Hay Fever Diagnosis And Treatment- Allergy/Immunology, Ear Nose And Throat (ENT), Pediatrics

What is hay fever?

Hay fever (also known as allergic rhinitis) is a common allergic condition which causes symptoms such as sneezing, itchy eyes, runny nose, and congestion. Hay fever is caused due to outdoor or indoor allergens or pet dander.

An allergist should be consulted.

Diagnosis:

In order to diagnose hay fever, patient’s detailed medical history is taken. Patient is also asked to provide details about his/her lifestyle, work and home environment, family’s medical history as well as severity and frequency of the symptoms.

Following tests are done to diagnose hay fever:

• Skin prick or scratch test: This test is also known as a percutaneous test. A small drop of a probable allergen is pricked or scratched into patient’s skin. If the patient is allergic to the allergen, a bump develops at the site. This test provides results within 10 to 20 minutes.
• Intradermal test: This test is more sensitive than prick or scratch test. During this test, a small amount of a possible allergen is injected underneath the skin by a thin needle. The site of the injection is examined after 20 minutes for a reaction.
• Blood test: A blood test is done to measure patient’s immune system's response to a specific allergen. This test is also known as the radioallergosorbent test (RAST). This test measures the quantity of allergy-causing antibodies in patient’s bloodstream, known as immunoglobulin E (IgE) antibodies.

Treatment:

• Avoidance: Patient should avoid unnecessary indoor and outdoor exposures to allergens. It is the first approach for the management of seasonal or perennial forms of hay fever. When pollen counts are at their peak, patient should avoid going out. If patient has to go outside, wear pollen mask and use glasses or sunglasses to minimize the amount of pollen getting into eyes. Wash bedding regularly in hot water. Patient should wash hands immediately after touching pets. It is also recommended that patient should avoid rubbing nose and eyes.
• Medicines:
  • Intranasal corticosteroids: They are utmost effective drug for the treatment of hay fever. They help to prevent as well as treat nasal itching, inflammation, congestion, sneezing, runny nose, and itching. They are used as a long-term and safe treatment for the patients.
  • Antihistamines: Antihistamines are generally given as oral tablets and syrup. They are also given as eye drops or nasal sprays. They help to relieve itching, sneezing and runny nose. Histamine is responsible for the symptoms of allergic reactions. Antihistamines block histamine release from immune system during allergic reaction.
  • Decongestants: They are available as pills, syrup and nasal sprays. They are helpful to relieve the stuffiness and pressure caused due to swollen nasal tissue.
  • Nasal sprays: Different types of nasal sprays are available. Saline nasal sprays help counteract symptoms such as dry nasal passages or thick nasal mucus. Cromolyn sodium nasal spray helps relieve symptoms by preventing the release of histamine. Ipratropium nasal spray is beneficial to stop severe runny.
  • Leukotriene inhibitors: They block the action of leukotriene, a substance which is responsible for the symptoms of hay fever.
  • Oral corticosteroids:  Corticosteroid tablets are prescribed sometimes to relieve severe allergy symptoms.
• Allergy shots (immunotherapy): Immunotherapy is recommended when any other treatment option doesn’t work effectively or lead to side effects. During immunotherapy, patient is given injections with small amount of allergen on regular basis over three to five years. This way the patient’s body gets used to the allergens and the need of medicines are decreased.

References:

• https://www.mayoclinic.org/diseases-conditions/hay-fever/symptoms-causes/syc-20373039
• https://www.mayoclinic.org/diseases-conditions/hay-fever/diagnosis-treatment/drc-20373045
• https://acaai.org/allergies/types/hay-fever-rhinitis

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