies on the market.
Symptoms.
The symptoms vary from person to person and often involve
sneezing, runny/blocked nose, red, watery, and itchy eyes,
and an associated itchy throat. Very often there is also a
wheezy chest, which really suggests a degree of asthma. Unfortunately
the peak pollen time is the early summer when school and university
examinations take place. As a result sufferers find it difficult
to revise and to perform well in the actual examinations.
Causes
Different pollens are present at different times of year and
thus the time that you are affected depends on the pollen
to which you are allergic. Other factors which may aggravate
the situation are the weather and the air quality.
Treatment
There are various treatments, some of which are available
over the counter from a pharmacist. Antihistamine tablets
or medicine reduce the effect on the body of one of the main
chemicals released by the allergic response.
There are nasal sprays which contain steroids and other substances
which reduce the local inflammatory response in the nose.
There are also eye drops which have similar effects on the
eye. Those people with asthmatic symptoms need treatment as
for asthma.
Occasionally the doctor may consider it necessary to prescribe
either tablets containing steroids, or possibly an injection.
These can have more serious side effects than the other treatments,
so the possible benefits have to be weighed against the possible
disadvantages. There are currently thought to be arguments
in favour of the tablets rather than the injection.
There are injection treatments to desensitise patients against
the substance to which they are allergic. Unfortunately these
can bring on serious reactions, and can only be given under
close hospital supervision, and are thus hardly ever used.
Prevention
There are several things you can do to lessen symptoms by
avoiding contact with the allergens, these include:
- In the summer stay inside between 5pm
and 7pm, when pollen counts are usually high. Keep windows
and doors closed, especially at these times and when sleeping.
- Use an air conditioner or filter when
possible, at home, work, and in the car, to remove pollen
and other allergens from the air.
- Damp dust and vacuum your home regularly,
to minimise the presence of pollen and dust.
- Airing bedclothes in direct sunlight
is also helpful.
- Be aware of the pollen count (usually
broadcast along with the weather), and avoid areas of high
pollen concentration, eg long grass, lawn mowings, and trees
if allergic to these. If you need to work in these environments
consider wearing a mask and goggles.
- Avoid unnecessary extra irritants such
as smoke and chemical fumes.
Medicines used in Hayfever
Decongestants (e.g. Sudafed)
You may find considerable relief by using a decongestant nasal
spray or tablets. Decongestants constrict blood vessels in
the lining of the nose and therefore reduce inflammation.
Decongestant nasal sprays should only be used for a short
time, if they are used for longer than say one week, congestion
can actually get worse.
Antihistamines (e.g.
Clarityn, Neo-Clarityn, Semprex, Piriton)
Histamine is the body-chemical responsible for the irritation
and inflammation that occurs in response to pollen. Antihistamines
are very effective in relieving the symptoms of hayfever.
You can buy antihistamines over the counter. Be careful to
take a non-sedating antihistamine, older types cause sedation
and are therefore dangerous. You should not drive when taking
sedating medicines. Antihistamines are normally given first.
If antihistamines do not control the symptoms, eye-drops or
nasal spray can be prescribed in addition.
Anti-Allergy Eye Drops
(e.g. Opticrom) and Nasal Spray
(e.g. Rynacrom)
Cromoglycate and Nedocromil are anti-allergy drugs that are
not steroids. It can be dangerous to use steroids in the eyes.
Anti-allergy eye-drops are useful as an adjunct to antihistamines
if the eye symptoms are still a problem. Anti-allergy nasal
sprays are not prescribed very often because people find steroid
nasal sprays so effective.
Steroid Nasal Sprays
(e.g. Nasacort, Flixonase, Nasonex)
Steroids are powerful anti-inflammatory agents. Steroid nasal
sprays are very effective in controlling the nasal symptoms
of hayfever. They do not help with the other symptoms, so
it may be necessary to combine the treatment with antihistamines
or eye-drops. It is safe to use nasal steroid sprays for prolonged
periods, unlike decongestant sprays.
Steroid Tablets or Injections
We use these only as a last resort as there are potentially
serious side effects. You should always insist that you are
given full written information detailing the possible side
effects so that you may make an informed decision to have
steroid treatment for hayfever. You should not have holiday
vaccinations for Yellow Fever, Polio (live version) or Typhoid
(live version) within 3 months of having steroid treatment.
A short course of steroid tablets is a useful treatment for
severe hayfever as a last resort or in extreme circumstances
when you have to be symptom-free e.g. for a wedding, exam
or theatre performance.
Further Information
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