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28th December 1997

Sports

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Hey and a ho and its hay fever again

Your Health  - By  Dr. Sanjiva Wijesinha

When spring comes round again, you can be sure that someone in your family, your school or your workplace is going to start getting their usual attacks of hay fever.

This condition usually affects Atopic people - those who are prone to get urticaria, asthma, eczema and who belong to families where there is a history of allergy.

Hay fever generally affects children or young adults, and the attacks normally become less frequent and less severe as one gets older. The symptoms are brought about by Allergens (substances to which the nose and throat are allergic) in the atmosphere. Now the commonest such allergen is pollen-and this is why the hay fever becomes so widespread when there is a lot of pollen in the air.

But pollen is not the only cause of hay fever. Other allergens such as dust accumulating at home or at work, plant materials or chemicals in factories, wood dust, cleaning sprays, chemical fumes, tobacco smoke, fluff and fur from animals - all these can bring on the symptoms.

The typical features of hay fever - also called Allergic rhinitis - are sneezing, watery nose, tearing and itching of the eyes, ears and throat. The congestion of the nose and throat can lead to secondary infection of the middle ear and the sinuses. Another manifestation of recurrent hay fever is the development of nasal polyps-little growths on the inner surface of the nose, which act to block the free flow of air when one inhales.

The most effective method of controlling hay fever is by prevention - which means avoiding exposure to the offending allergens. This of course is easy to prescribe but difficult to put into practice!

Removal of pets from the home to avoid animal fur, using air filters to minimize the entry of airborne pollen into the house, even changing one's home or moving to areas where the pollen count in the atmosphere is not so high - all these are methods which people have used to get over the problem.

Immunotherapy, a technique which involves repeated injections of gradually increasing doses of the allergen that is considered responsible for the symptoms, can be effective in theory. In practice, it is not always efficacious because it depends on accurately identifying the specific allergen - and this is not easy.

There are many drugs which can be used for hay fever. Antihistamines ( for example phenergan, piriton, avil, hismanal, teldane) are useful-although they do have side effects like drowsiness.

Decongestants can be helpful - either to be taken by mouth (eg sudafed) or topically (ephedrine nasal drops, atrovent). However, continued use of these nasal sprays can result in a rebound effect when the drug is stopped suddenly and may result in the rhinitis becoming chronic.

New drugs like topical steroids (beconase nasal spray, rhinocort, flixonase) which relieve symptoms of both seasonal and chronic rhinitis and as sodium chromoglycate (rynacrom) for prophylaxis have given encouraging results.

Of course, the fact that there are so many different methods of treatment available implies that no one treatment is ideal! One has to discuss the matter with one's own doctor and work out which the best therapy is for each individual.


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