WHAT IS ALLERGY?An allergy is a hypersensitivity reaction of the body's immune system to harmless substances, such as pollen, animal dander, dust mites, and mold. These substances, which always contain a type of protein, are called allergens. An allergy to these substances causes symptoms of nasal congestion, sneezing, runny nose, watery eyes, and itching of the eyes, nose, and throat.
Nasal complaints caused by irritating (chemical) substances, such as tobacco smoke or paint fumes, are not caused by allergies. Everyone can be affected by these substances to a greater or lesser extent.WHAT IS HAY FEVER?At the end of the last century, it was discovered that allergy symptoms primarily occurred at the end of summer, during haymaking. The illness was therefore called "hay fever." However, hay fever is not caused by hay, but by pollen from flowering grasses. Because allergies can also be caused by all sorts of other substances, it's more appropriate to call it "allergic rhinitis," which means an allergic reaction of the nose.WHAT ARE THE MAIN ALLERGENS?House dust mites are harmless, almost invisible to the naked eye, spiders found in all Dutch homes. They live primarily in house dust and feed primarily on skin flakes. They thrive in warm, moist environments with abundant skin flakes, such as mattresses, pillows, and carpets. The bed is a particularly popular spot. House dust mites are present year-round, but their numbers increase in autumn.
The main causes of allergic conditions are shown in the image above: the house dust mite, greatly enlarged here, but actually less than half a millimeter in size, responsible for house dust mite allergies.
And below, flowering grass, the cause of hay fever.
Other pollen allergies are caused by flowering trees, particularly willows and alders. Finally, the cat is the most allergenic representative of pet allergies. Dogs, and especially horses, are also notorious in this regard.
Animal products, such as dander from cats, dogs, and rodents, can also trigger allergic reactions.WHAT COMPLAINTS ARE CAUSED BY ALLERGIES?People who suffer from allergic rhinitis can be divided into two groups. The first group, also called "runners," primarily suffer from a watery, runny nose, sneezing, and sometimes itchy, watery eyes. Most "runners" are allergic to pollen, some to animals.
The second group, the "blockers," primarily suffer from nasal congestion and occasionally a runny nose.
In addition to these nasal symptoms, asthmatics may also experience shortness of breath and wheezing.HOW DOES THE NOSE WORK?The inside of the nose is lined with a mucous membrane. This mucous membrane is full of glands that can produce mucus, and it's also filled with blood vessels. Normally, just enough mucus is produced to keep the nose comfortably moist. The mucus in the nose acts as a protective layer against bacteria and viruses. Too much mucus in the nose causes sniffling. Besides too much mucus in the nose, a thickening of the nasal mucous membrane also causes nasal congestion. This thickening occurs when the blood vessels in the nasal mucous membrane temporarily trap blood and thus increase in thickness, such as during an allergy attack.WHAT HAPPENS DURING AN ALLERGY ATTACK?When an allergen (e.g., grass pollen) enters the nose, a reaction occurs in the nasal mucosa (the lining of the nose). The nasal immune system reacts abnormally to the allergen to which the person is allergic. The allergen binds to antibodies (such as immunoglobulin E) that are bound to cells in the nasal mucosa. The binding of the allergen to these antibodies stimulates the cell, causing it to release certain substances, such as histamine. These substances dilate small blood vessels, resulting in allergic symptoms such as an itchy nose, sneezing, and nasal congestion. This is called allergic rhinitis.CAN ALLERGIC RHINITIS BE THE CAUSE OF OTHER PROBLEMS?Various illnesses and complaints can be (partly) caused by allergic rhinitis. These include ear infections, sinus infections, coughing, headaches, and fatigue. These symptoms often improve with effective treatment of the allergy.ARE ALL NOSE SYMPTOMS CAUSED BY ALLERGIES?Not all nasal complaints are caused by allergies. Nasal complaints can also be caused by infections, irritants, and abnormalities in the structure of the nose. The most common nasal infection is a cold. A common cold usually clears up within a week.
Some people react strongly to non-allergic irritants such as tobacco smoke, (paint) odors, fog, and temperature changes, resulting in nasal congestion, sneezing, and a runny nose. This is called non-allergic or vasomotor rhinitis. The nasal symptoms of allergic and vasomotor rhinitis can resemble each other. In many people, symptoms are caused by both allergens and irritants.HOW DOES THE ENT DOCTOR DETERMINE WHETHER YOU ARE ALLERGIC AND TO WHAT?The ENT specialist will ask questions to determine whether you are allergic and, if so, to what. To determine exactly which substances you react to, a skin test is performed, in which several injections containing allergens are administered into the skin. Redness and swelling may occur at the injection site. Although this skin reaction usually disappears after half an hour, redness and swelling may recur after 4-24 hours. The size of the red spot determines the severity of the allergy. The test's reliability is measured with two control injections, in which the skin must react in one case and not in the other (only a solvent and a solvent containing histamine are injected, respectively).
A blood sample can also be used to determine whether someone is allergic, and if so, to which substances. The results of this test usually take some time.
If there are any doubts about a particular substance, further investigation is possible by injecting the substance directly into the nose and measuring the reaction. This is a time-consuming investigation, which is usually not necessary.HOW CAN CONTACT WITH THE MAIN ALLERGENS BE AVOIDED?When treating allergies, it's crucial to avoid contact with the allergen as much as possible. This is sometimes easier said than done. Your ENT doctor can advise you on the measures necessary for you.
House dust mites live in dust, preferably in warm, damp places. Eliminating dust mites as much as possible is called remediation. The most important room in the house where dust mites should be controlled is the bedroom. Ensure a dry bedroom by turning on the central heating in the fall. To kill dust mites, wash bedding and curtains at 60 degrees Celsius. If necessary, protect the mattress and pillow with a dust mite-proof cover. Smooth floors and cleaning them (preferably daily) with sticky dust cloths and/or a wet mop prevents the buildup of dust in which dust mites can live. Brochures with detailed advice on remediation measures against dust mites are available from your ENT doctor. You can discuss with your ENT doctor which measures are appropriate in your case.
Air purifiers have no proven effect on allergy symptoms. Therefore, purchasing such a device is not recommended.
If you have a grass pollen allergy, you can listen to the hay fever reports broadcast daily on Radio 1 after the 5:30 PM news in May and June. During this period, "The expected weather situation for hay fever sufferers" is shown on page 709 of Teletext.
During periods of high pollen counts, keep windows and doors closed as much as possible. If you experience severe symptoms, avoid going outside too much. Pollen counts are especially high early in the morning on warm, sunny days.
If you are allergic to a pet, the best solution is to remove it from the house. If you decide not to do this, at least keep the animal out of the bedroom.WHAT MEDICINES DOES YOUR DOCTOR PRESCRIBE?Allergy medications are divided into protective agents, which must be used continuously, and those used when allergy symptoms already exist.
The protective agents are usually corticosteroid-containing nasal mists. These medications are particularly effective for nasal congestion.
Antihistamines provide rapid relief if symptoms already exist. These medications can be administered as tablets, nasal sprays, or eye drops/ointments. For less severe symptoms, cromoglicate-containing nasal sprays or eye drops can also be used.
Hyposensitization, a course of injections containing allergens, is primarily used for pollen allergies; sometimes also for house dust mites and cats. Hyposensitization takes 3 to 5 years, usually requiring injections every 4 to 6 weeks. Hyposensitization reduces sensitivity to the allergen in question, thus reducing the severity of the allergic reaction.
In recent years there have been indications that sublingual immunotherapy (allergen in drop form under the tongue) could also be an effective remedy. |
