Spring allergies… HELP!

Apr '13 NC web banner-2By:  Brian W. Donnelly, M.D.

Are you suffering from a runny nose, watery eyes and an annoying cough? It is possible you are suffering from allergies.

In the spring, as plants grow, pollen is released into the atmosphere. For people who are allergic, their body responds to this exposure by releasing chemicals that increase inflammation. One of these chemicals is histamine. Histamine usually causes swelling and itchiness.

Not everyone has allergies. It has been estimated that 11 percent of the U.S. population suffers from respiratory allergies. But that works out to 35 million people, which is nothing to sneeze at.

The first line of defense for alleviating the symptoms is an oral anti-histamine. Diphenhydramine has been used for decades, and is still quite effective. The problem with this medication is that it can cause drowsiness, and its effect lasts from 4 to 6 hours. More popular are the second generation anti-histamines that last 12 or even 24 hours. These more convenient medications include fexofenadine, loratadine and cetirizine. These had all recently been prescription drugs, but are now available over the counter. All of these are available in liquid form, facilitating their use in children.

The next line of defense is either an intranasal anti-inflammatory medication (steroid) or an oral anti-leukotriene, such as montelukast. Currently a prescription is required for both of these types of drugs. The intranasal medications can take several days to reach full effectiveness, so if you know your allergy symptoms start in early May, you should start to use your nasal spray in late April. Montelukast is available in tablet form, chewable form, or dissolvable granules.

Anti-inflammatory eye drops are also available over the counter if the eyes are sufficiently itchy or swollen.

If allergy symptoms cannot be controlled with these measures, your doctor can arrange for testing. Sometimes, immunotherapy – allergy shots – are indicated.