Your Health: Hay fever hits hard

Allergic rhinitis, commonly called hay fever, affects as much as 40 percent of children and 10 to 30 percent of adults in the United States. It is “seasonal” if symptoms occur at particular times of the year and “perennial” if they remain year round.
Common symptoms include sneezing, itchy eyes, nasal congestion with a decreased sense of smell, headache and fatigue.
These symptoms can tremendously impair one’s quality of life, as well as productivity. American workers lose an estimated 6 million work days yearly to this disorder and incur costs of several billion dollars in evaluation and treatment.
Seasonal rhinitis usually occurs from spring to early fall and is due to pollens from trees, grass and weeds. Perennial rhinitis, lasting throughout most of the year, is caused by indoor factors, such as dust mites, animal dander and mold. 
Nasal stuffiness from allergic rhinitis can cause swelling and obstruction of the sinuses which can cause a sinus infection.
There is a strong association between allergic rhinitis and asthma. As much as 50 percent of patients with asthma have allergic rhinitis. Sleep disorders in adults and a high proportion of ear infections in children are also associated with allergic rhinitis. 
Treatment for people who think they have allergic rhinitis can begin with an over-the-counter antihistamine, such as Benadryl or Chlor-Trimeton. However, these are often associated with the bothersome side effects of drowsiness. They should be avoided in children younger than 2 years and in elderly patients.
Newer antihistamines, such as Claritin and Zyrtec, are now available without a prescription and cause significantly fewer side effects than the older antihistamines. They are also more conveniently dosed, at once or twice a day. 
Intranasal steroids have been shown to be very effective in relieving the symptoms of allergic rhinitis with minimal side effects in recommended doses. These nasal sprays are available by prescription from a doctor.
n Terry Hollenbeck, M.D., is an urgent-care physician at Palo Alto Medical Foundation Santa Cruz in Scotts Valley. Readers can view previous columns on his website, http://valleydoctor.wordpress.com, or email him at

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. Information in this column is not intended to replace advice from your own health care professional. For any medical concern, consult your own doctor.
Allergy treatment at a glance
– Avoid substances and situations that cause your reaction.
– If symptomatic, try over-the-counter, nondrowsy antihistamines, such as Claritin or Zyrtec.
– If still symptomatic, see your doctor for prescription intranasal steroid sprays.
– If none of the above is helpful, ask your doctor for a referral to an allergy specialist.
— Terry Hollenbeck