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

CALENDAR NOT RELIABLE PREDICTOR OF "HAY FEVER SEASON"

Question: Late in the summer every year I get itchy eyes, a congested nose and other allergy symptoms. I've always wondered why this is called "hay fever" since I haven't been around hay and I don't have a fever?

Answer: That is a great question. Hay fever is a common but not a descriptive term that indicates an allergic response to plant pollen. If you have ever put up hay, you have probably had the allergic symptoms you describe. Almost everyone gets these symptoms from the high levels of grass pollen and dust one encounters when working in hay. Perhaps that is where the "hay" part of "hay fever" comes from. I can't even offer a guess about the origin of "fever" in the name, since fever is not a part of allergic response.

About 15 percent of the population suffers from hay fever, and most of these individuals develop it by age 30. Since humans can be allergic to pollens from trees, grasses and weeds, the hay fever season varies from person to person. For example, Easterners and Midwesterners who are allergic to tree pollens suffer in the early spring. People sensitive to grasses suffer in the late spring and early summer. Those most sensitive to weeds, like you, are at their worst from midsummer to late fall. Keep in mind, however, some unfortunate souls are sensitive to more than one of these allergens, so some hay fever victims put up with their symptoms from early spring to late fall.

The most common symptoms of hay fever are just as you reported:

repeated and prolonged bouts of sneezing

a stuffy and watery nose

redness, swelling and itching of the eyes. The nose, throat and mouth may also itch or be irritated, and ear problems are common as well.

The severity of these symptoms varies from person to person and from year to year.

People who are stricken with hay fever may eventually develop complications. Nasal polyps, the growth of additional tissue in the nose, and sinus infection are common examples. In addition, about 30 percent of all people with hay fever develop asthma a breathing problem with much wheezing and coughing.

Question: I usually take non-prescription allergy medications for my hay fever, but they don't always work. Are there other things I should do?

Answer: Obviously, the best approach is to avoid the offending pollen entirely. Unfortunately, this is rarely a realistic alternative. You should see your doctor if you still have symptoms after trying several of the non-prescription products. He or she can help you identify the specific things to which you are allergic and also offer other beneficial treatments.

Air purifying devices can be effective in making a home relatively free of the offending pollen. Sometimes just switching to a new, high efficiency filter in the air conditioner may remove enough pollen to reduce the allergy symptoms to a tolerable level.

Most people, however, require some type of drug to reduce the symptoms of hay fever. Antihistamines are the most common type of medication used for this. The non-prescription variety are actually very effective when taken in sufficient strength, but at this dose they also cause most people to be sleepy. There is some variation from product to product, so it usually worth trying several before heading to the doctor's office.

Prescription-type antihistamines don't cause sedation, but they are considerably more expensive than the non-prescription ones. Additional relief can be provided by use of special nose sprays that contain a topical steroid such as beclomethasone. These are more effective that antihistamines taken by mouth, but they only clear up the nose and throat symptoms. Allergy testing and allergy shots are the next step for those individuals with prolonged episodes that don't respond to other treatments.

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.