News

25-10-2015

It is estimated that 15% of the Australian population will suffer from symptoms of hay-fever,( itchy, watery eyes and nose, sneezing  and itchy throat ) this Spring and Summer. It is caused by an allergic reaction to pollens, irritating the lining of the nose. Many factors affect the pollen load in the air, from temperature, rainfall, humidity, wind direction and hours of sunlight.

Quality of life can be significantly reduced by the symptoms and poorly controlled nasal symptoms can increase the severity of asthma, and is associated with sinusitis, middle ear infection and nasal polyps. Most treatments are available over-the counter at pharmacies.

Management options in 2015:

1. avoiding trigger factors and non-medicated treatments such as saline nose washes, wearing sunglasses when outdoors

2. Antihistamine -  most commonly used to manage mild and intermittent symptoms, particularly of itchy and watery eyes and sneezing. Less beneficial in managing symptoms of nasal blockage. The older preparations caused sedation, interacted with alcohol   The newer preparations have fewer unwanted side effects and most act within one to two hours and last 2 to 24 hours. There are no meaningful differences in safety and efficiency between the newer antihistamines. Our bodies do not " get used" to them and their effectiveness does not alter with time.

3. Intranasal steroid sprays - the most effective and considered first-line for persisting symptoms in adults. These have been demonstrated as more effective in controlling nasal symptoms, reduced eye symptoms , are well tolerated and can be used long term without problems. There is no clear evidence of one preparation being more effective than another, the two areas of difference are in systemic absorption and cost

4. Oral decongestants - these are useful in specific cases, such as the need to travel, but are contraindicated in those with hypertension or coronary heart disease and must be used with care in those with hyperthyroidism, glaucoma or prostate enlargement. They have side-effects that include nervousness and insomnia

5. Decongestant Nose sprays - useful for immediate relief of blocked nose, but if used for more than two to three day an cause rebound blockage of the nose by inflaming the lining of the nose

6. Antihistamine eye drops - can be added to intranasal steroids when symptoms persist

7.leukotriene-receptor antagonists ( eg montelukast) - currently being evaluated, but early results are not encouraging

8.Immunotherapy -- those with severe symptoms, failed previous treatment strategies, and the desire to avoid reliance on medication may benefit. The treatment can occur over three to four years and requires referral to an Immunology Specialist. The allergen is given by regular injection or  sublingual and is expensive and time-consuming. The aim is to re-educate the immune system to reduce the allergic response

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