FAMILY MEDICINE® COLUMN
By John C. Wolf, D.O.
Associate Professor of Family Medicine®
Ohio University College of Osteopathic Medicine

TREAT SPRING ALLERGIES WITH OVER-THE-COUNTER MEDICATIONS FIRST

Question: I have been suffering with a stopped-up nose, runny nose, sneezing and itching eyes. I get these same hay fever symptoms every fall, but I've never had them in the spring before this year. How can I tell if this is a cold or a new problem with allergies?

Answer: The symptoms you describe indicate an irritation to the mucous membranes lining the nose and eyes. All of us have had these symptoms as the consequence of a viral infection we call "the common cold." Also, at least 15 percent of us occasionally have symptoms of this type as a result of exposure to non-infectious things such as pollens, pet dander, dust mites or other substances. In these situations, the immune system responds to the offending substances -- doctors call them allergens -- as though they were harmful, cold-producing germs. The symptoms, which are a necessary part of the body's fight against a cold, signal an excessively vigorous and undesirable response to a relatively harmless allergen.

Just as you have noticed, sometimes it is difficult to correctly identify the cause of nasal irritation. However, you can make an accurate guess by observing those around you. A "cold" is highly contagious and, therefore, will shortly afflict those around you while allergies are not contagious at all. Cold symptoms also improve in a few days while allergies continue for as long as exposure to the offending substance continues.

Allergies that occur in late summer and fall are often called "hay fever" although I'm not sure why since most of us get this without working in hay, and "fever" is also not part of the constellation of symptoms. The condition is more accurately described as "allergic rhinitis" or more simply, "allergies," regardless of the time of year when it occurs. Those who suffer from allergies have an immune system that responds more easily and more vigorously than is necessary for the risk posed by pollen or other allergens. These individuals, and this includes you, are at increased susceptibility for developing allergies to new pollens. I would guess that this is what has happened to you this spring.

In the northern and eastern parts of the country, spring allergies are usually due to pollen from trees or spring grasses. Fall allergies are usually due to the pollen of fall flowering native grasses that are frequently described by the derogatory term "weeds." Molds, pet dander and house dust can cause problems year round.

Avoiding the offending allergen is the best treatment for allergies. Sometimes this is a realistic option -- for example, simply keeping the pet out of the bedroom. For other allergies it may be completely unrealistic -- for instance, staying indoors in a climate-controlled room 24 hours a day. Fortunately, there are a number of non-prescription as well as prescription medicines that help with allergic rhinitis. The non-prescription products are generally safe and affordable, so they are the best things to try first. If the first product you try doesn't give you satisfactory relief, try another one. Remember to choose one with different active ingredients, not just the same drug with a different brand name on the label. Your pharmacist can help guide your selection of products.

Individuals who have allergies that are not relieved by non-prescription products, or those who have other medical conditions such as high blood pressure, should see their family doctor. There is a cornucopia of effective treatments for this malady. Your doctor can prescribe one that is right for you.

Family Medicine® is a weekly column. To submit questions, write to John C. Wolf, D.O., Ohio University College of Osteopathic Medicine, Grosvenor Hall, Athens, Ohio 45701.