About one in ten Irish people experience the discomfort of allergic rhinitis (hay fever) every year. Some only have symptoms during the summer. This is called seasonal allergic rhinitis). Others have symptoms all year round (called perennial rhinitis). If you have asthma, allergic rhinitis can make asthma worse.

Allergic rhinitis may be a seasonal condition. People with seasonal allergic rhinitis are allergic to pollen and spores.

Pollen is the tiny, dust-like particles given off by certain types of trees, grasses, weeds and flowers. Spores come from fungi and moulds.

Perennial rhinitis (when symptoms occur all year round) is usually caused by allergens such as house dust mites, furry or feathery animals, and some foods.

If you have an allergy, your body reacts when you come into contact with certain allergens. As soon as you inhale them, or if they get into your eyes, they irritate the sensitive linings of your nose, throat and eyes. This causes the symptoms of seasonal or perennial rhinitis to appear.

Asthma and allergic rhinitis?
Between 60-80% of people who have asthma also have allergic rhinitis. Both asthma and allergic rhinitis are caused by an allergic reaction and the two conditions frequently overlap. Many of the same allergens are known to trigger asthma and allergic rhinitis. If allergic rhinitis is treatment effectively, it could reduce asthma symptoms and may even prevent the development of asthma.

One airway, one disease. Asthma and rhinitis are related conditions linked by a common airway. The air we breathe in passes through the nose (at the start of the airway) and then continues into the lungs.

With asthma the breathlessness and wheezing is caused by narrowing of the small branched airways (bronchioles) in the lungs. Inflammation of these small airways causes increased phlegm, making the obstruction worse. The dry cough that develops is an attempt to clear the airways.

In allergic rhinitis the obstruction occurs in the nose. Blocked and runny nose occurs because the inside of the nose has become inflamed. In the same way as coughing is an attempt to clear the obstruction in the lower part of the airway, sneezing is an attempt to clear the mucus from the upper part of the airway.

What causes allergic rhinitis??

There are more than 30 types of pollen and 20 types of spores that can trigger allergic rhinitis. Grass pollen is the most frequent cause of hay fever.

Tree pollen can also cause problems. Troublesome trees include the elder, horse chestnut, hazel and birch. The birch is the most common culprit. Weeds like plantains, mugwort, nettles and docks also produce bothersome pollen. Wind pollinated flowers (eg. the daisy family) are another common source of problems. Spores are produced by fungi, such as mushrooms and mould. Compost heaps are a frequent source of these.

Different pollens and spores are released throughout the year. To identify which one may be causing your allergy, as a starting point, make a note of when your symptoms occur.

What causes perennial rhinitis??
The major indoor allergens that cause perennial rhinitis are the house dust mite and furry and feathery animals. Other things that can cause problems all year round are moulds, certain chemicals and some foods.

Unfortunately it can be very different to identify exactly which allergens are causing your problems. It’s a good idea to keep a diary to record the times when your symptoms are worse and try to identify what might have triggered them. Discuss the results with your GP, who may help to identify your main allergens or failing that may refer you to an allergy specialist.

What are the symptoms??
Typical symptoms of hay fever and perennial rhinitis are:
Sneezing
Itchy, blocked or runny nose
Red, itchy throat, inner ear or mouth
Headaches
Loss of concentration and generally feeling unwell.

Different people experience different symptoms. Some may experience them all, others may experience a couple.

The common cold can often be confused with hay fever and perennial rhinitis because they all cause similar symptoms. However, a cold normally lasts for around week. Sneezing, a streaming nose and itchy eyes, which persist for a few weeks, may well be due to either seasonal or perennial rhinitis.

How can I control my symptoms?
Whether you have seasonal or perennial rhinitis, there are two main courses of action open to you:
You can try to avoid the allergies that affect you.
You can take effective medication (as allergens are impossible to avoid completely)
A combination of the two is often the most successful method of controlling symptoms.

Avoiding pollen and spores
Pollen and spores are a problem in towns and cities as well as in the countryside. This is because they are small and light enough to be carried in the air over great distances during the course of the day. Most pollen is released in the morning and rises skywards with the heat of the day. It then gets whisked overland by winds and breezes. The pollen sinks back to earth in the late afternoon or early evening as the temperature starts to drop.

Although it’s difficult to avoid pollens and spores completely, there are several sensible and worthwhile precautions you can take.

Indoors:
Keep doors and windows closed especially mid-morning and late afternoon to early evening. These are the times when the pollen count is usually at its highest.
Vacuum regularly and dust with a damp cloth.
Avoid drying your clothes outside. But if you do, give them a good shake before bringing them back into the house. That way you will get rid of any pollen and spores that might have blown onto them.
If you have been out walking or gardening, shower, wash your hair and change your clothes when you get back in. That way you won’t carry spores and pollen around the house.
Splash your eyes with cold water regularly. This will help flush out any pollen. It will also soothe and cool your eyes.
Keep fresh flowers out of the house.
Keep furry pets out of the house during the hay fever season. If your pet does come indoors, wash or bathe them regularly to remove any lingering pollen from their fur.
Another important tip is to stop people from smoking in your home as this can make hay fever worse.

Outdoors:
Check the pollen forecast on the television or in the newspaper before venturing outside. This will give you an idea of how high or low the pollen count is in your area.
Try to stay indoors if there is a high pollen count.
Wear wraparound sunglasses, these will help stop pollen blowing into your eyes.
Smear Vaseline inside your nose. This may not sound pleasant, but it can help to stop pollen and spores from settling on the lining of your nose.
Try to stay out of places with lots of grass, like parks or fields.
Keep your car windows closed. Some cars can be fitted with pollen filters. Ask at your local garage for further details.
Try to avoid mowing the lawn or weeding. These activities can create clouds of pollen and spores.
If you enjoy gardening, consider creating a hay fever friendly environment for yourself. Grow insect pollinated plants like the geranium, iris and clematis. Consider replacing the lawn with attractive paving. Don’t grow any new hedges and don’t cut existing ones yourself. Do away with compost heaps, (which produce mould spores).

For further information on Low Allergy Garden contact the Asthma Society of Ireland.

How to cope at exam time
If you are getting ready to sit an exam, it is important that you get hay fever symptoms under control as early as possible.

Once hay fever is under control you will find yourself sleeping better at night. This means you will feel much fresher during the day and will be able to concentrate much hard on your revision. You obviously feel a lot better in yourself if you are not sneezing, sniffing or rubbing your eyes all the time.

The day before the exam:
See your doctor well in advance of the hay fever season (and certainly no later than the Easter holidays) to make sure you have got the right treatment.

On the big day:
Don’t forget to take your regular medication!
Tell the adjudicator if your hay fever is bothering you.
Splash your eyes with cold water before going into the exam room.
Try not to sit near an open window.
Keep a supply of tissues and effective, quick-acting hay fever treatments close at hand just in case.

How to cope on holidays
The hay fever season varies from country to country. It all depends on the climate and the type of vegetation. However, it is possible to plan a holiday that will not be ruined by your hay fever:

Go somewhere, which has low pollen counts all year round. For example, there is generally less pollen around in coastal areas where the breeze blows fresh air in off the sea.
Mountain regions and moor land tend to contain fewer pollen-producing plants and can be kinder on your hay fever.
Try visiting places outside their peak pollen season. For example, the grass pollen season in Mediterranean regions starts and finishes about five weeks earlier than in northern Europe. This means that by mid-July the pollen count in popular holiday destinations like southern Spain, France, Italy, Greece and the Mediterranean islands is usually well past its peak.
Grass pollen is at its most abundant in Florida between April and October. In the Caribbean it’s a problem in June, July and from October and March.

Avoiding indoor allergens
If you have perennial rhinitis and are allergic to the house-dust mite, the following tips may help:

Use barriers covers for your bedding.
Hot wash (at 60°C) all bedding at least once a week.
Vacuum frequently using a high-efficiency vacuum cleaner.
Dust regularly with a damp cloth.

Other tips
If you don’t already own a pet, think carefully before getting one.
If you already have a pet, keep it out of the living room and bedroom areas and bathe it regularly.
Give up smoking and don’t let others smoke in your home. Chemicals in cigarette smoke can make allergies worse.

Treatments for hay fever and perennial rhinitis
There is no cure for either hay fever or perennial rhinitis. . However, in most cases symptoms can be controlled effectively using a range of treatments

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