Hayfever can dramatically alter your perception of the hot weather! For 20% of the Irish population the good weather at this time of year can herald a variety of annoying symptoms, including itching, sneezing, nasal congestion (stuffy nose), runny nose, and a postnasal drip (the sensation of mucus draining from the sinuses down the back of the throat). In some people, these particles also cause reactions in the lungs (asthma) and eyes (allergic conjunctivitis). Thankfully, symptoms can usually be controlled with a combination of environmental measures, medications, and immunotherapy.
So, what is it? Hayfever or “allergic rhinitis” reflects inflammation of the nasal passages usually due to pollen and is seasonal (although a more severe version of rhinitis is called “perennial rhinitis” and these poor souls may suffer with symptoms all year round). Although the term “rhinitis” refers only to the nasal symptoms, many people also have symptoms that affect the eyes, throat, and ears.
What can you do? There are many things that you can do and many things that we can do. You can start off by reducing your exposure to pollen (or other allergens in perennial rhinitis). Easier said than done! Your Doctor can prescribe a few different proven medications when avoidance is impossible.
Surprising to some, antihistamines are not our first line treatment. Nasal glucocorticoids (steroids) delivered by a nasal spray are the best single treatment for the symptoms of allergic rhinitis. These drugs have few side effects and substantially relieve most symptoms in people. Studies have repeatedly shown that nasal steroids are more effective than oral antihistamines for symptom relief.
For those patients suffering with more severe symptoms, you may need to use a nasal decongestant for a few days before starting a nasal steroid to reduce nasal swelling. This facilitates transfer of the nasal spray to more areas within your nasal passages.
A few people notice symptom relief on the first day of treatment with nasal steroids, although it may take days to weeks to notice the full effect. Nasal sprays work best when they are used properly and the medication remains in the nose rather than draining down the back of the throat. This is usually the reason why they might not work for some, so be careful- avoid sniffing too hard, as this can result in the medicine draining down your throat and thus become ineffective!
Antihistamines relieve the sneezing, itching, and runny nose of allergic rhinitis, but they do not relieve nasal congestion. It is usually best to combine them along with nasal steroids or decongestants. This should provide greater symptom relief than using either of these medications alone.
If these individual therapies do not work, try “dymista”. “Dymista” is a prescription nasal spray containing both nasal steroid and an antihistamine and is the proven best combination treatment on the market.
For the well-motivated amongst you, nasal irrigation with salty water is particularly useful for treating postnasal drip, sneezing, nasal dryness, and congestion. The treatment helps by rinsing out allergens and irritants from the nose. Saline rinses also attempt to clean the nasal lining. You could even try using it before applying a spray-containing medication to get a better result from the medication.
If all else fails, talk to your Doctor about “allergen immunotherapy”. This involves trying to alter the way a patient’s immune system reacts to allergens. The most common form of immunotherapy is regular injections although there is a tablet version. In children, allergen immunotherapy can help stop the development of allergic asthma later in life.
So, don’t accept suffering with these annoying symptoms! There is always something that works. Talk to your Doctor and there should be no reason to fear the hopefully long, hot Summer ahead of us!