Achoo! Achoo! ...Spring Is Here!
By Arturo Gastanaduy, MD.
A & G Pediatrics
Click aqui para español- >¡Atchis, Atchis! ¡La primavera ha llegado!
Green lawns, full bloom trees and multicolor flowers bring the pleasant sound of birds singing telling us that spring is here. However, we also will be hearing lots of sneezing, pointing out that allergic rhinitis (AR) season has also come back.
Allergic rhinitis is very common, especially in young people, affecting close to 20% of children and adolescents. It is more frequent in boys than girls and in persons with family history of allergies and maternal smoking. People with AR have three times more chances of developing asthma.
The illness is caused by hypersensitivity reaction of the nasal mucosa to foreign substances (allergens). Re-exposure produces an immediate reaction that produces vasodilation, mucosal swelling, increased mucus secretion and increased sneezing. Classical symptoms are itchy, congested nose, profuse and clear nasal discharge, frequent sneezing, loss of sense of smell, and itchy, red, teary eyes.
It is not a life-threatening illness, but it produces adverse effects on the quality of life of affected persons. It has been associated with sinus infections, asthma attacks, disturbed sleep, snoring, tiredness, poor school performance, puffy dark circles under eyes, mouth breathing, dental malocclusion, and transversal nasal crease.
Historically, allergic rhinitis was classified as seasonal or perennial. Seasonal was usually caused by tree, grass or ragweed pollens while perennial was caused by indoor allergens, like animal dander, house dust mites and mold spores. The World Health Organization has classified AR based on duration of symptoms as intermittent (<4 days/week or <4 weeks/year) and, persistent (>4 days/week or >4 weeks/year). This classification is more helpful to develop a management plan. Diagnosis of AR is based on medical history and physical exam, and occasionally specific tests are needed. AR is a chronic condition and there is no cure for it; nevertheless, it can be controlled, resulting in better quality of life of affected individuals.
Every person is unique, and the symptoms are variable, therefore, treatment must be individualized and may need to be modified. Do not expect a “magic pill” from the doctor, but instead ask for a treatment plan and how to evaluate it. Most likely, the plan will include changes at home and of life style to decrease exposure to allergens, some medications like nasal corticosteroids, non-sedating oral antihistamines, etc.
Most of the patients can be managed by their primary care doctor. Sometimes referral to an allergist may be necessary.