We often think of spring as the season of new growth—a time of natural rebirth that many celebrate. For people with allergies, however, spring’s natural bounty can be the enemy; allergy sufferers brace themselves to endure an onslaught of sniffly symptoms.
Thirty to 35 per cent of Canadians suffer from allergies and asthma. While tree pollen is the main culprit in spring, grass pollen takes over in early summer, and weed and ragweed pollens from late summer until the first frost.
Pollen is a fine powder produced by some plants when they reproduce. It is carried by the wind and can travel for kilometres. “Even workers on oil rigs can get seasonal allergies,” says Dr. Lori Connors, an allergist and clinical immunologist, and assistant professor in the departments of medicine and pediatrics at Dalhousie University in Halifax.
Symptoms can include itchy, watery eyes, redness in the whites of the eyes, nasal congestion, runny nose and stuffiness. “People can also get an itchy sensation in their mouth, in their palate or in their ears,” says Dr. Connors. “If they also have asthma, they can get wheezing, a cough or shortness of breath when exposed to pollens.”
Dr. Connors says allergies can be quite serious. Some studies on allergic rhinoconjunctivitis (which refers to the group of symptoms that result from inflammation of the mucous membranes of the eyes and nose) have noted that people with allergies often miss work or school. Studies of children with allergies have shown that their performance at school can be impaired because of fatigue. “If you’ve got longstanding inflammation, you are not sleeping well and you can’t really concentrate,” she says.
Allergies and asthma
Asthma is a respiratory illness that means it is difficult to breathe because of inflammation and constriction of the airways. While the exact cause is unknown, asthma can be triggered by pollens, pet dander, cigarette smoke, strong scents, a head cold, emotions, breathing super-cold air and exercise. About 60 to 80 per cent of people with asthma will find that allergies play a role in their asthma. “From an allergist’s perspective,” says Dr. Connors, “we think it is important to treat both allergy and asthma, because if you don’t treat the nose, often the chest won’t fully resolve.”
Help for allergy sufferers
Dr. Connors says most people who have allergies will try over-the-counter medications before visiting an allergist. She advises those people to consult a pharmacist regarding what might work best, and cautions against using over-the-counter nasal sprays, which can make the symptoms worse if they are used for more than three to five days.
If you suspect that you have allergies, have your family physician refer you to an allergist, who can do a skin prick test on your arm to confirm that suspicion.
“We put extracts of different environmental allergens on the skin and prick through the top layer of the skin,” says Dr. Connors. She explains that allergists use a mixture of all tree pollens that might be found in the geographical area. An allergic reaction will set off a wheal and flare response: a wheal is a pale raised welt; a flare is a halo of red flushed skin around the wheal. Once the allergen has been identified, treatment can be focused.
Environmental control comes first—steps can be taken at home and in other areas of daily life to reduce exposure. Windows should be kept closed to create a pollen-free zone in the bedroom; laundry should be dried indoors rather than on a clothesline; car windows should be kept closed when driving; outdoor activities such as walking or running should be confined to afternoon or evening, since pollen is dispersed early in the morning. Allergy sufferers can also check websites, such as theweathernetwork.com, for pollen counts in their area.
The next line of defence is to explore medications that can help control the symptoms. These include intranasal corticosteroids (prescription nasal sprays), antihistamines and leukotriene-receptor antagonists, which work well for both allergies and asthma. It may also be worth getting a neti pot, which can be used to pour a saline rinse in through one nostril and out through the other, flushing the nasal cavities.
The final treatment option is called allergen immunotherapy. “If you are allergic to birch pollen, we would put you on immunotherapy—birch pollen at low doses—where we can kind of trick your immune system into tolerating the pollen over time,” says Dr. Connors. “You would either get an injection year round to help you manage that, or get pre-seasonal immunotherapy, consisting of weekly injections for a couple of months before the season arrives.”
With the proper diagnosis and treatment, those with allergies may actually be able to leave the “sufferer” label behind.