Bouts of sneezing occuring in a particular season, in medical terminology called seasonal allergic rhinitis and in layman’s language hay fever. It is the commonest form of allergy. Hay fever does not have any connection with hay. It is the seaonsal occurance of sneezing and running of the nose with congestion in the nose and itching in the eyes and nose.
Year after year, these symptoms occur in a patient in the same seasons while in other months, he feels perfectly normal. It may occur in children or in older people, but, mostly it occurs among young people. Males and females are equally effected by it. The symptoms may be mild or very severe and distressing.
Hay fever occurs in those who have inherited an allergic background. As the pollens to which they are allergic appear in the air in a particular season of the year, the symptoms of the disease occur seasonally.
SYMPTOMS
The onset of sneezing may be gradual or quite sudden, depending on the degree of exposure to the particular pollens to which the patient is allergic. When the onset is gradual, the attack is usually preceded by a mild sensation of itching and burning of the eyes or mild irritation in the nose or itching of the palate inside the mouth. Attacks of sneezing start especially in the early hours of the morning when there is a sudden increase in the concentration of pollens in the air. Marked nasal congestion and profuse running of the nose and eyes follow the sneezing paroxysms.
As the attack progresses, the nasal mucous membrane become highly sensitive and responds with sneezing to small stimuli which were previously innocuous, such as the slightest draft, strong odours, or minute amounts of dust.
Many patients suffering from hay fever also complain of various constitutional symptoms, such as lassitude, loss of appetite, drowsiness, etc. Some of these symptoms may be due to the self-administration of antihistamine drugs.
ACCOMPANYING ASTHMA
In some patients, symptoms of bronchial asthma also appear. They may start at the onset of the disease, or appear later. In certain cases, along with the symptoms of hay fever, there is a cough only and no bronchial spasm. Symptoms of cough and asthma may continue even when attacks of sneezing cease.
Diagnosis of the condition is not difficult and is revealed by the case history.
In the treatment of such case, it is important to find out the pollen or pollens to which the patient is allergic. This is done by means of skin test with the extracts of the pollens. Scratch or intracutaneous tests giving positive reactions for the pollens coupled with a confirmation of the same through consultation of the pollen calendar, confirms the causative pollens.
TREATMENT
Hyposensitization with the incriminated pollens yields excellent results in this condition.
ROLE OT ANTIHISTAMINES
Symptomatic treatment with antihistamine tablets is very helpful; one has to try one or more kinds of antihistamines to find out which one suits a person particularly well.
The name antihistamine suggests that these drugs work by acting against and destroying histamine that is produced in allergic reactions. This, it does to a large extent but since in an allergic reaction, other substances besides histamine are released as well, it is understandable that antihistamines do not abolish all the symptoms of an allergic reaction.
Antihistamines have proved most useful in cases of hay fever.
Given at the beginning of the attack, they are most effective; they lessen itching, sneezing and running of the nose. Long-acting antihistamines can also be tried in these cases.
Antihistamines come in different forms; tablets capsules, injections such as Avil, Phenergan and as mixtures alone or in combination with other drugs such as Actifed and Sudafet. However, antihistanmines are no substitute for a proper detection of the allergens and subsequent hyposensitization.
SIDE EFFECTS
Almost all antihistamines cause drowsiness. If one drug proves unsuitable in this regard, another can be tried. Giving antihistamines with Cream coffee, also help in lessening the feeling of drowsiness. The drowsiness caused by antihistamines, sometimes, prohibits their administration during the day time, for example, when the patient has to drive a vehicle or to do some such active work.
In rare cases, central nervous system stimulation may be a side reaction with some antihistamines, producing symptoms such as irritability, tension, insomnia etc. Antihistamines should be given only when needed, and not continuously as a routine.
In order to prevent getting attacks of sneezing or hay fever, the following precautions are helpful:
□ Avoid needless outdoor activities in the particular seasons.
□ Avoid grardening or farming
□ If possible, keep bedroom windows closed and use air conditioners.
Symptoms of hay fever lessen as the patient grows older.