Dr. Rose: Pollen allergy - why is an investigation important?

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With the advent of the ragweed season, those who are sensitive will face difficult weeks if they are not prepared in time for the symptoms that regularly arrive in summer’s second half. Together with our expert, Dr. Rose Private Hospital’s allergist Dr. Magdolna Krasznai, we gathered the most important information about testing, medication, and immunotherapy.

Why is it important to investigate pollen allergy symptoms? Why is it good to know what allergens are causing our symptoms?

Pollen allergy or allergic rhinitis (hay fever) occurs seasonally. There are three main allergy seasons in Hungary - the early-blossoming trees, the grass, and the weed (ragweed) season. Typical symptoms include a bilateral, watery runny nose, sneezing, tearing, itchy eyes, nose, throat and ears, and nasal congestion. It is important to have an allergological investigation so that a patient with allergic rhinitis can take preventive measures at the right time, as well as start a step-by-step therapeutic medication treatment before the season so that unpleasant symptoms do not develop. Based on our knowledge of pollen sensitivity, we plan our daily, weekly, monthly activity and vacation, taking into account the pollen concentration. Recognize what we are sensitive to, and in which season our symptoms can occur. Based on the knowledge of cross-reactivity we should also pay attention to what we eat!

At what interval is it worth repeating the skin prick test?

The test should be repeated every two to three years. Allergic sensitivity and the severity of the allergy may also vary, and medication should be used accordingly. An allergy investigation is recommended during asymptomatic periods when antihistamines are not being taken!

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In what cases can the (antihistamine) tablet help and in what cases does the doctor prescribe a nasal spray (containing corticosteroids)? Why is it important to see a specialist with pollen allergy symptoms?

The antihistamine is effective for a watery runny nose, sneezing, eye symptoms, and itchy nose, throat, and ears. For such complaints, the antihistamine may be used in the form of a spray, tablet, syrup, or eye drops. In case of nasal congestion, the use of an anti-inflammatory nasal spray containing steroids is recommended. In the case of both symptoms ­– a watery runny nose and nasal congestion - a topically applied nasal spray containing both components is excellent! In all cases, nasal rinsing is recommended to remove pollen!

In the case of a pollen allergy, it is important to use modern, appropriately staggered treatment to ensure quality of life.

If nasal congestion is the main symptom, a specialist ear-nose-throat examination is strongly recommended. Nasal congestion, together with other symptoms, can also occur in the case of seasonal pollen allergy, but for perennial, or year-round complaints, often the main symptom is caused by house dust mites or animal fur. There may also be a number of ear-nose-throat diseases in the background!

In what cases does the allergist recommend immunotherapy?

Symptomatic allergic patients who do not respond well to medication may be considered after appropriate investigation. It is justified for moderate-to-severe symptoms lasting at least two seasons, when an allergy investigation demonstrates an outstanding sensitivity to one or two allergens. During the investigation, the skin prick test and specific IgE antibody examination, as well as the patient’s medical history clearly confirm this.

What should we pay attention to while taking medication, and how can we alleviate symptoms?

Proper eating, in order to avoid cross-reactivity. We should monitor the pollen report, when possible do not stay outdoors, and plan our summer vacation accordingly. Wear a mask, glasses, use a pollen filter, and wash your hair, nose and face regularly!

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What can untreated hay fever lead to?

The patient's quality of life deteriorates, and their symptoms worsen. Nasal discharge and high nasal congestion cause sleep complaints, insomnia, fatigue, and irritability. The quality of learning and work deteriorates. Inflammation of the allergic mucosa of the upper respiratory tract, when not properly treated, also affects the lower respiratory tract, so hyperresponsiveness and hypersensitivity of the lower respiratory mucosa develop. For this reason, coughing and shortness of breath also occur in addition to the symptoms of allergic rhinitis. One-third of patients with allergic rhinitis develop allergic asthma, as improperly treated allergic rhinitis promotes the development of asthma!