Coping with Allergies

April 26, 2000

Hello and welcome to gazoontite.com's expert chat with allergist Ahmed Mohiuddin, M.D. With spring here, we thought a medical expert could help us understand the effects of outdoor allergens like pollen, and give us suggestions for reducing our allergy symptoms this season. As a leading researcher and author in the fields of hay fever and nocturnal asthma, Dr. Mohiuddin is an expert in asthma and allergy management.

Page 1 of 5

Gazoontite: Hello and welcome to gazoontite.com's expert chat with allergist Ahmed Mohiuddin, MD. With spring here, we thought a medical expert could help us understand the effects of outdoor allergens like pollen, and give us suggestions for reducing our allergy symptoms this season. As a leading researcher and author in the fields of hay fever and nocturnal asthma, Dr. Mohiuddin is an expert in asthma and allergy management. We are pleased to have him join us today. Please welcome Dr. Mohiuddin!

Dr Mohiuddin: Welcome everyone. I look forward to answering your questions!

BusyMom: What is hay fever? What causes it?

Dr Mohiuddin: Hay fever is actually a very old term. It was coined more than a couple of centuries ago, because people believed that the symptoms were caused by moldy hay. The symptoms described were nasal stuffiness, itching, tearing, and itchy, swollen eyes. That term "hay fever" has stuck, even though we use it more to denote allergic rhinitis caused by not just moldy hay, but also from a variety of other things, like dust mites and dander, cockroach antigens, tree/grass weed pollens, and other pets or animal exposures.

Cayla: What are the common symptoms of hay fever?

Dr Mohiuddin: Most people equate hay fever with sneezing, itching of the nose, itchy, teary, red eyes. A lot of people don't realize that hay fever, or allergic rhinitis, can cause congestion, blockage of the nose, sinus pressure, headaches, and post-nasal drip. And a post-nasal drip can cause recurrent sore throats, especially in the mornings when first waking up, and even stomach symptoms like abdominal pain from the swallowed mucus. They can also cause ear problems, as patients complain their ears feel full or clogged, or ringing in the ears, and decreased hearing; or even loss of balance. A lot of the sneezing/itchy eye problems are seen in patients who have seasonal, mild allergic reactions. Many of these patients take over-the-counter antihistamines, and they respond quite well to those. It's the patient who primarily has the congestion and blockage and sinus problems that doesn't respond well to over-the-counter antihistamines. In fact, most of the patients that I see as an allergist don't even have sneezing and itching as their symptoms. It's important to keep in mind that a chronic cough and sneezing and itching are most often from common allergies.

AlanticStar: Can hay fever be serious?

Dr Mohiuddin: There is no direct mortality associated with hay fever. It is serious in the sense that it causes a significant amount of morbidity. Allergic rhinitis is the most common chronic disease in the country. It accounts for a very significant number of missed work days and school days, and a significant amount of money spent on medications and treatment. The direct cost of treating allergic rhinitis is estimated to be over $4 billion a year. Allergic rhinitis can be associated with a number of other conditions. For example, 50 percent of patients with allergic rhinitis also have asthma. 30-50 percent of patients who have chronic ear problems also have allergic rhinitis. A third of patients who have chronic sinus problems also have allergic rhinitis. A significant proportion of patients with nasal polyps may have allergic rhinitis, although some studies have shown a very low association with allergic rhinitis. The total cost of treating all these other conditions is over $10 billion a year.

ChataLot: What can you do in order to control your symptoms in a hurry? Any short fixes?

Dr Mohiuddin: (laughing) Well, no, there are no short fixes. The management of allergic rhinitis is three-tiered, if you will. The first step in controlling allergies, once you find out what you're allergic to, is to control your environment. Sometimes it can be easy. If, for example, you have a pet that you're allergic to, and that is your only allergy, then removing that pet from the home can take care of the problem. Usually, though it's not as simple as that. Most patients who have allergic rhinitis have multiple allergy-producing substances. There is still a lot we can do to reduce that exposure to these multiple allergens, depending on what they're allergic to. The second step in treating allergies is to use medications. And the third step is using immunotherapy, or allergy shots.

Page 1 of 5