Allergic rhinitis (hay fever): symptoms, causes, medications, etc.

Definition

What is allergic rhinitis?

Allergic rhinitis or hay fever is a form of inflammation of the lining of the nose that occurs when you inhale allergens (substances that cause allergies). This condition is the result of the body's overreaction in response to allergens that enter the body.

For many people, allergic rhinitis may be more commonly known as an allergic cold or seasonal allergy. These allergic reactions can get worse at certain seasons of the year, or develop into allergies that appear throughout the year.

Hay fever is a very common condition that affects all age groups. According to statistical data from the American Academy of Allergy, Asthma & Immunology, there are about 10-30% of the world's population who are likely to suffer from this disease.

Most of the symptoms are very similar to those of a cold, such as congestion, itchy and swollen eyes, sneezing, and pressure in the sinuses (small cavities inside the skull). However, unlike colds, allergic rhinitis is not a condition caused by a virus.

Apart from causing discomfort, allergic rhinitis can have a long-term effect, affecting performance and daily life. However, you can prevent the recurrence of rhinitis by avoiding allergens and taking proper allergy treatment.

Symptoms

What are the symptoms of allergic rhinitis?

Not everyone who has allergic rhinitis will show symptoms. Symptoms may appear only when you are exposed to large amounts of allergens or at certain times. Meanwhile, there are also people who experience allergy symptoms throughout the year.

Quoted from the Mayo Clinic, symptoms of allergic rhinitis (hay fever) the most common ones are:

• runny and stuffy nose,
• watery, itchy, red eyes (allergic conjunctivitis or allergic eye),
• sneezing,
• cough,
• itchy nose, roof of mouth, or throat,
• the skin under the eyes is swollen, blue in color, as well
• fatigue.

The symptoms above usually appear as soon as you come into contact with an allergen. Certain symptoms such as persistent headaches and fatigue may not appear until long-term exposure to the allergen.

The symptoms of allergic rhinitis also have many similarities to those of a cold. However, there are differences between the two, namely:

• Allergic rhinitis,causes a runny nose with runny mucus, and no fever. Symptoms will continue to appear as long as you are exposed to the allergen.
• Common cold, causes runny liquid or thick yellowish liquid. There are also symptoms of fever and aches and pains that appear three days after being exposed to the virus.

Symptoms of allergic rhinitis in babies

Allergic rhinitis can occur in all age groups, including infants. Symptoms usually appear after the baby is exposed to allergens such as dust and mites or after consuming cow's milk.

Symptoms of allergic rhinitis that often appear in babies include:

• skin reactions such as itching and redness,
• swelling of the lips, face, and around the eyes,
• digestive system disorders, such as stomach pain, nausea and vomiting, diarrhea, constipation,
• runny or stuffy nose, as well
• the appearance of eczema symptoms.

When do you need to see a doctor?

Apart from the various symptoms previously mentioned, it is possible that there are other symptoms that are less common. Consult an allergy specialist if you think you experience signs related to nasal allergies.

You also need to see a doctor if:

• have had a severe allergic reaction or anaphylaxis,
• treatments that were once effective no longer work, and
• the symptoms that appear have no effect on the treatment given.

Many people, especially children, are so accustomed to allergies that they don't seek treatment. In fact, allergies can get worse and even endanger lives.

Therefore, monitor any symptoms you experience and don't hesitate to discuss with your doctor.

Cause

What causes allergic rhinitis?

Allergy is an abnormal reaction of the immune system when fighting foreign substances that enter the body. The immune system should be able to distinguish which substances are dangerous and which are not. However, an allergy sufferer's immune system doesn't work that way.

Their immune system is unable or mistakenly distinguishes foreign substances in the body. Their bodies perceive ordinary substances such as dust, pollen, etc. as a threat, and then call the immune system to attack them.

The immune system response involves a chemical compound called histamine. The immune system also forms immunoglobulin E (IgE) antibodies and works together with other immune cells that function to fight foreign substances and germs in the body.

Although useful in preventing disease, histamine and the body's immune response to allergic reactions produce a disturbing set of symptoms. This symptom is what you experience when you come into contact with various causes of allergic rhinitis.

Rhinitis generally occurs when you inhale an allergen in the form of:

• pollen,
• grass,
• dust and mites,
• mold and lichen spores,
• animal hair, urine, saliva, and dandruff,
• cigarette smoke,
• pollution, as well
• perfume.

During certain seasons of the year, pollen from flowers and trees can be a problem for people with allergic rhinitis. Grass and weeds also produce more pollen in summer so people with nasal allergies need to be more vigilant.

Risk factors

Who is at risk hay fever ?

Anyone can have allergic rhinitis (hay fever) , both children and adults. However, the risk is higher in people with the following conditions.

• Have a family history of allergies. Allergies run from parents and the risk is much higher if both of your parents suffer from this condition.
• Suffering from other allergies or similar diseases. This is even more so if you have asthma, eczema, or food allergies.
• Grown. Rhinitis from childhood may disappear in adulthood, but new rhinitis appears after the age of 20 years may persist into old age.
• Work in areas full of allergens. Work environment allergens include wood dust and textiles, chemicals, latex, and smoke and odors.
• Often exposed to allergens. The trigger can come from common allergens or other substances that you often inhale without realizing it.

Diagnosis

How is allergic rhinitis diagnosed?

First of all, the doctor will ask about symptoms to see your general health condition. This step is also useful for determining whether you have seasonal or annual allergies.

The doctor may also examine the inside of your nose to see if there are nasal polyps. Nasal polyps are swellings that grow on the inside of the nose or sinuses.

Diagnosis of allergic rhinitis often needs to be started by administering antihistamine drugs first. If your symptoms improve after taking antihistamines, it is almost certain that you have allergic rhinitis.

After that, the doctor can continue the examination by the following two methods:

1. Allergy test

If the trigger for allergic rhinitis cannot be ascertained, the doctor can recommend an allergy test in two ways, namely:

• Skin prick test. Your hand is dripped with some allergens, then pricked with a needle to see the results. Red dots indicate allergies.
• Blood test. This test aims to detect IgE antibodies in your blood. The presence of IgE indicates that you have an allergy.

Allergy tests should be performed and supervised by an allergy specialist in a hospital or clinic. This is because allergy testing carries the risk of a severe allergic reaction which must be treated as soon as possible.

2. Further examination

In certain cases, for example, if your doctor suspects nasal polyps or sinusitis, you may need to undergo further tests at the hospital. Examinations carried out include:

• Nasal endoscopy. The doctor inserts a long, small tube with a camera to look directly inside the nose.
• Respiratory airflow test. The doctor inserts small instruments into your nose and mouth to measure the flow of air as you breathe.
• CT scan and X-rays. Both of these examinations aim to see the inside of your body.

Medicine and medication

How to treat allergic rhinitis?

The first step to treating allergic rhinitis is to avoid the trigger as much as possible. If this method does not work, you can take over-the-counter drugs or with a doctor's prescription.

If your allergic reaction is not too severe, over-the-counter medications are usually enough to relieve the symptoms. For an allergic reaction that is worse, you may need a prescription medication from your doctor.

Many allergy sufferers get better because they take a combination of several allergy medications. You may need to take a variety of allergy medications until you find the one that works best for you.

If you are diagnosed with allergic rhinitis, you will need to consult your doctor before starting taking medications or choosing other treatment methods. Here are the treatments you can choose from:

1. Medicines

Medicines are useful for reducing symptoms. Some of the common allergic rhinitis medications prescribed by doctors are as follows.

• Antihistamines. This drug works by inhibiting the production of histamine so that allergy symptoms can be reduced.
• Decongestants. One of the drugs that can treat congestion is a decongestant, but its use should not exceed 3 days.
• Corticosteroid sprays. Effective for treating seasonal allergies. This medication helps prevent and treat an itchy nose.
• Cromolyn sodium. This medication is available over the counter as a nasal spray. Its function is to relieve symptoms and prevent the release of histamine.
• Montelukast. This drug works to inhibit leukotrienes, which are chemicals in the immune system that cause allergic symptoms in the form of excessive mucus.
• Ipratropium. This medication is available as a nasal wash spray and helps relieve a severe cold by preventing excess fluid production.
• Oral corticosteroids. Corticosteroid pills such as prednisone are sometimes used to relieve symptoms of severe allergies.

If you are currently using other allergy medications, you should consult your doctor before taking allergic rhinitis medications. Avoid taking prescription drugs carelessly because there is a risk of side effects.

2. Allergy shots

Allergy shots or immunotherapy are treatment methods for severe allergic rhinitis. This treatment is done by giving allergen injections periodically until the symptoms are under control.

3. Sublingual immunotherapy

This treatment is similar to allergy shots, but allergens are not injected. The allergens will be put on the bottom of your tongue. There is a risk of side effects such as itching of the mouth or ears and irritation of the throat.

Prevention

How can you prevent allergic rhinitis?

You simply cannot prevent hay fever , but you can prevent allergic reactions by avoiding the triggers. You also need to understand how to manage recurrent allergies so that the reaction does not get worse.

Here are some lifestyle changes you can make to prevent allergic reactions.

• Stay home when dust, pollution, and pollen are high.
• Take a shower immediately after going out all day.
• Routinely clean furniture surfaces that are often exposed to dust.
• Use a mask when you have to do activities in an environment full of allergens.
• Routinely clean pet hair and bathe it if necessary.
• Do not use carpets or similar mats that can trap dust.
• Close your windows in dry, windy, or dusty weather.

Prevent allergic rhinitis in babies

Allergic rhinitis is a symptom of cow's milk allergy in infants. In this condition, the most important thing that parents should pay attention to is nutrition for allergic babies.

One way to prevent hay fever in babies is to give breast milk. During breastfeeding, the mother may be advised to avoid all foods containing cow's milk protein and its derivatives.

If the mother does not provide breast milk, the doctor will usually recommend changing cow's formula to other milk alternatives. Feeding may take 2 - 4 weeks.

In addition, giving baby cow's milk extensively hydrolyzed can also be a solution. This milk has a smaller protein fraction so that the child's immune system can receive milk protein better.

According to one study, extensively hydrolyzed cow's milk can reduce eczema-like symptoms for babies with a high risk of allergies. However, to reduce the effects of rhinitis, food allergies, and asthma, further research is needed.

The Indonesian Pediatric Association recommends giving milk for 6 months at the age of 9-12 months. After that, you can test whether your little one is tolerant of cow's milk by giving him cow's milk formula. If there are no symptoms, consumption of cow's milk can be continued.

Allergic rhinitis is the immune system's overreaction to the allergens you inhale. Symptoms range from mild sneezing to cold-like symptoms that interfere with daily activities.

You can manage this condition by avoiding the triggers and taking allergy medication if necessary. If there are any worrisome allergy symptoms, don't hesitate to consult a doctor so that you can get the right treatment.