Salsations- Respiratory Allergies

Fall/Spring Sniffles

The arrival of spring brings warmer weather, beautiful flowers and allergy season. Each year, allergic rhinitis (hay fever) affects about 40 million people in the United States and up to 40% of children, with direct costs of about $ 4.5 billion annually and indirect costs reflecting as much as 3.8 million days of lost time & productivity at work and school.

An allergic reaction occurs when the body’s immune system attacks a harmless substance. This substance called the allergen enters the body. The body then develops antibodies, which reacts with the allergen. Mast cells in the body release histamine which cause itching, swelling and inflammation. This is the allergic reaction. Common spring allergens are pollen from trees, grass, and weeds. Treatment for this condition includes prevention and the use of pharmacologic agents. According to the Joint Task Force on Practice Parameters in Allergy, Asthma and Immunology, oral antihistamines which neutralize histamine are the first-line therapy for the treatment of allergic rhinitis.

Since antihistamines are generally not effective in relieving nasal blockage, a decongestant agent (e.g. Pseudoephedrine) may be added to oral antihistamine therapy. This agent shrinks swollen membranes in the nose and make it easier to breathe. The use of a first-line antihistamine (e.g. Benadryl) may result in occupational, learning, and/or driving impairment therefore selecting a second generation non-sedating antihistamine( Allegra, Claritin, Zyrtec) with less risk for these side effects should be considered and is preferred. Intranasal antihistamines, such as Astelin are also considered to be appropriate as first-line treatment for allergic rhinitis, or as combination therapy with nasal corticosteroids and antihistamines. If symptoms are really hard to control immunotherapy may be recommended.

Presently, it is recommended that treatment be initiated two weeks before the start of allergy season. Thanks to new advances in pharmacology, allergy sufferers no longer have to dread the coming of spring. The use of second-generation antihistamines, nasal steroids and immunology has greatly decreased discomfort and thereby enhanced the quality of life for those with seasonal allergic rhinitis.

By: Rose Marie Samaniego, M.D.