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Recently I have been seeing an increase in cases of Hay Fever which in medical terms is referred to as; allergic rhinitis. Most of my patients have been attributing this to the blossoming of the mophane trees which usually happens around December and January.
Allergic rhinitis refers to inflammation of the nasal membranes, usually due to an allergy. The symptoms of allergic rhinitis can be confused with symptoms of a common cold. The symptoms include, sneezing, itchy noses, eyes and palate, congestion, read eyes and tearing. They may also be fatigue, drowsiness and malaise.
The differentiating factor between allergic rhinitis and common cold is the onset and duration of symptoms. Allergic rhinitis usually starts immediately on exposure to the allergen while a common cold develops over a day to 3 days after exposure to the virus. A common cold usually lasts 3 to 7 days while allergic rhinitis will persist for as long as there is exposure the allergens.
An allergen is a substance that can cause an allergic reaction. In some people their immune system recognises these substances as foreign and dangerous. Their bodies therefore produce antibodies to fight against this substance hence leading to an allergic reaction and symptoms of allergy. Some of the common allergens include animal fur (i.e. cats and dogs), dust, insects or mites faeces, insects’ bites, fungal spores, pollen, food such as peanuts, milk, nuts wheat and eggs.
Certain people are at an increased risk of developing hay fever. These includes people who have allergies or asthma. Individuals who have certain skin conditions such as eczema are also at risk of developing allergic rhinitis. Having a first degree relative with allergies or asthma also predisposes an individual to having allergic rhinitis. Other risk factors include environmental exposure from work and exposure to smoke and strong odour.
The diagnosis of this condition is done by a health care worker based on a typical history and examination findings that are compatible. The healthcare worker can also do tests to confirm allergies. These tests include a blood test for allergies and what is referred to as a skin prick test. The blood test detects antibodies that are raised when there are allergies and can also test for specific allergens. A skin prick test is done by pricking an individual on the arm with specific allergens that can cause allergies. A healthcare worker then observes for formation of a raised bump known as hives. If an individual is allergic to a specific substance then they will develop hives where they have been pricked.
The treatment of allergic rhinitis involves avoidance of the particular allergen once it is known. Medications are usually directed at symptomatic relief. The medications include nasal corticosteroids that treat itching and congestion of the nose. Antihistamines are also a mainstay of treatment and work by blocking a substance called histamine which is released during an allergic reaction and is responsible for most of the symptoms. Antihistamines can be given in the form of tablets, nasal sprays and eye drops. Another important group of medications for treating this condition is oral corticosteroids which are used to treat severe allergies. This however should be used with caution as long term use has side effects.
Allergic rhinitis is a condition that has significant morbidity and can affect quality of life. It is thus important to take heed of the symptoms and make an early diagnosis and initiation of therapy.