Hay fever

Introduction

• Hay fever, or allergic rhinitis, is an allergic reaction to airborne allergens such as pollen, dust mites, mold, or animal dander.
• It is characterized by nasal congestion, sneezing, runny nose, and itchy eyes.
• Symptoms can be seasonal (triggered by pollen during certain times of the year) or perennial (year-round).
• Effective management includes avoiding allergens, using medications, and sometimes immunotherapy.

Causes of Hay Fever

1. Airborne Allergens
   • Pollen: Grass, tree, and weed pollen are common triggers in seasonal hay fever.
   • Dust Mites: Found in bedding, carpets, and upholstered furniture.
   • Mold Spores: Indoors or outdoors, especially in damp conditions.
   • Animal Dander: Tiny skin flakes shed by pets.
2. Immune System Response
   • Overreaction of the immune system to harmless substances, producing histamine and other chemicals that cause symptoms.
3. Genetic Predisposition
   • Family history of allergies or asthma increases risk.

Symptoms of Hay Fever

1. Nasal Symptoms
   • Sneezing, runny nose, nasal congestion.
   • Postnasal drip.
2. Eye Symptoms
   • Red, itchy, watery eyes (allergic conjunctivitis).
3. Throat and Ear Symptoms
   • Itchy throat, ears, and palate.
4. Other Symptoms
   • Fatigue, irritability, or difficulty concentrating (often due to poor sleep).

Complications of Hay Fever

• Sinusitis: Inflammation or infection of the sinuses.
• Asthma Exacerbation: Hay fever may worsen asthma symptoms.
• Sleep Disturbance: Nasal congestion can lead to poor-quality sleep.
• Decreased Quality of Life: Impacts work, school, and daily activities.

Diagnosis of Hay Fever

1. Medical History
   • Symptom patterns, triggers, and family history of allergies.
2. Physical Examination
   • Nasal congestion, swollen nasal passages, or watery eyes.
3. Allergy Testing
   • Skin Prick Test: Identifies specific allergen sensitivities.
   • Blood Test: Measures allergen-specific IgE antibodies.
4. Differential Diagnosis
   • Exclude other causes of similar symptoms, such as non-allergic rhinitis or sinus infections.

Treatment Options for Hay Fever

1. Medications

2. Lifestyle Modifications

• Avoid Allergen Exposure
  • Stay indoors during high pollen counts (mid-morning and evening).
  • Use air purifiers and keep windows closed.
  • Wash hands and face after being outdoors.
• Environmental Controls
  • Use dust-mite-proof bedding.
  • Reduce indoor humidity to discourage mold growth.
• Personal Habits
  • Shower before bedtime to remove allergens.
  • Avoid drying clothes outside during high pollen seasons.

3. Immunotherapy

• Allergy Shots (Subcutaneous Immunotherapy)
  • Gradual exposure to allergens to build tolerance.
• Sublingual Immunotherapy (SLIT)
  • Allergen tablets or drops dissolved under the tongue.

4. Alternative and Supportive Therapies

• Saline Nasal Irrigation
  • Reduces nasal congestion and flushes out allergens.
• Herbal Remedies
  • Butterbur and quercetin may help but should be used with caution.

Monitoring Parameters

• Track frequency and severity of symptoms.
• Evaluate response to medications or immunotherapy.
• Monitor for side effects, especially with long-term corticosteroid use.

Patient Counseling Points

• Explain the importance of avoiding known allergens and triggers.
• Advise proper use of nasal sprays (e.g., tilt head slightly forward, spray away from the septum).
• Stress the need for adherence to long-term treatments like immunotherapy.
• Educate on reading pollen forecasts and planning outdoor activities accordingly.

Use in Children

• Use child-friendly formulations of antihistamines or nasal sprays.
• Monitor closely for side effects like drowsiness.

Use in Pregnancy

• Safe options include loratadine or cetirizine; avoid decongestants in the first trimester.

Use in Elderly

• Consider age-related changes in drug metabolism and potential interactions.

FAQs About Hay Fever

Q1: What causes hay fever?

• Allergic reaction to airborne allergens like pollen, dust mites, or mold.

Q2: Can hay fever be cured?

• There is no cure, but symptoms can be managed effectively with treatment.

Q3: What are common symptoms of hay fever?

• Sneezing, runny nose, itchy eyes, and nasal congestion.

Q4: How is hay fever treated?

• With antihistamines, nasal sprays, and lifestyle changes.

Q5: Can hay fever cause asthma?

• Yes, hay fever can exacerbate asthma or increase the risk of developing it.

Q6: Are antihistamines safe for long-term use?

• Yes, modern antihistamines are generally safe for prolonged use.

Q7: Can I prevent hay fever?

• Avoid allergens and use preventive treatments like nasal sprays during allergy season.

Q8: Is hay fever hereditary?

• Yes, a family history of allergies increases the likelihood.

Q9: What foods can worsen hay fever?

• Certain foods may cross-react with pollen (oral allergy syndrome), such as apples or nuts.

Q10: Is hay fever more common in specific seasons?

• Yes, it peaks in spring (tree pollen), summer (grass pollen), and autumn (weed pollen).

Q11: Can I exercise with hay fever?

• Yes, but avoid outdoor activities during high pollen counts.

Q12: Does air conditioning help with hay fever?

• Yes, it can filter allergens if fitted with a HEPA filter.

Q13: Can hay fever resolve on its own?

• Symptoms may improve with age, but treatment is usually needed.

Q14: Are there natural remedies for hay fever?

• Saline rinses and butterbur may help, but consult a doctor before use.

Q15: When should I see a doctor for hay fever?

• If symptoms are severe, persistent, or affecting your quality of life despite treatment.