Sniffling, sneezing might be fall allergies

With its col­or­ful leaves, foot­ball games and cooler tem­per­a­tures, fall is a favorite time of year for many peo­ple — unless they suf­fer from aller­gies. The sever­ity of symp­toms varies widely among peo­ple, but the sneezes, wheezes, snif­fles, headaches and fatigue nearly inca­pac­i­tate some sufferers.

The fall allergy sea­son actu­ally begins in August, but it is in full force now. From the vol­ume of traf­fic we are see­ing in our prac­tice, this is an espe­cially bad year for fall allergies.

The pri­mary cul­prit is rag­weed. The release of its air­borne pollen into the noses of cer­tain peo­ple trig­gers an abnor­mal immune response expressed in aller­gic reac­tions. Rag­weed grows just about every­where around here — in fields, vacant lots and on roadsides.

More than 50 mil­lion Amer­i­cans suf­fer from aller­gies, the sixth lead­ing cause of chronic dis­ease in the United States. Rag­weed aller­gies affect 10 to 20 per­cent of the U.S. pop­u­la­tion, accord­ing to the Asthma and Allergy Foun­da­tion of Amer­ica. The threat per­sists until cold weather kills the weed.

Other cul­prits this time of year are mold spores and dust mites that can eas­ily become air­borne, just like plant pollen. We begin to see fall allergy symp­toms just prior to the start of school, and stu­dents who con­tract viruses at school often feel worse than usual if they also have allergies.

Aller­gies can trig­ger or worsen asthma attacks. Peo­ple with asthma are at higher risk for aller­gies, and vice versa. Accord­ing to the Amer­i­can Acad­emy of Allergy, Asthma and Immunol­ogy, about half of the 20 mil­lion Amer­i­cans with asthma also have aller­gic asthma — the type trig­gered by an allergen.

Our first step in treat­ment is to deter­mine the source of the allergy. This often can be accom­plished through a phys­i­cal exam­i­na­tion and care­ful review of the symp­toms and when they appear. Many aller­gies often are easy to iden­tify because the out­breaks fol­low spe­cific pat­terns of exposure.

Oth­er­wise, we might try a skin test that exposes the patient to a tiny sam­ple of the aller­gen to see if there is a reac­tion. In rare cases, when a skin test is not appro­pri­ate, a blood test can reveal the source of a reac­tion by mea­sur­ing the anti­bod­ies to a spe­cific allergen.

Because aller­gies can­not be cured, the most effec­tive treat­ment is to avoid expo­sure to the offend­ing aller­gen, but this is not always prac­ti­cal. Still, we advise patients with fall aller­gies to stay indoors on days or hours (usu­ally between 10 a.m. and 3 p.m.) when the pollen count is at its peak. The Amer­i­can Acad­emy of Allergy, Asthma and Immunol­ogy web ite, aaaai.org, and sev­eral other web­sites keep track of pollen counts in our area.

After they have been out­doors, we advise patients to shower, change clothes and rinse their nasal pas­sages with a salt-water solu­tion (sev­eral saline rinse kits are avail­able com­mer­cially). We also rec­om­mend that patients reg­u­larly change their fur­nace fil­ters. (Stu­dents with food aller­gies should be watch­ful of school cafe­te­ria choices).

Oth­er­wise, the focus of our treat­ment is symp­tom man­age­ment. Cor­ti­cos­teroids, usu­ally admin­is­tered through a nasal spray, decrease inflam­ma­tion that causes sev­eral symp­toms. Anti­his­t­a­mines block the release of the sub­stance his­t­a­mine, cre­ated by the immune response, pro­duc­ing the aller­gic reac­tions. Decon­ges­tants break up mucus and relieve nasal congestion.

Steroids are avail­able by pre­scrip­tion, while anti­his­t­a­mines and decon­ges­tants can be pur­chased over the counter. It’s always a good idea to con­sult your physi­cian before try­ing any med­ica­tion. All have side effects and some may be more effec­tive than oth­ers or con­traindi­cated due to con­di­tions such as high blood pres­sure. And don’t for­get to fol­low the dos­ing instruc­tions, espe­cially for nasal sprays. When used for more than three con­sec­u­tive days, they can actu­ally worsen symptoms.

In some cases, we may rec­om­mend allergy shots that build tol­er­ance by expos­ing patients to grad­u­ally increas­ing doses of an allergen.

Scott Rei­neck, DO, is a fam­ily med­i­cine physi­cian at Delaware Pri­mary Care and an active mem­ber of the Grady Memo­r­ial Hos­pi­tal med­ical staff.

Posted by Grady Memorial Hospital on Sep 29 2011. You can follow any responses to this entry through the RSS Feed. Comments can be made below.