Allergy Diagnosis and Treatment
Allergic Rhinitis, Sinusitis, and Rhinosinusitis
Inflammation of the nasal mucous membrane is called rhinitis. The symptoms include sneezing and runny and/or itchy nose, caused by irritation and congestion in the nose. There are two types: allergic rhinitis and non-allergic rhinitis.
This condition occurs when the body’s immune system over-responds to specific, non-infectious particles such as plant pollens, molds, dust mites, animal hair, industrial chemicals (including tobacco smoke), foods, medicines, and insect venom. During an allergic attack, antibodies, primarily immunoglobin E (IgE), attach to mast cells (cells that release histamine) in the lungs, skin, and mucous membranes. Once IgE connects with the mast cells, a number of chemicals are released. One of the chemicals, histamine, opens the blood vessels and causes skin redness and swollen membranes. When this occurs in the nose, sneezing and congestion are the result.
Seasonal allergic rhinitis or hayfever occurs in late summer or spring. Hypersensitivity to ragweed, not hay, is the primary cause of seasonal allergic rhinitis in 75 percent of all Americans who suffer from this seasonal disorder. People with sensitivity to tree pollen have symptoms in late March or early April; an allergic reaction to mold spores occurs in October and November as a consequence of falling leaves.
Perennial allergic rhinitis occurs year-round and can result from sensitivity to pet hair, mold on wallpaper, houseplants, carpeting, and upholstery. Some studies suggest that air pollution such as automobile engine emissions can aggravate allergic rhinitis. Although bacteria is not the cause of allergic rhinitis, one medical study found a significant number of the bacteria Staphylococcus aureus in the nasal passages of patients with year-round allergic rhinitis, concluding that the allergic condition may lead to higher bacterial levels, thereby creating a condition that worsens the allergies.
Patients who suffer from recurring bouts of allergic rhinitis should observe their symptoms on a continuous basis. If facial pain or a greenish-yellow nasal discharge occurs, a qualified ear, nose, and throat specialist can provide appropriate sinusitis treatment.
This form of rhinitis does not depend on the presence of IgE and is not due to an allergic reaction. The symptoms can be triggered by cigarette smoke and other pollutants as well as strong odors, alcoholic beverages, and cold. Other causes may include blockages in the nose, a deviated septum, infections, and over-use of medications such as decongestants.
Rhinosinusitis: Clarifying The Relationship Between The Sinuses And Rhinitis
Recent studies by otolaryngologist–head and neck surgeons have better defined the association between rhinitis and sinusitis. They have concluded that sinusitis is often preceded by rhinitis and rarely occurs without concurrent rhinitis. The symptoms, nasal obstruction/discharge and loss of smell, occur in both disorders. Most importantly, computed tomography (CT scan) findings have established that the mucosal linings of the nose and sinuses are simultaneously involved in the common cold (previously, thought to affect only the nasal passages). Otolaryngologists, acknowledging the inter-relationship between the nasal and sinus passages, now refer to sinusitis as rhinosinusitis.
The catalyst relating the two disorders is thought to involve nasal sinus overflow obstruction, followed by bacterial colonization and infection leading to acute, recurrent, or chronic sinusitis. Likewise, chronic inflammation due to allergies can lead to obstruction and subsequent sinusitis.
Other medical research has supported the close relationship between allergic rhinitis and sinusitis. In a retrospective study on sinus abnormalities in 1,120 patients (from two to 87 years of age), thickening of the sinus mucosa was more commonly found in sinusitis patients during July, August, September, and December, months in which pollen, mold, and viral epidemics are prominent. A review of patients (four to 83 years of age) who had surgery to treat their chronic sinus conditions revealed that those with seasonal allergy and nasal polyps are more likely to experience a recurrence of their sinusitis.
Allergies and Hay Fever
Forty-five million Americans suffer from a recurring problem called allergy. Allergic rhinitis was once known as hay fever because workers would sneeze and develop nasal and sinus congestion when they worked around hay in the fields. Hay fever, asthma, and eczema are the most common symptoms of an allergic reaction.
Allergy symptoms appear when the body's immune system begins to respond to a substance as though it were a dangerous invader (called an antigen or allergen). It does this by sending specific defenders called antibodies to the entry site. The battle between allergen and antibody results in a release of chemical mediators, such as histamine, into the bloodstream. Those chemical mediators cause changes in the body, which produce the symptoms that we feel.
Symptoms that may be caused by allergy are itching eyes, sneezing, nasal stuffiness, nasal congestion and drainage, and sometimes headache. Some people experience hearing changes, scratchy sore throats, hoarseness, sinusitis and cough. Other less common symptoms include balance disturbances, swelling in face or throat tissues, skin irritations, and even respiratory problems and asthma.
Some allergy sufferers experience symptoms all year.
Can Allergies Be Serious?
Allergies are rarely life threatening, but often cause lost workdays, decreased work efficiency, poor school performance, and less enjoyment of life. It is common for allergy sufferers to develop sinus or respiratory infections if allergy symptoms are not controlled. Considering the millions spent in anti-allergy medications and the cost of lost work time, allergies cannot be considered a minor problem.
Treatment And Prevention
A number of medications are useful in the treatment of allergy including antihistamine, nasal decongestant sprays, steroid sprays, and saline sprays. The medical management of allergy also includes counseling in proper environmental control. Based on a detailed history and thorough examination, your doctor may advise testing to determine the specific substances to which you are allergic.
The treatments employed by your otolaryngologists will depend on the materials to which you are allergic and the degree of your sensitivity to them. The only “cure” available for inhalant allergy is the administration of injections that build up protective antibodies to specific allergens (pollens, molds, animal danders, dust, etc.). Your physician will oversee your progress and care for any other nasal and sinus disorders that may contribute to your symptoms.
A Tradition of Caring…A History of Healing
Choosing Associates of Otolaryngology is the first step towards optimum health for you and your family. Selecting a healthcare provider is a big decision. Over the past 40 years, we have had the honor of treating hundreds of multi-generational families who have come to trust and depend on us.
At Associates of Otolaryngology we offer healthcare options that respect your values and honor your needs. For over 40 years, our board certified physicians have provided the highest quality health care to families in the Denver Metropolitan area and Rocky Mountain Region.
Our physicians will carefully evaluate your medical history, perform physical examination and provide personalized treatment options to meet your specific needs. Supporting our physicians are audiologists and specialty trained nurses for your complete hearing and allergy health care.
Together they offer you the attention you deserve and the care you require.
All your needs from initial consultation, to diagnosis, to treatment will be cared for at either our Denver or Park Meadows facilities.
You can rest assured that whatever your medical needs are, you have found excellent physicians with a qualified support staff for you and your family,We are available for emergencies 24 hours a day.