Hayfever

Definition

Hayfever, also known as ‘seasonal allergic
rhinitis’ is an allergic reaction to pollen which causes
inflammation and irritation to the lining of the eyes, nose and
throat.

Description

Hayfever results when nasal passages are exposed to
an allergy-causing substance (allergen). The membranes release
large amounts of histamine, which causes swelling and inflammation
in the area and an increased production of mucus. Pollen from trees
and grass is a common allergen carried by the wind and easily
breathed into the nose. As plants flower at different times a
pollen allergy often occurs at a specific time of year.

Allergy to grass pollen is the most common cause of
Hayfever, however if there is also an allergy to a tree pollen then
the Hayfever season is very prolonged. The incidence of Hayfever
can vary widely depending on the plants present in a particular
geographical location. Symptoms disappear when the offending plant
is not producing spores or pollen, usually during the colder months
of the year. Hayfever-like symptoms that occur all year round are
usually caused by indoor allergens such as house dust mites, pets
and possibly indoor molds. In this case the condition is known as
perennial allergic rhinitis.

Signs and Symptoms

Hayfever symptoms will vary from person to person.
Symptoms often first appear in childhood and adolescence. Studies
have shown that Hayfever severely affects quality of life. It
disturbs sleep, impairs daytime concentration and work performance
and is a significant cause of absenteeism from school and work.
Common Hayfever symptoms include:

? a runny, sometimes streaming, nose

? a strong sensation of tickling in the nose, throat, ears and
roof of the mouth

? frequent sneezing

? blocked nostrils, on one or both sides

? ‘nasal’ voice (like trying to talk through a pinched nose)

? inability to taste or smell food

? reddened, puffy, watering, itchy eyes

? irritating cough

? discomfort from swallowing large amounts of mucus which may
lead to nausea at times

In addition, people with Hayfever may find it
difficult to concentrate and may become listless and irritable.
Hayfever can cause asthma symptoms such as wheeze or breathlessness
to worsen especially if the person is particularly sensitive and is
exposed to high levels of allergen. Some people have asthma
symptoms only during the Hayfever season.

HAYFEVER AND SINUSITIS

Hayfever can cause chronic inflammation of the
sinus and mucus linings. This inflammation prevents the usual
clearance of bacteria from the sinus cavity, increasing the chances
of developing secondary bacterial sinusitis. If you experience the
following symptoms, consult your GP for an accurate diagnosis and
treatment;

? Thick, green or yellow coloured mucus from the
nose or down the back of the throat

? Temperature or shivers (fever)

? Facial congestion (a feeling of fullness) and
pain

? Headache/toothache

Treatment Options

As with all medical conditions your Doctor should
be consulted for an accurate diagnosis and treatment. There are a
number of treatment options for managing hayfever. It is important
to be clear about the dosage instructions for hayfever medicine and
how they may interact with other medicine you are taking. If you
have any questions, ask your Pharmacist for advice. Chronic,
long-term hayfever or the over-use of decongestants can damage the
lining of the

It is impossible to avoid pollen altogether
however, symptoms tend to be less severe if you can reduce your
exposure. The amount of pollen in the air tends to be highest on
warm, dry, and breezy mornings and lowest on rainy, cool days. The
pollen count is often given with TV, radio, internet, or newspaper
weather forecasts. The following may help when the pollen count is
high;

? Stay indoors as much as possible, and keep windows and doors
shut.

? Avoid freshly cut grass, large grassy places, and camping.

? Shower and wash your hair after being outdoors, especially
after going to the countryside.

? Wear wrap-around sunglasses when you are out.

? Keep car windows closed, and consider buying a pollen filter
for the air vents in your car.

? Avoid line-drying clothes and bedding when pollen counts are
high.

Your GP may recommended that you use a
corticosteroid nasal spray. If used regularly as directed, this may
help to reduce the inflammation in the nose, which is the cause of
nasal blockage and other symptoms. . A corticosteroid nasal spray
works best if you take it before your symptoms start and then on a
daily basis throughout the hay fever season. They are available
over-the-counter from your local Pharmacy and your GP can also
prescribe stronger nasal sprays.

Your Doctor may recommend that you take a
non-sedating antihistamine medication to help control hayfever
symptoms. These may be useful to control sneezing and itching, but
are not as effective as sprays to control a severely blocked or
runny nose. Ask your GP or Pharmacist for advice if you are
breastfeeding, as some medications can cause breastfed babies to
become irritable and restless. .

Decongestant nasal sprays or nasal drops can
provide fast, temporary relief from a runny or blocked nose.
However, these medicines should only be used for a few days at a
time. Regular use may damage the lining of the nose and can lead to
rebound congestion where the spray actually causes a blocked nose.
If your symptoms have not improved after three days, talk to your
GP or Pharmacist.

Immunotherapy (desensitisation) is a treatment that
involves a series of injections to ‘desensitise’ the immune system.
As immunotherapy is so intensive and time consuming, it is usually
only given to people who have not responded to other
treatments.

Diet Hints

? A clinical study has found that eating a
Mediterranean diet helps to reduce the symptoms of Hayfever in
adults and children. This type of diet is high in fresh fruits and
vegetables, e.g., grapes, oranges, apples, and fresh tomatoes. See
the Mediterranean diet topic for more information.
? If you feel that a certain type of food leads to a
worsening of symptoms it is best to avoid that food. Some people
report an increase in mucus production after eating dairy foods e.g
milk, cheese, cream etc. Dairy foods are high in calcium, an
important mineral for strong teeth and growing bones. If it does
become necessary to eliminate milk and other dairy products from
your diet, ensure you substitute with other calcium containing
foods and drinks, or take a calcium supplement.

? If you suffer from Hayfever and also
experience an itching or tingling sensation in your mouth when you
eat certain fruit or vegetables, ask your Pharmacist about oral
allergy syndrome.
? Fluids are needed to prevent dehydration. Try to drink 8
glasses of water each day.

Side Effects

CORTICOSTEROID NASAL SPRAY

It is important that you carefully read the instructions that
come with your medication as applying the drops or the spray
incorrectly can increase your risk of side effects, such as:

? irritation and dryness of your nose
? nose bleed
? unpleasant taste in your mouth
? itchy skin rash around the nose

ANTIHISTAMINES

Unlike older antihistamines, the newer types should not cause
drowsiness, although this can occasionally occur in some people. If
drowsiness does occur then avoid driving or using tools or
machinery. Also contact your Pharmacist or GP as there may be an
alternative antihistamine you can take.

NASAL DECONGESTANTS

Nasal decongestants shouldn’t be used for longer than seven
days. They may cause dryness and irritation in your nasal passage,
and can make the symptoms of congestion worse (this is known as
rebound congestion). #REF#Hayfever – Treatment. NHS Choices UK.
Last updated 21 Nov 2011. Available from URL:
http://www.nhs.uk/Conditions/Hay-fever/Pages/Treatment.aspx#ENDREF

Vitamins / Minerals / Herbs

Vitamins and minerals may only be of assistance if
dietary intake is inadequate. There is evidence that antioxidant
levels are low in people with allergies, particularly those with
asthma.

? Vitamin C with bioflavonoids and vitamin E
are antioxidants that are available as nutritional
supplements.
? Zinc and magnesium help to support the immune system and
may help to alleviate severity of Hayfever symptoms
? Garlic and horseradish are herbs with a long history of
traditional use in the management of Hayfever. These two herbs are
commonly found in herbal and nutritional preparations for
Hayfever.

Aromatherapy

The listed essential oils are suggested for the
health management of Hayfever. The most specific oils are shown in
capitals.
ANISEED, LAVENDER.
Application
VAPORISATION: Add 5 drops (total) single listed essential oil or
combination of both essential oils listed to water in oil
burner.

Notes

If you know when your Hayfever is likely to start
each year, you should start taking your treatment shortly before
your symptoms normally begin. It is more difficult to control
symptoms that are already well established.

Pharmacist’s Advice

1. Monitor pollen forecasts daily and stay indoors
   wherever possible when the count is high.
2. Antihistamines are often prescribed to help
   control the symptoms of Hayfever. There are many types available
   e.g., nasal sprays, tablets, eye drops or syrups. Ask your
   Pharmacist for a suitable product.
3. Corticosteroid nasal sprays are a treatment
   option for Hayfever. Ask your Pharmacist for advice concerning the
   long-term use of corticosteroids.
4. Face masks can be used to reduce exposure to
   allergens, particularly when outdoors. Your Pharmacist can supply
   these.
5. Applying an ointment around the edge of each
   nostril or using a gel nasal spray can act as a barrier to trap
   pollens. Ask your Pharmacist for advice.
6. To help with irritating nasal symptoms, it may
   help to you rinse your nose with salt water. Use a nasal saline
   spray from your Pharmacy.
7. Eyedrops may help to relieve red and irritated
   eyes. If you wear contact lenses ask your Pharmacist to recommend
   suitable eyedrops.
8. If your eyes are irritated choose hypo-allergenic
   eye make-up, especially mascara, available from your
   Pharmacy.