It's easy to dismiss hay fever as a minor nuisance. But call it by its proper name, allergic rhinitis, and you'll be on the way to recognizing it as a legitimate medical problem. Add the fact that it affects about one of every five Americans and drains the economy of about $2 billion a year, and you'll see that it's an important problem indeed. Fortunately, it's also a problem that responds very well to treatment.
NOSING AROUND
If you think about your nose at all, you likely to think of it as a simple organ of smell. It's true, of course, that the nose is responsible for the sense of smell, but smell means much more than the ability to enjoy pleasing scents. Because smell contributes importantly to taste, it plays a central role in maintaining good nutrition. Smell can also warn us of dangers ranging from toxic fumes and smoky fires to spoiled food.
Allergic rhinitis can blunt the sense of smell, and it can also interfere with the other important functions of the nose. When your nasal passages are functioning normally, about five to eight quarts of air pass through them each minute. Your nose has the job of conditioning that air before it reaches the sensitive tissue of your lungs. Your nose adds moisture, but to do that, it must produce large amounts of mucus. It also warms the air, with help from a large network of blood vessels. Finally, the nose traps small particles, keeping them out of the lungs.
If you have allergies and your nose traps pollen or other particles to which you are sensitive, an inflammatory process starts right in your nose. Immune system mast cells in the nasal tissue release chemicals such as histamine and leukotrienes. Blood vessels swell, causing nasal congestion, and mucus production soars, creating a runny nose. Just like that, you've developed some of the symptoms of allergic rhinitis -- and some of your nose's normal functions have been compromised.
TYPES OF RHINITIS
Allergic rhinitis is the most common. Seasonal allergic rhinitis comes and goes as various plants come into bloom. If your symptoms occur in the spring, you are probably allergic to tree pollen; in the summer, grass and weed pollens are the likely culprits; in the late summer and fall, ragweed is the most likely cause. But if your symptoms occur year-round (perennial allergic rhinitis), you are probably allergic to indoor allergens such as dust mites, mold, or animal dander.
Rhinitis can also occur without allergies. Examples include viral rhinitis (the common cold); drug-induced rhinitis (possible culprits include Viagra and the other ED pills, the alpha blockers used for benign prostatic hyperplasia, the ACE inhibitors and beta blockers used for hypertension, and aspirin and nonsteroidal anti-inflammatory drugs); and hormonal rhinitis (including the "pregnant nose" experienced by some women). In some people, exercise, eating, and exposure to cold or dry air, air pollutants, or strong smells can trigger rhinitis. Inflammation is absent in nonallergic rhinitis, and the symptoms are limited to a runny, stuffy nose.
A final category of rhinitis can be particularly tricky. It's rhinitis medicamentosa, irritation of the nasal membranes caused by overuse of decongestant nasal sprays such as phenylephrine and oxymetazoline that some people use for quick relief of allergic rhinitis.
SYMPTOMS
Nearly everyone with allergic rhinitis complains of a stuffy, runny nose. Sneezing is nearly as common, and a postnasal drip can trigger coughing. Typical symptoms extend beyond the nose to include an itchy or sore throat and itchy, burning, watery eyes that may look red due to allergic conjunctivitis.
Between 20 percent and 40 percent of patients with allergic rhinitis also have asthma. Other allergy-related disorders such as eczema may also be present. Some patients have nasal polyps, a deviated nasal septum, or sinusitis.
Most people with allergic rhinitis can diagnose the problem themselves simply by recognizing typical symptoms. In complicated cases, an ENT (ear, nose, and throat) specialist can check for polyps and other nasal abnormalities. If it is important to identify specific allergic triggers, allergists can perform skin tests; the so-called RAST blood test can also help pin down the culprits.
TREATMENT
Three strategies are available: avoiding triggers, using medications to reduce symptoms, and getting immunotherapy ("allergy shots").
Keep your windows and doors closed as much as possible during pollen season.
Use air conditioners instead of fans, which bring in outside air. Drive with your windows and vents closed and your air conditioner on.
NOSING AROUND
If you think about your nose at all, you likely to think of it as a simple organ of smell. It's true, of course, that the nose is responsible for the sense of smell, but smell means much more than the ability to enjoy pleasing scents. Because smell contributes importantly to taste, it plays a central role in maintaining good nutrition. Smell can also warn us of dangers ranging from toxic fumes and smoky fires to spoiled food.
Allergic rhinitis can blunt the sense of smell, and it can also interfere with the other important functions of the nose. When your nasal passages are functioning normally, about five to eight quarts of air pass through them each minute. Your nose has the job of conditioning that air before it reaches the sensitive tissue of your lungs. Your nose adds moisture, but to do that, it must produce large amounts of mucus. It also warms the air, with help from a large network of blood vessels. Finally, the nose traps small particles, keeping them out of the lungs.
If you have allergies and your nose traps pollen or other particles to which you are sensitive, an inflammatory process starts right in your nose. Immune system mast cells in the nasal tissue release chemicals such as histamine and leukotrienes. Blood vessels swell, causing nasal congestion, and mucus production soars, creating a runny nose. Just like that, you've developed some of the symptoms of allergic rhinitis -- and some of your nose's normal functions have been compromised.
TYPES OF RHINITIS
Allergic rhinitis is the most common. Seasonal allergic rhinitis comes and goes as various plants come into bloom. If your symptoms occur in the spring, you are probably allergic to tree pollen; in the summer, grass and weed pollens are the likely culprits; in the late summer and fall, ragweed is the most likely cause. But if your symptoms occur year-round (perennial allergic rhinitis), you are probably allergic to indoor allergens such as dust mites, mold, or animal dander.
Rhinitis can also occur without allergies. Examples include viral rhinitis (the common cold); drug-induced rhinitis (possible culprits include Viagra and the other ED pills, the alpha blockers used for benign prostatic hyperplasia, the ACE inhibitors and beta blockers used for hypertension, and aspirin and nonsteroidal anti-inflammatory drugs); and hormonal rhinitis (including the "pregnant nose" experienced by some women). In some people, exercise, eating, and exposure to cold or dry air, air pollutants, or strong smells can trigger rhinitis. Inflammation is absent in nonallergic rhinitis, and the symptoms are limited to a runny, stuffy nose.
A final category of rhinitis can be particularly tricky. It's rhinitis medicamentosa, irritation of the nasal membranes caused by overuse of decongestant nasal sprays such as phenylephrine and oxymetazoline that some people use for quick relief of allergic rhinitis.
SYMPTOMS
Nearly everyone with allergic rhinitis complains of a stuffy, runny nose. Sneezing is nearly as common, and a postnasal drip can trigger coughing. Typical symptoms extend beyond the nose to include an itchy or sore throat and itchy, burning, watery eyes that may look red due to allergic conjunctivitis.
Between 20 percent and 40 percent of patients with allergic rhinitis also have asthma. Other allergy-related disorders such as eczema may also be present. Some patients have nasal polyps, a deviated nasal septum, or sinusitis.
Most people with allergic rhinitis can diagnose the problem themselves simply by recognizing typical symptoms. In complicated cases, an ENT (ear, nose, and throat) specialist can check for polyps and other nasal abnormalities. If it is important to identify specific allergic triggers, allergists can perform skin tests; the so-called RAST blood test can also help pin down the culprits.
TREATMENT
Three strategies are available: avoiding triggers, using medications to reduce symptoms, and getting immunotherapy ("allergy shots").
- Steps to take for seasonal rhinitis:
Keep your windows and doors closed as much as possible during pollen season.
Use air conditioners instead of fans, which bring in outside air. Drive with your windows and vents closed and your air conditioner on.
- For year-round allergic rhinitis:
