Allergic Rhinitis (Hay Fever): Symptoms, Causes, Diagnosis and Treatment

Allergic Rhinitis, commonly known as hay fever, is a widespread condition affecting a significant portion of the population. This condition occurs when the body's immune system overreacts to specific allergens that are inhaled, often resulting in a collection of uncomfortable symptoms that can disrupt daily life. It is prevalent across all ages and genders, making it a universal health concern.

Allergic Rhinitis is an allergic reaction that occurs when your immune system overreacts to particles in the air that you breathe. These particles, known as allergens, can include substances such as pollen, dust mites, mold spores, pet dander, or tiny flakes of skin and urine shed by animals with fur or feathers.

Symptoms

The symptoms of Allergic Rhinitis often include a runny or stuffy nose, sneezing, red, itchy, and watery eyes, and swelling around the eyes. The fluid from the nose is usually clear and thin, but it may become thick and cloudy during a flare-up.

Causes

The exact cause of Allergic Rhinitis is not known, but it is believed to be a combination of genetic and environmental factors. Exposure to allergens, such as dust mites, pollen, and pet dander, can trigger the symptoms.

Impact and Complications

If left untreated, Allergic Rhinitis can lead to complications such as sinusitis and middle ear infections. It can also significantly impact a person's quality of life, causing sleep disturbances, fatigue, and difficulty concentrating.

Diagnosis

The diagnostic investigations for allergic rhinitis typically involve:
1. Detailed medical history and physical examination, focusing on symptoms and potential allergen exposure
2. Nasal examination, often using a nasal speculum, to check for physical signs of allergic rhinitis
3. Allergy testing, such as skin prick tests or blood tests (specific IgE tests), to identify specific allergens
4. Nasal cytology, in some cases, to examine cells from the nasal lining
At risk groups
- Individuals with a family history of allergies
- People with asthma or eczema
- Those exposed to high levels of allergens, such as outdoor pollen or indoor dust mites
Importance of Treatment
Treatment is crucial to manage symptoms, prevent complications, and improve the quality of life.

"Hay fever is usually worse between late March and September, especially when it’s warm, humid, and windy. This is when the pollen count is at its highest." - Allergy UK

Treatment Options

The treatment options for allergic rhinitis generally include:
1. Avoidance of identified allergens, when possible
2. Antihistamines, which can be taken orally or as a nasal spray to reduce allergic reactions. Some of these can be bought over the counter without prescription at a pharmacy.
3. Nasal corticosteroid spray, to reduce inflammation in the nasal passages.
4. Decongestants for short-term relief of nasal stuffiness. Decongestants should not be used by children under 6.
5. Leukotriene receptor antagonists, such as montelukast, for patients who do not respond to other treatments
6. Immunotherapy (allergy shots or tablets) for patients with severe symptoms who do not respond to other treatments

Doctors and Specialists Likely To Be Involved In The Patient’s Care

• General Practitioner (GP) - The first point of contact, responsible for initial diagnosis and management.
• Immunologist - Can be referred to/consulted by GP for specialist investigation and management of moderate to severe cases. They will likely conduct extended allergy testing and consider potential immunotherapy treatment.
• Otolaryngologist/Ear, Nose, and Throat (ENT) surgeon: Specialises in pathology affecting ear, nose and throat and can provide expertise in severe or complicated cases of allergic rhinitis.

Related Conditions or Complications
Allergic Rhinitis can lead to conditions such as sinusitis, sleep apnea, and ear infections. It can also exacerbate asthma symptoms.

"Effective management of Allergic Rhinitis can help prevent complications such as sinusitis and ear infections." - Mayo Clinic

Outlook and Prognosis

With appropriate treatment and management, most people with Allergic Rhinitis can lead normal, healthy lives.

Practical Tips & Coping Strategies

• Keep windows closed during high pollen seasons
• Use air purifiers to reduce indoor allergens
• Regularly clean your home to reduce dust mites
• Use hypoallergenic bedding
• Avoid outdoor activities during peak pollen times