North Texas ranks as being one of the worst areas in the country for allergies
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By Paul Kim, MD
Family physician on the medical staff at Baylor RegionalbrMedical Center at Grapevine
What is allergic rhinitis? It is the inflammation of thebrnasal passages, characterized by sneezing, nasalbrcongestion, nasal itching, and runny nose. The eyes, ears, sinuses, and throatbrcan also be involved. Often, allergies that are not appropriately treatedbrbecome viral infections or bacterial infections primarily of the sinuses.
Many people continue their daily lives with undiagnosedbrallergic rhinitis. Unfortunately when we are diagnosed we often do nothingbrabout it. According to Quest Diagnostics in 2011, upon reviewing the allergiesbrbased on laboratory results amongst the big cities across America, Dallasbrranked the worst with a sensitization index of 697. That means many many peoplebrare being affected by allergies here in our metroplex.
Across the nation, allergic rhinitis costs 5.3 billionbrdollars a year to treat directly and indirectly, causes 3 additional doctorbrvisits per year and leads to 9 more prescriptions being written per affectedbrpatient. This leads on average to a 1500 dollar increase in cost per year perbrallergic patient.
When you have symptoms a simple test to seebrif you have a cold or allergies is to take a strong antihistamine likebrBenadry/zyrtec. If most symptoms improve (please note that antihistamines causebrdrowsiness), allergies are playing a bigger role than we think and maybe we canbrwait on starting an antibiotic.
According to most professional societiesbrwho treat allergies the first line medication used for mild to moderatebrallergic rhinitis should be an intranasal corticosteroid alone which has abrbetter side effect profile than antihistamines. That little nose spray withbrthat blue cap that you get as a sample will treat eye symptoms, nose and throatbritching, sneezing and runny nose. The key to using this medication however isbrto use it regularly. It is thought that 3 days of continued use are neededbrbefore you start feeling a bulk of the positive effect in reducing allergies.brYou can monitor your need for the spray by following allergy counts on a sitebrlike pollen.com.
Oral antihistamines are effective atbrrelieving the histamine related symptoms such as sneezing, itching, runny nose,brand eye changes but not as effective at treating nasal congestion. The morebreffective ones are also more sedating. Intranasal antihistamines that deliver abrhigh concentration of medication to the specific targeted are very useful andbrthey do not cause you to get as drowsy as an oral pill would.
Nasal irrigation is another great way tobrhelp relieve symptoms by getting rid (albeit temporarily) of the allergenbrinducing the symptoms.
Nasal decongestants like oxymetazoline canbrcause rebound congestion after 3-5 days of use. Phenelyphrine andbrpseudoephedrine can cause rebound congestion after more prolonged use (2brweeks). Oxymetazoline often known as Afrin can cause rebound recurringbrcongestion that is often very difficult to treat.
Intranasal cromolyn has decreased effectivenessbrat decreasing symptoms and montelukast showed only minimal improvement of nasalbrcongestion in adults.
Immunotherapy that introduces the allergen extract by being given as abrshot or drops placed under the tongue has shown efficacy in 95% of patients whobrnote significant improvement of allergy symptoms after 1 year of regularbrtherapy.
Though it can be effective in some patients the evidence regardingbracupuncture , probiotics, and herbalbrpreparations in treating allergies is not robust enough to be recommended withbrhigh confidence.
Most importantly, if you feel symptoms and if oral antihistamines dobrnot seem effective enough or cause significant side effects, please contactbryour physician who would love to help you win the battle against something thatbrcan significantly detract from your quality of life.
About Baylor Regional Medical Center at Grapevine
Baylor Regional Medical Center at Grapevine is a full-service, fully-accredited not-for-profit hospital serving residents in more than 20 cities throughout the Dallas/Fort Worth region. Focused on being the best place to give and receive quality, safe and compassionate care, Baylor Grapevine works to lead the transformation of health care. The 276-bed hospital offers advanced medical services for cardiovascular services, women's services, oncology, neurology, spine care, orthopedics, diagnostic imaging, neonatal intensive care, intensive and emergency care.
About Baylor Health Care System
Baylor Health Care System is a not-for-profit, faith-based supporting organization providing services to a network of acute care hospitals and related health care entities that provide patient care, medical education, research and community service. Baylor recorded more than 2.8 million patient encounters, $4 billion in total operating revenue, $5.2 billion in total assets and $494 million in community benefit in fiscal year 2010. Baylor's network of more than 300 access points includes 27 owned/operated/ ventured/affiliated hospitals; joint ventured ambulatory surgical centers; satellite outpatient locations; senior centers and more than 150 HealthTexas Provider Network physician clinics.