Viktor Radcliff asked:


There are two types of allergic rhinitis: seasonal allergic rhinitis (hay fever)- when symptoms are experienced only during spring and/or summer, and perennial allergic rhinitis (PAR) – when symptoms are experienced all year round.

The allergens that most commonly cause perennial allergic rhinitis are house dust, dust mites, cockroaches, cat or dog dander, and fungi or molds.

Industrial dust,fumes and chemicals can cause an occupation-related allergic rhinitis.

There is often a family predisposition to developing perennial allergic rhinitis and other allergies.

The symptoms of perennial rhinitis are described as like those of a permanent cold: blocked stuffy nose,constant sore throats and postnasal drip,headaches,loss of taste and smell.People with allergic rhinitis, particularly those with perennial allergic rhinitis, may experience sleep disorders and daytime fatigue.Some people with perennial allergic rhinitis show poorer psychological functioning than non-allergic people.

Symptoms of perennial allergic rhinitis always flare up indoors.

The only way to prevent perennial allergic rhinitis is to avoid the allergen that causes it.For perennial allergic rhinitis caused by dust and dust mite, this means using dust mite covers for pillows and mattresses,cleaning floors and walls with a damp mop, and using an air purifier.For perennial allergic rhinitis caused by animal dander,keeping pets out of the bedroom, and off furniture, rugs and other dander-catching surfaces and having pets bathed and groomed frequently is the best solution.

Although perennial allergic rhinitis resembles the seasonal rhinitis in some ways, there are important differences in treatment options : perennial symptoms stem from allergens being inhaled deep into the lungs, so many medications that are effective in treating hay fever symptoms will be less effective.

Intranasal corticosteroid sprays have become the main recommended treatment in perennial allergic rhinitis,especially in patients with moderate or severe PAR.Decongestant sprays and tablets will help relieve a stuffy, blocked nose with catarrh.However,they should be used for short periods only.Anti-histamine medication may help, but it is far less effective than for hay fever.

Allergy testing is very important so you can identify the exact indoor allergen that causes the allergy.

Mihail Fortomas asked:


Allergic rhinitis, more commonly known as “hay fever,” happens when you breathe in something you are allergic to. The inside of your nose becomes inflamed or swollen.

When this happens, the body’s immune system overreacts to specific particles such as plant pollens, molds, dust mites, animal hair, industrial chemicals, tobacco smoke, foods, medicines, and even insect venom.

Allergic rhinitis affects 40 million people in the United States and is an extremely common condition, affecting approximately 20% of the population. While allergic rhinitis is not a life-threatening condition, complications can occur and the condition can impair one’s quality of life leading to a number of indirect costs. Recently, the total direct and indirect cost of allergic rhinitis was estimated at around $5 billion annually.

What are the symptoms of allergic rhinitis?

Signs of allergic rhinitis are similar to signs of a common cold. But, unlike symptoms for the common cold, allergic rhinitis can last for more than 8-10 days. Symptoms include: -stuffy or runny nose -sneezing -itchy or watery nose -itchy or watery eyes -coughing (caused by clear mucus running down the back of the throat) -feeling of a ‘permanent cold’ that never goes away -headaches and earache -constant sore throats and postnasal drip -sleep disturbances and snoring -loss of taste and smell -poor concentration

Children who have allergic rhinitis might have dark circles under their eyes known as Allergic shiners” (related to nasal congestion). They may also use either the palm or the back of their hand to push their nose up as they try to stop the itching (called the “allergic salute”).

What causes allergic rhinitis?

Like our previous discussion, allergic rhinitis is caused by substances that trigger allergies, called allergens. These allergens are found both indoors and outdoors. When allergic rhinitis is caused by common outdoor allergens, like mold or trees, grass and weed pollens, it is often referred to as seasonal allergies, or “hay fever.”

Allergic rhinitis may also be triggered by allergens found in your house like animal dander (tiny skin flakes and saliva), indoor mold, and cockroach or house dust mite droppings.

If you experience symptoms during spring, you may be allergic to tree pollens which we will discuss in detail further on.

To know for certain what causes your symptoms, an allergist or immunologist can perform skin tests to determine what you are allergic to.

What are my choices or treatment?

Over-the-counter antihistamines and nose sprays can help at first, but they can have a number of unpleasant side effects. These antihistamines can make you feel tired and drowsy while nasal sprays can make your stuffiness worse.

Doctor-prescribed nose sprays and antihistamines are different types of medication and are very helpful for controlling long-term symptoms. Some are safe for young children and all are safe for adults.

Consultation with an allergist will determine the medicine and treatment that is right for you.

Can I do anything to avoid getting allergic rhinitis? As prevention is worth a pound of cure, there are some things you can do in your house that might make your symptoms better if not avoid them altogether:

For those who have rhinitis, it may be best not to have pets. But if it cannot be helped, make sure to wash your pet (especially if hairy and furry) once a week. Keeping them out of the bedroom and off the furniture will help as well.

Put pillows and mattresses in sealed plastic covers that keep out dust mites, and wash sheets in hot water weekly. Washing machines at the local Laundromat will have hot enough water to kill the dust mites.

Keep windows closed. If possible, get an air conditioner and run a dehumidifier, so that there will not be so many pollens and molds getting in the house.

What are allergy shots?

For some patients, allergy shots, also known as immunotherapy, are very helpful, and safe. Allergy shots help how your body handles allergens by injecting into your body small amounts of the substances causing your allergy. Over the period of the therapy, your body will learn to accept the allergen without overreacting to it (which is the reason for the allergic reactions).

Your doctor may talk to you about allergy shots if your allergy symptoms are very bad and if they happen for most of the year. You can also consider this if you are constantly around the allergens (such as pollens and dust mites) and if in spite medicines, you are still symptomatic.

Chris Marshall asked:


Seasonal Allergies usually occur during spring, fall and summer. Winter is not a common time for Allergies because there are not as many plants in bloom during this time due to the cold weather. When plants bloom and flourish, so do seasonal Allergies but this does not mean that this allergy is caused mainly by plants. The weather can also play a big role in triggering seasonal allergies.

Seasonal Allergies Due To Pollen And Dust

Pollen is one of the main causes of seasonal Allergies as well as dust and mold spores. These are common occurrences during spring and summer as well as during fall. The pollen from plants can cause serious hay fever in some individuals who are highly sensitive to the allergens they contain. Pollen tends to become airborne when the right season comes and these cause allergic reactions in individuals.

There is actually little that you can do about being allergic to pollen, dust and mold spores. Seasonal Allergies are usually controlled and not eliminated with the use of antihistamines. Although, not all areas of the city may have pollen, mold spores or dust, chances are, whenever you go around the city, you will encounter airborne mold spores, pollen and dust separately. If you are sensitive to any of these allergens, then you are highly likely to have an allergic reaction.

What To Expect From Seasonal Allergies

Seasonal Allergies usually manifest themselves as sneezing, runny noses, itchy eyes and other allergic rhinitis symptoms. You might initially think that you have a cold but actually there is a great deal of difference between the two. Seasonal Allergies are usually not accompanied by fever whereas a cold is and a cold usually lasts for around 10 days compared to seasonal Allergies that last for as long as you are exposed to the allergens.

Seasonal Allergies also react well to antihistamines whereas colds to decongestants. Allergies that rely on seasons also occur during summer, spring and fall compared to a cold that usually occur during winter. Allergies are also dependent on the individual’s reaction to allergens while colds can be transmitted from one person to another.

As stated earlier, these kinds of Allergies react well to antihistamines. Some may need stronger medication to control but the key is to lessen your exposure to the allergens. Allergens updates are also posted by the government to help out those who are sensitive to hay fever and other allergens.

Bruce Scott Dwyer asked:


The link between celiac disease and asthma has been as difficult to prove as finding the reason celiac disease exists. However some tangible evidence (statistical relationships) have been found.

The majority of articles suggest there is no link between celiac disease and asthma, while anecdotal evidence from celiacs suggests that their asthma increases dramatically after the ingestion of any gluten foods.

For instance, an article by Dr Pradeep Bhandari (Ref 1) says that “Celiac disease and Asthma tend to run in families and the tendency to get these diseases is inherited genetically. However, they are not inter-linked. The tendency to get celiac disease is inherited genetically. It mostly affects people of European descent. It is also more common in families with Diabetes or rheumatoid Arthritis. Something in the environment is necessary to trigger the celiac disease in those who are susceptible. Asthma tends to run in families. A person with a parent who has Asthma is three to six times more likely to develop Asthma than someone who doesn’t have a parent with Asthma. But no single gene is responsible for Asthma. Instead, you may inherit a general predisposition to Asthma” Ref 1

However a 2005 study was performed on a population of 86 persons residing in the Maltese Islands in the Mediterranean Sea does suggest some correlation:

MALTESE RESEARCH 2005 (Ref 2: Ellul P, Vassallo M, Montefort S)

“Patients previously diagnosed to have CD (based on serological tests and duodenal biopsy) and attending a medical out-patient clinic answered a questionnaire designed to determine whether they had previously been diagnosed to have asthma or allergic rhinitis.” Ref 2

“All 86 patients (age range 16-69 [median 43] years; 65 female) answered the questionnaire about CD and asthma. They constituted 21% of the 409 patients with CD in the Maltese islands included in a register kept for controlling free prescription of gluten-free foods.” Ref 2

Of 86 respondents, 24 (27.8%; 21 female) had asthma, including 22 with known asthma and 2 with previously undiagnosed asthma; the frequency of asthma in CD patients was higher than that reported in the general Maltese population (11.1%; p<0.00005).[7] In addition, four non-asthmatic patients (one smoker, two ex-smokers, one non-smoker) reported wheezing in the absence of respiratory tract infection in the past; they however had normal pulmonary function tests.

In 16 patients, asthma preceded CD by 3 months to 39 years (median 20 years). Among these patients, gluten-free diet had led to improvement in asthma in 6 patients, possible improvement in 2 patients, and no change in 8 patients. In the remaining 8 patients, asthma followed CD by 2 to 14 years (median 8). Thirty-one of 86 patients with CD and 11 of 24 patients with CD and asthma gave family history of asthma among first-degree relatives.

Eighty-two patients (62 female) answered the questionnaire about allergic rhinitis. Of these, 36 (44%) suffered from allergic rhinitis; this frequency was higher than that reported in the general Maltese population (32.3 %; p<0.05). They conclude that their findings suggest that asthma and allergic rhinitis are more common in CD patients than in the general population in Malta. In patients with atopic diseases, index of suspicion for CD should be high.

FINNISH study in 2001 (Ref 3: Journal of Allergy and Clinical Immunology)

This study tested the postulate of whether TH1 and TH2 cells could co-exist. A correlation between these would suggest a correlation between celiac disease and asthma.

“Background: Asthma is generally regarded as a disease with strong TH2-type cytokine expression, whereas in autoimmune disorders, such as celiac disease (CD), insulin-dependent diabetes mellitus (IDDM), and rheumatoid arthritis (RA), TH1-type expression is seen. According to the cross-regulatory properties of TH1 and TH2 cells, one would assume that these diseases exist in different patient populations.” Ref 3

“Objective: We sought to test the hypothesis that asthma could exist in children with TH1-type diseases, such as CD, IDDM, and RA. Methods: Comparison was made of the cumulative incidence of asthma in children with CD, IDDM, or RA by linking Finnish Medical Birth Register data on the whole 1987 birth cohort (n = 60,254 births) with the data of several national health registers to obtain information on the incidences of these diseases during the first 7 years of life.” Ref 3

“Results: The cumulative incidence of asthma in children with CD (24.6%) or RA (10.0%) was significantly higher than in children without CD (3.4%) or RA (3.4%; P < .001 and P = .016, respectively). Asthma tended to be more common in children with IDDM than in children without IDDM. Conclusion: These data indicate that the TH1 and TH2 diseases can coexist, indicating a common environmental denominator behind the disease processes.”

IMPLICATIONS

While these two studies do not show a causal relationship (proof that one disease causes another), they do suggest that there is a strong correlation between the diseases. That means that if you have celiac disease there is a greater likelihood that you will have asthma. The main ‘take home’ point from this is that for people who are celiac, or gluten intolerant, and have asthma, that the removal of gluten from their diet is likely to decreases the incidence and severity of their asthma.

 

Cindy Heller asked:

Rhinitis during pregnancy can be due to allergic rhinitis, sinusitis, or non-allergic rhinitis. If the woman has had allergic rhinitis prior to pregnancy, this could worsen, stay the same, or even improve. This change in symptoms may be dependent upon many factors, including the presence of seasonal allergens and increase in pregnancy hormones.

Non-allergic rhinitis in pregnancy may also be due to an increase in pregnancy hormones, leading to nasal congestion, runny nose and post nasal drip. This is called “rhinitis of pregnancy”. The symptoms may mimic allergies, but since they are non-allergic in nature, do not respond to anti-histamines.

The pregnant woman with rhinitis may be concerned about the safety of medications during pregnancy, and therefore avoid taking medications.

If avoidance of allergic triggers is not possible or successful, medications may be needed to control symptoms.

Diagnosis of Allergic Rhinitis During Pregnancy

Allergy testing includes skin testing or blood tests, called a RAST. In general, allergy skin testing is not done during pregnancy, given the small chance of anaphylaxis which may occur. Anaphylaxis during pregnancy, if severe, could result in a decrease in blood and oxygen to the uterus, possibly harming the fetus. Therefore, allergy testing is usually deferred during pregnancy, although a RAST would be a safe alternative if the results are needed during pregnancy.

Safety of Allergy Medications During Pregnancy

According to the Food and Drug Administration (FDA), no drugs are considered completely safe in pregnancy. This is because no pregnant woman would want to sign up for a medication safety study while she is pregnant. Therefore, the FDA has assigned risk categories to medications based on use in pregnancy.

Pregnancy category “A” medications are medications in which there are good studies in pregnant women showing the safety of the medication to the baby in the first trimester. There are very few medications in this category, and no asthma medications.

Category “B” medications show good safety studies in pregnant animals but there are no human studies available.

Pregnancy category “C” medications may result in adverse effects on the fetus when studied in pregnant animals, but the benefits of these drugs may out weight the potential risks in humans.

Category “D” medications show clear risk to the fetus, but there may be instances in which the benefits outweigh the risks in humans. And finally, category “X” medications show clear evidence of birth defects in animals and/or human studies and should not be used in pregnancy.

Before any medication is taken during pregnancy, the doctor and patient must have a risk/benefit discussion. This means that the benefits of the medication should be weighed against the risks – and the medication should only be taken if the benefits outweigh the risks.

Treatment of Rhinitis During Pregnancy

Nasal saline. Rhinitis of pregnancy tends not to respond to anti-histamines or nasal sprays. This condition seems to respond temporarily to nasal saline (salt water), which is safe to use during pregnancy (it is not actually a drug). Nasal saline is available over the counter, is inexpensive, and can be used as often as needed. Generally 3 to 6 sprays are placed in each nostril, leaving the saline in the nose for up to 30 seconds, and then blowing the nose.

Anti-histamines. Older anti-histamines, such as chlorpheniramine and tripelennamine, are the preferred agents to treat allergic rhinitis during pregnancy, and are both category B medications. Newer anti-histamines such as over-the-counter loratadine (Claritin/Alavert and generic forms) and prescription cetirizine (Zyrtec) are also pregnancy category B medications.

Decongestants. Pseudoephedrine (Sudafed, many generic forms) is the preferred oral decongestant to treat allergic and non-allergic rhinitis during pregnancy, although should be avoided during the entire first trimester, as it has been associated with infant gastroschisis. This medication is pregnancy category C.

Medicated nasal sprays. Cromolyn nasal spray (NasalCrom, generics) is helpful in treating allergic rhinitis if it is used before exposure to an allergen and prior to the onset of symptoms. This medication is pregnancy category B and is available over the counter. If this medication is not helpful, one nasal steroid, budesonide (Rhinocort Aqua), recently received a pregnancy category B rating (all others are category C), and therefore would be the nasal steroid of choice during pregnancy.

Immunotherapy. Allergy shots can be continued during pregnancy, but it is not recommended to start this treatment while pregnant. Typically the dose of the allergy shots is not increased, and many allergists will cut the dose of the allergy shot by 50 percent during pregnancy. Some allergists feel that allergy shots should be stopped during pregnancy, given the risk of anaphylaxis and possible danger to the fetus as a result. Other than anaphylaxis, there is no data showing that the allergy shots themselves are actually harmful to the fetus.

Raily Arena asked:


Hay fever, also known as Allergic Rhinitis, is a common form of allergy that people have been suffering from for many decades.  Health experts estimate that about 50 million people chronically suffer from this type of nasal allergy.  If you frequently experience symptoms such as nasal congestion, sneezing, runny nose, postnasal drip, red, swollen eyes and frequent colds, you could have Allergic Rhinitis.  Oftentimes, it takes only small particles such as pollen to affect the human body in many ways.  Some of these effects include:

- Throat itchiness that may be intermittent or continuous

- Laryngitis or hoarseness due to pollen affecting the larynx

- RAD or Reactive Airway Disease, a prolonged respiratory irritation characterized by difficulty breathing, chest tightness, wheezing and coughing

- Asthma attacks – often times, your doctor will diagnose RAD before he diagnoses asthma

- Postnasal drainage, which could lead to sore throat because of fluids flowing into and irritating the throat

- Nasal salute, particularly in young children; characterized by a red crease across the nose due to constant rubbing, wiping and scratching

- Allergic conjunctivitis, which can lead to redness, itchiness and teary eyes

- Darkened areas around the eyes

- Headaches

- General fatigue

Why symptoms occur

When exposed to foreign substances such as allergens, the immune system becomes hyper-sensitive and the body reacts.  This is the same kind of reaction that happens when the human body is invaded by microorganisms such as bacteria and viruses.  Once the body is exposed to these types of allergens, it produces substances called histamines which causes inflammation, production of mucus and other symptoms associated with hay fever.

Causes of hay fever

Although pollen is the most common cause of allergies that lead to hay fever, there are other substances that can trigger symptoms as well.  These include dust, molds, pet dander, insects and food.  Although hay fever symptoms can easily be detected, proper diagnosis by a qualified physician is the best way for correct assessment of the condition.

Testing for hay fever allergies

The most common method of determining allergies is skin testing, wherein a minuscule amount of allergen is introduced into the skin to produce a reaction.  The doctor will then try to determine if cross-sensitivity is present, such as when allergies are caused by varying substances with similar protein structures.

Controlling symptoms

As a first step, people with allergies are adviced to avoid or at least minimize contact with substances and items that may trigger an attack.  It’s also important to be aware of your environment and to perform tasks necessary to reduce allergens, avoid work that might aggravate your sensitive skin and protect your body.  With the correct knowledge and treatment regarding Allergic Rhinitis, there is no reason why it cannot be managed efficiently.

Alien asked:

The word ‘allergic’ is often used loosely and has become almost a part of our general conversation. In a way it has become synonymous with ‘dislike’. Many ailments which cannot be immediately diagnosed are incorrectly attributed to allergy. Infact, allergy is an unusual response of the body caused by substances like foods, pollens, house dust, feathers, fungus, insecticides, drugs, and chronic infection.

The common allergic diseases are allergic rhinitis and hay fever, and the common cause is pollen. Allergy is due to abnormal antibodies of the IgE type which are formed only in some -susceptible individuals. Normally the antibodies are supposed to be protective. But the abnormal antibodies are fixed on special allergic cells called mast cells and on coming into contact with an allergen such as a pollen, release chemical agents such as histamine, serotonin, and slow-reacting substances. The release of these substances produce symptoms of allergy characterized by a running nose, itching, rash, and breathing difficulty.

Treatment

The management of allergic reactions includes specific treatment aimed at removing the cause, blocking allergic reaction by immuno-therapy, and symptomatic treatment. Some examples of allergen-avoidance are stopping use of such drugs, installation of air filters in air conditioners, keeping pets out of living room and removing dust collecting furniture and carpets.

Specific Treatment

Specific treatment consists of removal of the offending agents. This is done by ‘allergen testing’. Various extracts of possible offending agents are available and these are injected into the skin to detect the causative agent. However, in most cases it is difficult to identify the causative agent, but if it is found, desensitization of the individual can be carried out by injecting its doses. It has been found that through desensitization, the abnormal antibodies, that is, the IgE antibodies, are reduced or completely abolished, and protective antibodies, that is, the IgG anibodies are developed.

Symptomatic Treatment

The aim of symptomatic treatment is to check the release or antagonize the action of released chemical mediators of allergic reactions. The most important of these chemical mediators is believed to be histamine. For this reason antihistaminics are employed in almost all cases of allergy. Sometimes decongestants are combined with antihistaminics to enhance effects. Only in extremely severe cases are corticosteroids used.

Uses of Antihistaminics

Besides their use in allergy, antihistaminics are useful for prophylaxis and treatment of motion (travel) sickness and vomiting during pregnancy or following radiation. They are beneficial in the symptomatic treatment of Parkinsonism but ineffective in bronchial asthma. They are quite often used to treat common cold. In this condition anti-cholinergic effects of these drugs afford symptomatic relief by decreasing secretions of nose and respiratory passages.

Adverse Effects: The most common adverse effects are drowsiness and sedation which interfere with daytime activity, mental alertness, and reflex actions. Other side-effects include giddiness, ringing in the ears, weariness, fatigue, loss of appetite, nausea, vomiting, rapid pulse, a slight fall in BP, constipation, abdominal pain, dryness of mouth, urinary hasitancy and blurring of vision. Very high doses may induce fever. These adverse effects are more common in elderly people.

Precautions

Alcohol is forbidden with these drugs as sedation of a dangerous level may occur.

Driving and operating any kind of machine should be avoided after taking these drugs as they cause drowsiness.

If taken after a meal, the intensity of side-effects can be minimized.

Drugs containing chlorcyclizine and meclizine which are also antihistaminic, should not be self used by a pregnant woman. These may cause some adverse effects on the foetus.

Ointments containing these drugs should not be used for a prolonged period; allergic reactions have been found to be more common on local application of these drugs. (At times these anti-allergic drugs, when taken orally or more commonly, when applied on the skin, may cause allergic reaction. Is this not a paradox?)

Other Drugs for Symptomatic Treatment

Ketotifen (Ketovent, Ketotif)

This drug stabilizes the cell membranes of mast cells and thus prevents the release of histamine. Besides having antihistaminic properties, it is useful in preventing an attack of asthma. It does, however, cause drowsiness, a dry mouth, dizziness, nausea and weight gain.

Cromolyn Sodium (Ifiral, Fintal)

Used as eye drops (2%) in allergic conjunctivitis, nasal spray (2%) in allergic rhinitis and metered dose inhaler (1 to 2 mg/puff) in bronchial asthma.

Nedocromil

This drug is used 2 puffs, twice a day, in place of cromolyn.

Topical steroids like flunisolide (SYNTARIS) and budesonide (BUDECORT) are nasal spray.

Non-Sedative Antihistaminics for Symptomatic Treatment

These new generation anti-allergic drugs do not reach the brain and do not produce sedation (cetirizine causes some sedation) which is common adverse effects of all the drugs available in this group. These are therefore used more widely. They do not impair psychomotor activities such as driving and do not enhance effects of alcohol or diazepam. They are useful in allergic rhinitis, allergic conjunctivitis, urticaria, drug allergies and atopic eczema. They are not effective in motion sickness, vertigo and should not be used in pregnancy. These agents are less effective than older drugs in common cold.

Decongestants Used in Symptomatic Treatment

These agents reduce the swelling of mucous membranes (shrinking effect) in allergic diseases by constricting small blood vessels. Some drugs are used by mouth such as pseudoephedrine (PSEUDAFED 60 mg tab) and phenylpropanolamine. The latter is rarely used alone.

Alexander Chong asked:

Otitis media is an inflammation that occurs in the middle ear. Middle ear space contains fluid that could be easily infected and the infected middle ear is called otitis media with effusion. The cause of the chronic OME (otitis media with effusion) for most of the allergic rhinitis patients is mainly due to the IgE-mediated allergies. IgE-mediated allergy is the allergy that happens when IgE antibody (one type of the white blood cell) binds with the mast cell. IgE antibody is being produced by the plasma cell when foreign particular from outside of the body entering into the blood through nasal mucosal surface. Once the IgE antibody binds with the mast cell around the nose, histamine is secreted from this cell and it is the main chemical that causes itching and hypersensitive of the nose.

According to the publication by a group of scientists, 50% of the children who had chronic OME also had nasal allergy. Effects of the seasonal allergic rhinitis to the Eustachian tube function and middle ear pressure had been studied by a few groups of medical scientists. According to one of the studies, Eustachian tube of the pollen allergic patients become obstructed increases from 15% to 60% from the starting to the maximum of the pollen exposure. In one of the studies, ragweed pollen, which is seasonal pollen, was let it exposed to a group of people. What had been discovered is that it will cause immune reactions in the Eustachian tube and nose. Apart from this study, the other study reported that house-dust mite, which was a perennial allergen, also caused Eustachian tube obstruction. In the same study, they found out that 55% of the adults, who had nasal allergy, experienced the development of the Eustachian tube dysfunction when this group of adult was exposed to house-dust mite. In the following study, new thing that had been found out was Eustachian tube obstruction happened more frequently for the patients who had allergic rhinitis. In allergen provocation studies, scientist found out that nasal obstruction usually occurred before the development of the Eustachian tube obstruction. In allergen provocation study, individuals who took part in this study were exposed to allergen to provoke their nasal allergy symptom. In this study, researchers also discovered that various of inflammatory mediators such as histamine have been detected in middle ear effusions of the children who had OME. If Eustachian tube obstruction that was caused by perennial exposure to allergen such as house-dust mite was left it untreated for quite a sometime, it could form middle ear disease, especially, when priming phenomenon occurs in the Eustachian tube. Priming phenomenon happens when mucosa in the organ responds to lower doses of allergen with repeated exposure. Allergic rhinitis could have priming phenomenon too when the mucosa in the nasal passage responds to low amount of allergen that has been inhaled through the nostril. For the Eustachian tube obstruction that was caused by seasonal exposure to allergen such as ragweed pollen, its physiologic hyperresponsiveness could extend beyond the ragweed season.

Studies show that half of the newly occurrence otitis media are diagnosed immediately after patient had been infected by viral URTI (virus that causes flu and common cold). By using traditional standard culture techniques, it is quite rare that viruses could be isolated from the middle ear effusions in the patient with otitis media. However, with the newly developed PCR-based molecular analysis, viruses in the middle ear effusions could be detected and discovered that 53% of the middle ear effusions are positive for viruses. An experimental, which was carried out by infecting real human with rhinovirus-39, had been carried out in Children’s Hospital of Pittsburgh to study the effect of this virus to the middle ear pressure and Eustachian tube. Result of this experiment showed a substantial increase of Eustachian tube dysfunction and also abnormal middle ear in approximately 30% of the people who had been infected in this study. However, all these people who had been infected by this virus had less possibility to develop an otitis media disease. In another study, where influenza A virus was intranasally inoculated to a group of peoples, 59% of the inoculated people experienced the development of middle ear under pressure and only 25% of these people developed otitis media. In this study, one of the inoculated people developed middle ear under pressure followed by purulent otitis media. This patient middle ear effusion was taken for PCR analysis and it showed positive result for both influenza A and Streptococcus Pneumoniae. Streptococcus Pneumoniae is some kind of spherical, Gram-positive, alpha-hemolytic bacterium and it is a member of the genus Streptococcus.  In this group of inoculated people, 80% of them who had infected by this virus experienced the development of Eustachian tube dysfunction and 80% of them had middle ear under pressure. With this group of infected people, five of them had developed OME on the 4th day after the viral exposure. One of the patients had dizziness and vertigo symptoms, which is mainly due to the inner ear malfunction. All these studies support the causes of otitis media by URTIs virus and causes of otitis media starting from the development of Eustachian tube obstruction and abnormal middle ear pressure. In the recent publication about the study of a group of children with acute otitis media, micro-organisms in the fluids of the middle ears of the children were isolated by the investigator of this study. They found out that 65% of the fluid samples that had been collected contained both bacteria and viruses. These results show that virus infection in the middle ear creates an environmental that is suitable for the breeding of bacteria.

Based on the information that had been collected from a few recent publications of the studies of the relationships of the allergic rhinitis to the OME (otitis media with effusion), we could conclude that allergic rhinitis or common cold/flu will cause Eustachian tube obstruction and middle ear pressure. When the situation becomes uncontrollable, Otitis media with effusion will develop and this may could permanent hearing impairment. Therefore, allergic rhinitis and common cold/flu should be treated immediately without any delay. This is because these common illnesses may become serious and develop to chronic sinusitis disease and otitis media with effusions, which is quite difficult to cure.

Steve Marshal Caldwell asked:

Allergy is the most common condition through which every individual suffers at least once in his lifespan. Allergy is caused by the naturally occurring substances known as allergens. When these allergens react with your body, it release the histamines to control the effect of the allergens, hence allergy is caused. Pollen, dust, and bee venom are the types of allergens. Allergy is the result of excessive activation of certain white blood cells called mast cells and basophils by a type of antibody known as IgE, resulting in an extreme inflammatory response. Another definition of allergy explains it as an abnormal reaction by an individual’s immune system against a normally harmless substance. Some common well-known allergic reactions are allergic conjunctivitis, allergic rhinitis, asthma, food allergies, hay fever, hives, and eczema.

Allergies are categorized in the different types on the basis of the body parts they affect and on the basis of allergens. Different types of allergies are as follows:

1. Food Allergy

Food allergy is the one of the most common type of allergy. You can not decide that who is allergic to which food item. The most common symptoms of the food allergies are runny nose, itching, urticaria, vomiting, nausea, coughing, and angioedema. When this reaction becomes severe it is called as anaphylaxis. Children suffer from the food allergic reactions the most because there immune system is not well developed and they take that food for the first time.

2. Gastrointestinal Tract Allergy

Gastrointestinal tract allergy is caused when you eat any item or inhale any item that contains allergens. The allergen enters the gastrointestinal tract and causes the irritation of the tract. Abdominal pain, bloating, vomiting, and diarrhea are the symptoms of the gastrointestinal tract allergy.

3. Pet Allergies

Many individuals are allergic to pets. Allergens are found in the skin, hairs, saliva, and urine of pets. These allergens cause the eyes, nose, and skin allergies. Rashes, such as eczema and hives (urticaria) and irritation of eyes and nose are the symptoms caused by the pet allergies.

4. Tree or Grass Pollen Allergy

Maximum number of individual suffers from the allergies caused by the pollens that are released by the trees and plants during the flowering season. These allergies are generally called as the seasonal allergies. It is called as the allergic rhinitis. Sneezing and coughing are common symptoms caused by pollen allergy.

5. Dust Allergy

Dust allergy is caused when the dust particles (allergens) enters your nose, eyes, ear, and skin. Dust allergy is the one of allergies that can lead to the dangerous consequences. Swelling of nasal mucosa, impaired hearing due to entrance of allergens in eustachian tube, dead skin as the pores of the skin are filled with dust, and redness of eyes are the common symptoms of the dust allergy.

6. Smoke Allergy

Air pollution is growing day by day because of the smoke released from the different places. Some individuals are allergic to smoke released from vehicles, some are allergic to smoke released from factories, and some individuals to the smoke from cigarettes. These allergic show the symptoms like coughing, bronchoconstriction, wheezing and dyspnea, sometimes outright attacks of asthma.

7. Insects Stings and Bites Allergies

Allergies are caused when the insects stings or bites. Throat swelling, hives over the entire body, difficulty breathing, nausea, diarrhea, and shock are some of the symptoms caused by insect bites. Rashes on the skin are also noticed on the part where the insect bites.

8. Latex Allergy

This is the allergy seen among the individuals who are allergic to the rubber latex. Latex allergy may cause allergic reactions ranging from sneezing or a runny nose to anaphylaxis, a potentially life-threatening condition. Doctor should be consulted immediately in case of severe allergic reactions.

9. Clothes Allergy

Yes, it is true that some people are allergic to clothes. Laundry detergents can cause people to break out in an itchy rash; some individuals are particularly allergic to cotton or nylon and they get red rashes on their body when they wear those clothes. Even eczema is noted in some cases.

10. Hay fever

A very common allergy caused by the pollens or anthers released by the trees or plants during the flowering season and by the release of leaves during the shedding season. Sneezing, itchy nose and/or throat, nasal congestion, and coughing are common symptoms of hay fever. You can also notice fever in the individual suffering from the hay fever.

11. Medicines Allergy

Some cosmetics or some medicines cause allergic reactions on the people either externally or internally. Antibiotics are the most common medications that cause the allergies. If you suspect a medicine allergy, talk to your doctor first before assuming a reaction is a sign of allergy. Note: Please take the medications only and only after taking the permission from the doctor.

12. Chemical Allergy

Dyes, household cleaners, and pesticides used on lawns or plants can also cause allergic reactions in some people. Sometimes even the harmful chemicals are released in the water bodies by some chemical factories and thus cause the allergic reactions when we drink that water or wash the face with that water. Please note that this is the most severe case of allergy.

John Hilaire asked:

There are a number of allergens that can cause seasonal allergic rhinitis. Most of these identified allergens are airborne, such as the pollen that is blown about from trees, plants and grasses. Another type of airborne allergen, mold spores, is the seasonal culprit of mold allergies.

This type of allergy is generally found from spring to early fall, with a peak in the late summer months, although other types of mold can cause symptoms nearly year-round. The allergens that cause mold allergies are generally found in humid climates, and moist areas like rotted logs and compost piles.

They can also be found indoors in damp basements or closets, or even lurking in your shower stall. Fresh food storage areas are also a popular hangout for mold spores, as well as house plants and certain pieces of furniture.

Why do Mold Allergies Occur?

If you suffer from a mold allergy, your immune system has incorrectly identified mold spores as a substance that is harmful to your body. The response of your immune system is to produce antibodies called immunoglobulin that will create chemicals that will ward off these potentially damaging substances. The result is symptoms like sneezing, wheezing, watery eyes and itching. In the case of a mold allergy, the mold spores are airborne and inhaled into the body through the respiratory tract.

This is why nasal congestion and coughs are common complaints of mold allergy sufferers. The incidence of symptoms from a mold allergy will be dependent on the abundance of the allergen and the ability of the air currents to spread the spores. These factors can be affected by changes in weather patterns throughout the day, making mold counts somewhat ineffective in determining the severity of the allergen exposure.

Treating Mold Allergies

Because mold allergies are airborne, they will most often result in the symptoms of rhinitis, which will include nasal congestion, watery eyes and coughing. The best treatment for rhinitis is generally an over-the-counter antihistamine, decongestant or nasal spray to treat the inflammation and congestion. If over-the-counter medications are not effective in treating your mold allergy symptoms, it is a good idea to see your doctor for possible prescription relief for your mold allergy.

There are a number of medicines that your doctor can recommend to treat your mold allergies through the use of prescription antihistamines and steroidal nasal sprays that will reduce the inflammation in your sinus passages. Allergies to molds and other airborne allergens can cause seasonal or even year-round rhinitis, depending on which allergens affect you. The good news is that there are many options in treating these allergies to allow you more symptom-free days and a higher quality of life.