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Recently someone asked me about allergies – why do they happen? It was then when I understood that it is a very difficult thing for doctors to explain in “non-medical” terms. Most people, when they think of allergies, think about sneezing, itchy and runny nose. Others think it is when we get a swollen face, or hives or react to foods. Well, there are different types of allergies: food allergies, allergic conjunctivitis (allergies in the eyes), asthma, eczema. I will focus on allergic rhinitis also called “hay fever” — which, by the way, does not give you a fever.
Rhinitis means inflammation of the inside of the nose. This causes sneezing, nasal congestion, runny nose and postnasal drip (that mucus that goes down the back of the throat). So, rhinitis can be caused by different things, (most commonly due to viruses that give us colds) and sometimes can be from allergies.
When it is allergic rhinitis, it is because our nose reacts to particles in the air. These particles make some specific cells in our nose (that are part of our immune system) release substances (like histamine) that cause inflammation, and with inflammation comes congestion and all the symptoms mentioned above. What makes it worse is that after being exposed, a cascade of other inflammatory substances start being released, making symptoms stay there longer. This can happen in many people only at certain times of the year (mostly with changes in the weather) or if you are as (not) lucky as me, it can be all year around! The main reason there are so many treatment options for allergies is that not one medicine can help everyone. And with allergic rhinitis, it is not only the nasal symptoms that are bothersome, it may also be accompanied by fatigue, weakness, cough, itchy throat and even disturbance of sleep.
So, who has a higher risk of being allergic? Many people will never experience the symptoms related to allergies, but those who do most likely have parents that are allergic, maternal smoking in the first year of life, being born during a season with high pollen in the air (although newborns and small babies will not experience symptoms because it normally takes a few years of being exposed to allergens before symptoms start showing up).
I mentioned that there are several medication options to treat allergies. In very small children under the age of 2 years the recommended medications are all available over-the-counter antihistamines: loratadine, cetirizine or fexofenadine (the generic names of the medications are being used here and all of these medications come in a liquid form for the little ones). After the age of 2 years, the recommended first line treatment will depend on the severity, duration and how often symptoms are present. It could be an oral medication like the ones listed above, a steroid (a nasal spray that works like the oral ones (anti-histamine)), or an intranasal steroid (very safe since it is only topically used, directed towards the nose). Sometimes patients will require a combination of treatments when only one fails to treat all symptoms. There are several other prescribed options once all these over-the-counter alternatives have failed to alleviate symptoms. Discuss with your doctor if you have questions or concerns.
Dr. Gomez practices medicine at Pediatrics of Queen Creek, PLLC, 22709 S. Ellsworth Rd, Ste F104, Queen Creek, 480-792-9200; Dr.Gomez@bethesdapeds.com;
www.BethesdaPeds.com.
Dr. Gomez is a board certified Pediatrician, who knew from an early age that she wanted to be a “doctor for children and teenagers”. She and her husband moved to Arizona in 2006, shortly after marrying, and then began her pediatric residency program in 2007 at St. Joseph’s Hospital and Medical Center in Phoenix. She took over Pediatrics of Queen Creek upon finishing her residency in 2010. At her graduation she was given the 2010 The Walt Vikram Award, granted to the graduate that had demonstrated the most exemplary compassion in the care of newborns. She has worked with community programs to teach and educate the public on several health topics. She has a special interest in educating parents about healthy eating, breastfeeding and helping those families dealing with asthma. Dr. Gomez is a mother of 2: a very funny and active boy and a loud and happy daughter. They enjoy traveling and their special Friday movie nights at home.
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