We are now entering the middle of summer here in the Midwest and, taking the good with the bad, we are well into the allergy season. Everyone is familiar with the typical symptoms of environmental allergies: sneezing, congestion, postnasal discharge, plugged ears, itchy eyes, and scratchy throat.
Allergies occur because of an interaction between the pollens and what are called IgE antibodies. These are present on certain cells within the nasal lining. The interaction between the proteins within the pollens and these antibodies on the surface of mast cells and basophils cause the cells to release chemicals called cytokines and histamine. These are the elements which cause the allergic symptoms. The chemicals cause release of fluid into the nasal and sinus tissues, increased secretion and mucus, swelling, and congestion.
The diagnosis of an allergic response is frequently easy to make. Following exposure to cut grass, hikes through the woods, animals, insect bites, and molds, the symptoms will develop. Over the course of a given year, the trees pollenate first, usually in the early to middle spring. These are followed by the grasses and then the weeds. The most common offender in the weed family is ragweed.
Unlike a cold or respiratory infection, allergy symptoms can wax and wane from day to day. Often this depends upon the weather and the amount of rain. There are many Apps such as weather.com which will document the pollen counts in a given area. People will find that these will often correlate with their symptoms.
There are many agents available to assist in managing the symptoms of allergy. Antihistamines have a long track record of benefit. These agents block receptor sites for the histamine molecule within the nasal lining, preventing actions such as itching, swelling, discharge, and headache. The older agents, such as chlorpheniramine, work, but they are associated with a short duration of action and sleepiness. The newer agents such as loratadine, cetirizine, and fexofenadine have all day benefit without causing sleepiness.
Decongestants are agents that shrink the blood vessels within the nasal lining. This improves the nasal airway, facilitating better breathing, and they also cut down on discharge. Although strictly speaking they don’t react against the allergic process, they are helpful for symptomatic control.
Nasal steroids such as Nasacort were once only available by prescription. They are now becoming increasingly available over-the-counter. The mechanism of nasal steroids against allergies is not completely clear, but clinical experience has shown that they’re helpful in reducing not only the nasal symptoms but also itching in the eyes. The onset of action is a bit longer than the antihistamines or decongestants, but they do not carry the potential for side effects such as sleepiness or insomnia.
Nasal saline rinses using a neti pot or a Neil med system are becoming increasingly popular. The offending allergens can be trapped within the mucous of the nasal lining, and the gentle rinsing will help eliminate those thus preventing symptoms.
The suggestions above are frequently of benefit for allergy sufferers. For more severe cases, however, formal evaluation with allergy skin testing and immunotherapy may be necessary.
To schedule an appointment with an allergy doctor in the Chicago suburbs to discuss your treatment options, please call: 630-654-1391 (for Hinsdale office) or 630-759-0065 (for Bolingbrook office).