Coping with spring allergies

GBMC doctor answers questions about seasonal allergies

  • Dr. Gregory Small
Dr. Gregory Small (Courtesy of GBMC )
May 28, 2014|By Meredith Cohn, The Baltimore Sun

The winter was cold and snowy and the spring has been wet and warm, and that combination has made it easier for trees to produce much more pollen than normal. And that means runny noses and red, watery eyes for many who suffer from allergies. But Dr. Gregory Small, board-certified in internal medicine and a primary care physician at Greater Baltimore Medical Center at Texas Station, says that there are a number of ways to treat these allergies.

What are the main spring allergens and symptoms?

Allergens are substances that provoke an allergic reaction that manifest as asthma when the reaction is in the lungs, allergic conjunctivitis when it's in the eyes or allergic rhinitis when it's in the nasal tissues. Allergic conjunctivitis symptoms include red, itchy eyes that may develop swelling as well as a gritty sensation. Most commonly, patients experience allergic rhinitis that results in nasal discharge and congestion that can cause facial pain and pressure. The associated postnasal drip commonly causes a sore throat, a hoarse voice, and Eustachian tube dysfunction which can be felt as a popping sensation in the ears. Spring allergies are typically the result of pollen from trees, grasses, and weeds. Molds can also release spores that serve as allergens as well.

Did the cold and wet winter make conditions worse for spring allergies?

It depends on the patient and their threshold for an allergic response to a particular allergen. In warmer winter seasons, such as ... 2013, the trees can pollinate earlier and cause a prolonged season for allergy sufferers. However, in seasons that have a greater contrast in temperatures, the warmer time frames may be shorter but can result in higher pollen counts, triggering stronger responses. The wet weather certainly can contribute to higher pollen counts as well by promoting quicker plant growth early in the allergy season.

Can an especially bad year produce symptoms in people who have not had symptoms before?

The term "bad year" for allergy sufferers would depend on the patient and their allergen threshold for the development of symptoms. In patients with longstanding allergies and lower pollen thresholds for symptom development, a warmer winter can promote an earlier and longer season. A wet winter and early spring with a greater contrast in temperature between the season changes can cause increased spikes in the pollen counts that are able to trigger an allergic response, manifesting as allergic rhinitis or conjunctivitis, in patients that have not previously suffered from spring allergies. The number of patients suffering from allergy symptoms has been rising over the years, thought to be related to higher pollen counts.

What are the treatments, and when do they require a doctor's visit?

Nasal irrigation, commonly with a saline rinse, is effective at relieving congestion and washing the nasal lining of allergens. Nasal sprays, particularly steroid sprays, are very effective in reducing nasal tissue inflammation and relieving symptoms. Oral antihistamines, such as Claritin or Zyrtec, are also beneficial in alleviating symptoms. Prior to using one of the antihistamine formulations, combined with a decongestant, it is recommended to consult with a physician. While many of these treatments can be initiated without a physician prescription, patients should work with their physicians to identify their allergens for the best treatment plan. It is important to know that other environmental allergens, such as from pets, dust mites, mold or other sources in the home may magnify the symptoms of spring allergies. The absolute best approach in managing the allergic response is to minimize allergen exposure when possible. Physicians, particularly allergists, can also provide allergy shots that are designed to improve a patient's response to their offending allergens. Patients should also consult with their physician immediately if they experience facial pain or pressure that is not improving or worsening despite attempts with the above treatments, development of a fever, or feelings of tightness in the chest or wheezing.

How long will spring allergies last?

Spring allergies in the Baltimore area will typically cause symptoms into June. If a patient has symptoms that persist it is certainly possible that other environmental allergens besides the spring pollen or mold are contributing to their response. Again, allergy testing can identify any other allergens contributing.

meredith.cohn@baltsun.com

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