Hay Fever
"What is hay fever?" Hay fever is the popular term for a seasonal caused allergic rhinitis. It is not caused by hay, as the name might suggest, but by the pollen of blooms and blossoms (=pollen) which are released by the plants during the time they are in blossom. For this reason it is referred to as an pollen asthma or a pollinosis. Allergenic are the protein components of the inner part of the pollen grains. "How do you get hay fever?" Hay fever is an allergy, therefore it is no infectious disease and for this reason it is not contagious. The cause, as with all allergies, is a false regulation of the immune system. In case of an allergy it comes to an exaggerated reaction of the immune system. All of a sudden its reaction unreasonably violent on substances which are normally harmless for the body, such as e.g. pollen; the body has got in touch with it countless times without suffering an allergic reaction. How this defence reaction is triggered off has not been definitely cleared, yet. Besides a congenital allergic constitution (atopy), different factors are hold for a cause for this disorder of the immune system:
"What happens during a hay fever attack?" The actual allergic reaction is preceded by a repeated contact with the allergenic substance. The body is sensitised by the substance classified as harmful by the immune system, the defence is being prepared by the development of antibodies/immunoglobulin (IgE-antibodies) in the blood. The antibodies are taken up by the surface of mast cells containing histamine in their inside and are waiting for their defence operation in case of another contact with the allergen. Is this contact established, for instance while inspiring the pollen via the mucous membrane of the nose, the mast cells burst and release histamine, which triggers off the allergic symptoms, as swellings and itching. "Which plants produce allergies?" Basically pollen of all kinds of plants can cause allergic reactions. The majority of the pollen allergies, however, are triggered off by wind pollinating plants. These plants produce more pollen because a pollination by the wind does not go off that accurate. According to its way of transference, the pollen uses to be finer and lighter in order to keep carried for a longer period of time in the air. It sticks only loosely to the blossom and is spread by the wind miles long. With plants being pollinated by insects (the major part of the flowers) the pollen sticks firmly to the bloom and for this reason it is only be found in the air of the surrounding area and in a low concentration. Owing to the similar structures of the proteins in the inner part of the pollen which are causing allergies, frequently a cross sensitivity is developed between different kinds of pollen among themselves and certain food-stuffs, which causes upon consumption unpleasant itching and swelling in the oral area. The principle cause of pollen allergies in Central Europe are the following plants: Trees: If the pollen of birch, alder and hazelnut are causing the allergies, frequently arise cross sensitivities upon the consumption of nuts, almonds, malaceous and stone fleshy fruit. Pollen of the conifers cause hay fever in very rare cases, since they are quite large and are not inhaled. Grasses and Cereals: Herbs: "When do you get hay fever?" The pollen is whirled up by the wind during the flourishing period and often is carried away over long distances. They are transferred by air on the mucous membranes where they cause allergic reactions. If the affected person gets in touch with the allergen, that means with the pollen of the plant, the allergic reactions are triggered off. How long the hay fever continues and in which months it occurs, depends on which plants you are having an allergic reaction to and how long the period of flourishing lasts. Many allergic persons suffering from hay fever have a particularly allergic reaction to plants which flourish during the season when they were born. In the majority of the cases hay fever starts during the childhood or youth, however, in principle it can arise at any age. "Do the cases of hay fever increase?" Even this form of allergic disease is in the process of increasing. According to statistics it has increased ten-fold during the last decades. These values increase by leaps and bounds which has naturally to be put down to its cause that allergic diseases receive more attention nowadays; but even this attitude exists not just by chance. "Which part does the pollution of the environment play?" The increasing pollution of the air has its effects on the human body and on the plants. Due to the increased pollutant content in the air the mucous membranes are affected / irritated and, because of this, they are more permeable for allergens. In areas with a high air pollution, the pollen count increases. In order to compensate the possible damages of the genetic make-up caused by the air pollution, the plants release more pollen. Furthermore, pollen become even more aggressive allergens due to the contaminants sticking on them, which in turn irritate additionally the mucous membranes. As well it is suspected that environmental toxic material attacks the immune system and intensifies by this the proneness to allergies. "Is it hereditary?" There is an inherent readiness, a predisposition arising in large numbers within a family (atopy) to develop allergies. It can be determined from the immunglobulin-E-level (IgE). However, a high IgE-level does not mean that this person unavoidable has to fall ill with an allergy. "Is it a disease or dangerous?" Hay fever is no life-threatening disease but it is, for the affected persons, especially for children, really agonizing and exhausting. If a person is not affected by allergies, he might think – well, hay fever, that is only an allergy, actually it is no disease – in fact, a severe hay fever is a physical and psychological impairment which is much more serious than e.g. a common cold. If you have a flu or a feverish cold, you feel sick, you feel pain and you feel awful – but in this case you go to bed, take your medicine and you know that you will get over the worst within one or two days. Frequently already simple bed rest gives a clear relief to the sick person. With allergies, that is different. The symptoms are similar but the situation is completely different. Complete physical exhaustion goes together with a continuous stress: the tickling, the itching, the burning make that the body and mind simply cannot find rest and you never know when it will be over - and if you find rest for a moment, you must reckon on that it is about to start over again. Children who are exposed to these attacks are even more helpless. Support and comprehension on part of their parents and teachers can take a lot of load off the children. Therefore avoid additional pressure even though the results at school are getting worse during allergic phases. "Do I have to see a doctor because of that?" You should see your physician in any case, particularly if your child is affected, since the allergy can get worse and other organs can be affected. If not treated, the hay fever frequently turns into a permanent allergic cold; chronic inflammations of the sinus of the nose and the middle ear can be unpleasant consequences. If the allergic irritation extends to the lower respiratory tract, bronchial asthma will be added to the troubles. In order to find out which otorhinolaryngologic physicians and allergologists (specialized as a paediatrician) set up a practice as a doctor in your area, ask your family doctor or your health insurance. "How can I make out that it is hay fever?" An important distinguishing feature is the occurrence of this allergy depending on the season. During the months of winter (November - February) persons allergic to pollen have no trouble since the plants releasing pollen have a rest period. The complaints do not start until the plants are in their period of blossom. This varies according to the species of the plant – some are in blossom already in February, others not until late summer until up to October - and are subject to seasonal variations. "Where do I know from which plants are flourishing at the moment?" Information about this topic can be taken from the following sources:
"How does hay fever manifest itself?" Symptoms are: an itching nose, acute sneezing impulse, runny nose without interruption, swelling of the mucous membrane of the nose and the sinus, it is difficult to breathe, itching of the palate, pharynx, and the auditory canals. Frequently the eyes or conjunctiva, respectively, are affected, too. They are reddened, run with tears and itch violently. The eyelids are swollen. Rubbing does not ease the symptoms but intensifies the irritation and makes it worse. Very often the allergic reaction extends as well to the lower respiratory tract, then asthmatic trouble - asthma bronchiale is developed. "What can the physician do to help you?" The doctor can find out to which substances you have an allergic reaction. In order to do this an exact anamnesis is necessary: for the doctor it is important to know, when, i.e. during which season of the year the attacks occur, in which situations the symptoms get worse, when they arose for the first time, etc. In order to define the trigger of the allergy exactly, he can, if necessary, carry out various allergy tests. When it is settled which substance has caused the allergy, it can be decided on the kind of treatment. "Which possibilities of treatment exist?" The treatment of hay fever consists basically in limiting the contact with pollen as far as possible. – It is impossible to avoid it completely. Poly Prevent S25® (to be purchased in pharmacies), for example, puts a protective film on the nasal mucosa in order to avoid or limit respectively the contact with pollen and other allergens. To reduce / fight the symptoms, a medicinal treatment is recommended. Basically two kinds of medical remedies exist which are employed in this case:
If you know when to expect allergic attacks, you can start in good time with the prophylactic taking of certain medical remedies of which the effect partly does not arise immediately but only after approximately 1-2 weeks. Here are to be mentioned especially eye- and nose-drops and nose-sprays respectively, which contain DNCG (disodium cromoglicidacid) (such as for example Allergocrom or Vividrin). They are very well tolerated and for this reason they are suitable for long-term therapies. The active agent stabilizes the walls of the mast cells and, by doing this, reduces the output of histamines, which trigger off the allergic symptoms. Since the effect does not occur immediately, it has to be paid attention to a preventive, regular administration of these medical remedies. With acute trouble of the nose, mucous membrane decongesting agents are administered. The substances contained contract the blood vessels of the nasal mucosa and by doing this they counteract the nasal congestion and secretion. These agents can only be used for a short time (not longer than one week), since the mucous membrane of the nose would be affected in case of longer application. Antihistamine preparations are administered in form of juice or tablets, eye- or nose-drops preventive and as well as to ease acute complaints. Antihistamine preparations block the effect of the histamine and reduce by this the allergic trouble. Erates show unpleasant tiring side effects. Agents containing cortisone, corticoids, should only be used in exceptional cases, when DNCG and / or antihistamine preparations do not show any satisfactory effect. They are administered in form of nasal sprays or eye-drops in a relatively low dosage. The strong anti-inflammatory effect does not start immediately but only after 1-4 days. The risk of side effects is estimated relatively low due to the low dosage in comparison with cortisone injections or tablets. This form of treatment should not be carried out long-term and only under stringent control of your physician or oculist, respectively. A further treatment method is the hyposensitization, probably the most effective treatment method for different allergies. It is an immunotherapy which is based on the desensitisation of the body against the known allergens where the body is confronted in increasing dosages with the allergy causing substances until it develops, in the best case, a tolerance of these, i.e. no further allergic reactions occur. A requirement for this treatment is a definite identification of the allergen. The duration of the treatment is individually different, but it has to be carried on for at least three years. It has to be paid attention to the fact that it requires considerable time and a conscientious, regular execution. It usually is executed outside the pollen season. The success rate is of approximately 80 %; in the majority of the cases and with a proper execution of the therapy, after all, there is a clear improvement of the symptoms. In principle, younger patients have a better chance of a cure which is favoured by an early treatment (in the first 5 years upon the first occurrence of the allergic reactions). The prognosis is unfavourable in case of simultaneous sensitisation for allergens of different kinds, for instance mites and pollen or pollen and mould fungus. "When is an allergy test necessary or useful respectively?" In case of an pollen allergy, an allergy test is not necessary because the source of the allergy in comparison to other allergies (nutritional allergies, contact hypersensitivity) it is relatively easy to determine it. Besides the relevant symptoms, the seasonal occurrence of the allergic reactions is a clear hint of a pollen allergy. The definite determination of the allergen by an allergy test is further the requirement for a deficiency, which is in case of a pollen allergy difficult to carry through, though, since the respective pollen are nearly everywhere in the period of blooming and the contact with the allergenic substance can only be reduced but not absolutely avoided. An allergy test is necessary if a hyposensitization is going to be executed. The usefulness, however, has to be thoroughly weighed up with this prolonged treatment which is taking an enormous amount of time. "How can I help myself?" It is impossible to avoid the contact with pollen completely since pollen is to be found nearly everywhere during the flourishing period. Nevertheless, with some measures you can reduce or avoid unnecessary allergenic exposure, respectively. A precondition for the efficient reduction of the stimulus is the knowledge due to which pollen you suffer from allergic reactions. The lower the concentration of pollen in your surroundings is and less direct contact you have with the pollen, the better for you: Get informed about the present pollen count. Avoid going for a walk through meadows, if you suffer from an allergy on grass pollen. Change your clothes after longer stays in the open and take a shower. Do not take your allergens to your bed – brush, and even better, wash your hair before going to bed. Keep the windows of your car shut during the period of pollen count. Pay attention to the possible cross sensitivities when consuming certain food-stuffs in order to avoid additional discomfort. Plan your vacation, if possible, in areas with a low strain of pollen (on the seaside, in the mountains). Avoid additional stimulation of the mucous membranes (nose, eyes, bronchus) by smoke, dust, exhaust fumes and suchlike. Self-help groups: to get in touch with self-help groups can be very helpful and relieving for affected persons, especially parents of children suffering from allergies. Besides the exchange of experiences about different kinds of therapies, good physicians, medicinal remedies, support by the Health insurance and many things more, it lessens the feeling of helplessness with respect to the allergic disease. An information by ulti med Products (Deutschland) GmbH |