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Allergic rhinitis also known as theÂ hay feverÂ is an allergic reaction/irritation of the nasal passage in our body. It irritation occurs when an allergen (allergy causing agent) such as pollen or dust is inhaled by an individual with a sensitive immune system. This in turn triggers the production ofÂ antibody. The antibodies produced due to the reaction usually bind toÂ mast cells (AÂ mast cellÂ orÂ mastocyte is a residentÂ cellÂ of several types of tissues and contains manyÂ granulesÂ rich inÂ histamineÂ andÂ heparin)Â which containÂ histamine. When the mast cells are stimulated by pollen and dust, histamine (and other chemicals) is released, this causes itching, swelling, andÂ mucusÂ production. Symptoms vary in severity from individual to individual. Very sensitive individuals can experienceÂ hives or otherÂ rashes. Certain matter in polluted air and chemicals such as chlorineÂ and detergents, which can normally be tolerated, can greatly intensify the condition.
The late symptoms include postnasal dripping of clear mucus which frequently causes a cough. Loss of the sense of smell is common, and loss of taste sense occurs occasionally. Nose bleeding may occur if the condition is severe. Eye itching, redness, and excess tears in the eyes may intensify if the condition is left unchecked.
Reason for the disease
Allergic rhinitis which is triggered by theÂ pollensÂ of specific seasonal plants is commonly known as "hay fever", because it is most prevalent duringÂ hayingÂ season. On the other hand it is possible to suffer from hay fever throughout the year. The pollen which causes hay fever varies between individuals and from region to region; generally the tiniest visible pollens ofÂ wind-pollinatedÂ plantsÂ are the principal cause. Pollens ofÂ insect-pollinatedÂ plants are too large to remain airborne and pose no risk. Examples of plants commonly responsible for hay fever include:
Trees such as pine, birch, alder, cedar, hazel, hornbeam, horse chestnut, willow,Â poplar, plane, linden/lime and olive
Grasses especiallyÂ ryegrass andÂ timothyÂ are the allergic agents
Weeds includeÂ ragweed, plantain,Â nettle/parietaria,Â mugwort,Â Fat hen andÂ sorrel/dock
Dust mites, cockroaches, molds and animal dander, are examples of year-around allergens.
Tree, grass and ragweed pollens are primarily seasonal outdoor allergens. Seasonal pollens depend on wind for cross-pollination. Plants that depend on insect pollination, such as goldenrod and dandelions, do not usually cause allergic rhinitis.
Another major cause is mold spores grow in warm, damp environments. The highest mold spore counts occur in early spring, late summer and early fall, but mold spores can be measured indoors year-around.
Animal allergens are also important indoor allergens. The major cat allergen is secreted through the sebaceous glands of the animal's skin. These small, light proteins are capable of staying suspended in the air for up to six hours and can be measured for several months after a cat is removed from an indoor environment. All these are the reason leading to this allergy.
The goal of rhinitis prevention is to reduce the symptoms caused by the inflammation of affected tissues. In cases of allergic rhinitis, the most effective way to decrease allergic symptoms is to completely avoid the allergen.
Eliminating exposure to allergens is the most effective preventive measure, but requires consistent effort. Many people with pollen allergies reduce their exposure by remaining indoors during hay fever season, particularly in the morning and evening, when outdoor pollen levels are at their highest. Closing all the windows and doors prevents wind-borne pollen from entering the home or office. When traveling in a vehicle, closing all the windows reduces exposure.Â Air conditionersÂ are reasonably effective filters, and special pollen filters can be fitted to both home and vehicle air conditioning systems.
Rinsing is very often recommended as part of the healing process after sinus or nasal surgery. For this rinse, boiled or distilled water is only necessary during recovery from surgery, as the entire contents of the bottle is used.
Seasonal allergens (such as tree, grass and ragweed pollens) are difficult to avoid outdoors, but can be controlled by closing windows and running air conditioners.
Excessive exposure to allergens, such as outdoor molds, can be prevented by avoiding lawn mowing and other activities likely to stir these up.
Maintaining an allergen-free environment also includes covering pillows and mattresses with plastic covers, substituting synthetic materials (such as foam mattresses or acrylics) for animal products (such as wool or horsehair) and removing dust-collecting household fixtures (like carpets, drapes and bedspreads). Also students who go out for education and have this condition should avoid chalk boards.
Disease curing method
There are many ways by which this disease can be controlled. These include the use of antihistamines, steroids, decongestants, desensitization and other alternative treatments.
SeveralÂ antagonisticÂ drugs are used to block the action of allergic mediators, or to prevent activation of cells and degranulation processes. These include the use of chemicals such asÂ antihistamines,Â cortisone,Â dexamethasone,Â hydrocortisone,Â epinephrineÂ (adrenaline), theophyllineÂ andÂ cromolyn sodium. One antihistamine,Â azelastine, is available as a nasal spray. Many allergy medications can have unpleasant side-effects, most notablyÂ drowsiness.
SteroidsÂ such asÂ prednisoneÂ are effective at reducing nasal inflammation, but their use is limited by their short duration of effect and the side effects of prolonged steroid therapy. Topical decongestants may also be helpful in reducing symptoms such as nasal congestion, but should not be used for long periods as stopping them after protracted use can lead to a rebound nasal congestion. More severe cases of allergic rhinitis require immunotherapy (allergy shots) or removal of tissue in the nose or sinuses.
Medication side effects
Every medicine has side effect. Some are hidden and some are visible to human eye. The use of antihistamine causes drowsiness. AÂ case-controlÂ study on histamine found "symptomatic allergic rhinitis and rhinitis medication use are associated with a significantly increased risk of unexpectedly dropping a grade in summer examinations".
Another study "suggests that drivers who need antihistamine drugs should avoid those that act centrally" because they "greatly impaired driving behavior"
The use of steroids for a longer period of time can cause serious side effects. It can cause damage to liver, effects the blood cholesterol level and it causes inhabitation of natural hormones. Decongestants should not be used for long periods as stopping them after protracted use can lead to a rebound nasal congestion (Rhinitis medicamentosa). Desensitization involves surgery and immunotherapy which involves risk and may cause long-term damage. All these medicines have side effects which may cause small term and long term damage to different parts of the body.
It is better to adopt and apply preventive measures rather than waiting for the condition to become severe and using medication.
Statistical occurrence around the world
Allergic rhinitis (AR) represents a global health problem, affecting 10% to more than 40% of the population worldwide. It has been identified as 1 of the top 10 reasons for patient visits to their primary care physicians.
In northern latitudes birch is considered to be the most important allergenic tree pollen, with an estimated 15-20% of hay fever sufferers sensitive to birch pollen grains. Olive pollen is most predominant in Mediterranean regions. An estimated 90% of hay fever sufferers are allergic to grass pollen.
The following statistics relate to the prevalence of Allergic rhinitis:
15.6% of population self-reported having hay fever and allergic rhinitis in Australia 2001 (ABS 2001 National Health Survey, Australia's Health 2004, AIHW)
15.1% of male population self-reported having hay fever and allergic rhinitis in Australia 2001 (ABS 2001 National Health Survey, Australia's Health 2004, AIHW)
15.9% of female population self-reported having hay fever and allergic rhinitis in Australia 2001 (ABS 2001 National Health Survey, Australia's Health 2004, AIHW)
2,953,000 people self-reported having hay fever and allergic rhinitis in Australia 2001 (ABS 2001 National Health Survey, Australia's Health 2004, AIHW)
1,414,000 men self-reported having hay fever and allergic rhinitis in Australia 2001 (ABS 2001 National Health Survey, Australia's Health 2004, AIHW)
1,522,000 women self-reported having hay fever and allergic rhinitis in Australia 2001 (ABS 2001 National Health Survey, Australia's Health 2004, AIHW)
The statistical analysis confirms that this disease is among the most common diseases of all and should be prevented by adapting precautionary and preventive measures.