Allergy

Each spring, summer, and fall, trees, weeds, and grasses release tiny pollen grains into the air. Some of the pollen ends up in your nose and throat. This can trigger a type of allergy called hay fever.

Symptoms can include

  • Sneezing, often with a runny or clogged nose
  • Coughing and postnasal drip
  • Itching eyes, nose and throat
  • Red and watery eyes
  • Dark circles under the eyes

Your health care provider may diagnose hay fever based on a physical exam and your symptoms. Sometimes skin or blood tests are used. Taking medicines and using nasal sprays can relieve symptoms. You can also rinse out your nose, but be sure to use distilled or sterilized water with saline. Allergy shots can help make you less sensitive to pollen and provide long-term relief.

Allergy testing may reveal the specific allergens to which an individual is sensitive. Skin testing is the most common method of allergy testing. This may include a patch test to determine if a particular substance is causing the rhinitis, or an intradermal, scratch, or other test. Less commonly, the suspected allergen is dissolved and dropped onto the lower eyelid as a means of testing for allergies. This test should be done only by a physician, never the patient, since it can be harmful if done improperly. In some individuals not able to undergo skin testing (as determined by the doctor), the RAST blood test may be helpful in determining specific allergen sensitivity. Peripheral eosinophilia can be seen in differential leukocyte count.

Allergy testing can either show allergies that are not actually causing symptoms or miss allergies that do cause symptoms. The intradermal allergy test is more sensitive than the skin prick test but is more often positive in people that do not have symptoms to that allergen.

Even if a person has negative skin-prick, intradermal and blood tests for allergies, he/she may still have allergic rhinitis, from a local allergy in the nose. This is called local allergic rhinitis. Specialized testing is necessary to diagnose local allergic rhinitis.

The goal of rhinitis treatment is to prevent or reduce the symptoms caused by the inflammation of affected tissues. Measures that are effective include avoiding the allergen. Intranasal corticosteroids are the preferred treatment if medications are required, with other options used only if these are not effective. Mite-proof covers, air filters, and withholding certain foods in childhood do not have evidence supporting their effectiveness.[5]

Allergen immunotherapy (AIT, also termed desensitization) treatment involves administering doses of allergens to accustom the body to substances that are generally harmless (pollen, house dust mites), thereby inducing specific long-term tolerance.[21] Allergy immunotherapy can be administered orally (as sublingual tablets or sublingual drops), or by injections under the skin (subcutaneous). Discovered by Leonard Noon and John Freeman in 1911, allergy immunotherapy represents the only causative treatment for respiratory allergies.

 

Complications

Nasal allergy may cause recurrent sinusitis because of the obstruction to the sinus ostia. It may lead to the formation of nasal polypi. Nasal allergy can result in serious otitis media and orthodontic problems. Patients of nasal allergy have four times more risk of developing asthma.