Allergy Season is Upon Us…

 Namita Joshi 

The end of winter brings us some relief but, with the spring season just around the corner, many of us face an increase in the sneezing, runny nose, red irritated eyes, congestion and possible wheezing associated with exposure to various allergens.  Some of us may also experience lower respiratory symptoms such as cough, chest tightness or difficulty breathing. These hallmark symptoms of allergic rhinitis show a peak in childhood/adolescence and gradually diminish with aging.  In the coming weeks, instead of having a spring in our step, we may find ourselves seated in the waiting room of a medical office to seek advice and treatment for our allergies. The incidence of allergic rhinitis in North America is around 7%.  Knowing that you are not alone may be little comfort but, there are small changes that can be made to help ease the symptoms which may otherwise take a toll on both work and personal lives.

Allergic rhinitis can be either seasonal or perennial.  Small clues to a diagnosis can be revealed with an accurate history taking. A family history of similar or related symptoms is often seen in those who must deal with seasonal allergies.  A personal history of eczema or asthma is also often present.  The timing of symptoms and the environment in which they most frequently occur can point towards the offending allergen.  Are the symptoms most frequent outside? At work? At home?  There are certain recognized patterns which provide a good starting point for investigation.  Dates of pollination for various weed species generally are constant in a particular location but may vary quite differently from region to region.  In temperate North America the pattern most commonly seen has trees pollinating March-May; grasses from June to early July and ragweed mid-August to early October. Air currents can carry these pollens varying distances.  Molds present in soil and decaying organic matter may also scatter spores depending on the surrounding climate.  Perhaps some of us have already noticed allergies acting up more frequently during these times.  With perennial allergies, the culprit allergens are present year round and include animal dander, dust, dust mites and processed materials in industrial settings.  Often times, in up to 2/3 of cases, the exact allergen cannot be demonstrated despite thorough testing.  It is helpful to watch out for a variability in symptoms based on exposure to various possible allergens to help make a diagnosis.  Skin testing may also help to provide further pieces of the puzzle when searching for a cause.

What can we do? Avoidance of exposure may not always be possible but, it is the most effective means to control allergic disease.  Many people may find relief by keeping windows closed and staying in air conditioned environments during sensitive pollen days.    Use of air filters also help to decrease the concentration of airborne pollens.  More demanding methods of avoidance include removal of a beloved pet from the home to cut down exposure to animal dander; covering mattresses, pillows and comforters with plastic to decrease exposure to dust; not using carpets or fabric drapes in bedrooms and in the case of serious mold, a move from a home may also be needed.  Clearly, these are not easy tasks to undertake.  When exposure cannot be controlled, multiple drug therapies exist, including antihistamines and corticosteroids, which used under the watchful of a physician have proven effective and beneficial.  Keen observation and open dialogue is a great way to welcome the changes of spring and manage our allergies.

Namita Joshi is a foreign medical graduate living in Toronto.

Image credit: ©  iStockphoto.com/christian misje