Apr 6, 2009 9:39 am US/Eastern
Dr. Mallika's Files: Case Of 'Achoo Achoo'
Each week Dr. Mallika Marshall shares cases based on true stories from a local urgent care clinic, exclusively on wbztv.com. Names and identifiable characteristics of patients have been omitted or changed to protect patient privacy.
This Week's Case:
A 36 year old man comes to the clinic complaining of a nagging cough for the past two weeks. Upon further questioning, he reports that he has also had a runny nose, watery eyes, and an itchy throat. Sometimes his ears itch as well. He seems to get these symptoms around the same time every year. He doesn't remember ever feeling this way when he lived in Arizona five years ago. He currently works construction. He has tried over-the-counter cough and cold remedies without relief.
The patient's vital signs are normal and his lungs are clear. The whites of his eyes are slightly red and occasionally, during the exam, he coughs and sniffles.
Discussion
Hay fever, also known as seasonal allergies or allergic rhinitis, is a constellation of symptoms caused the body's overreaction to pollen. When a person with allergies breathes in pollen, the immune system produces antibodies and a chemical response. The pollens that cause hay fever include trees, grasses, and weeds and the extent to which they cause symptoms varies from person to person and from region to region.
Hay fever can mimic the Common Cold with cough, runny or stuffy nose, sneezing, and even sore throat and headache. But unlike a viral infection, allergies often cause itching…of the eyes, nose, mouth, or throat, and rarely cause fever (despite the name) or body aches.
Obviously, the best treatment for allergies is to try to avoid those things that trigger your symptoms in the first place. To reduce your exposure to pollen:
1) Keep your house and car windows closed
2) Use air conditioning on the "recirculate" mode
3) Shower before bedtime to wash pollen out of your hair and off your skin
4) Avoid going outside on dry, windy days
One home remedy that some people swear by is the Neti pot, a ceramic pot used for nasal irrigation to flush mucus out of the nasal passages. You can use this alone or in conjunction with medication.
There are several over-the-counter antihistamines that can help with mild to moderate symptoms. Some cause drowsiness, like diphenhydramine (Benadryl). Others typically don't, like loratadine (Claritin). Decongestants, like phenylephrine (Sudafed), can also help if you tend to have a lot of congestion.
If these medications don't do the trick, there are several prescription drugs that you can try. One of the most effective is a nasal steroid spray.
Acupuncture has also shown some promise in treating allergies.
If you notice that you develop the same annoying symptoms around the same time every year, you may be suffering from seasonal allergies. And in the future, starting medications before the season begins can help keep your coughing and sneezing at bay.
Follow-up
The patient was told to try loratadine, and he was given a prescription for a nasal steroid. Three weeks later he was feeling much better.
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