Spring is here – and for many people with hay fever, the suffering period has started with sneezing attacks and irritating coughing. The symptoms of pollen allergy and what you can do about it.
People with a pollen allergy face spring with mixed feelings. While others enjoy the fact that everything is blooming, they suffer from symptoms such as a stuffy nose, watery eyes, or coughing. All this is more than annoying and more than just a little cough and runny nose. Many pollen allergy sufferers can hardly sleep, work, learn, let alone enjoy their free time for weeks. And as if that were not enough, almost every third hay fever patient develops allergic asthma . Experts call this “level change”: The disease migrates from the nasal cavity into the bronchi, if the pollen allergy remains untreated.
This could be prevented by early therapy. However, the disease is still underestimated and not properly treated, experts say. To find the right treatment, patience is needed, because every allergic person needs a different one . “Work the doctor and patient well together, the hay fever can bring well under control and often avert the pollen asthma,” says Karl-Christian Bergmann, head of the allergological-pneumological ambulance at the Allergy Center of the Berlin Charité.
In the worst case hay fever until the fall
About every sixth adult in Germany has hay fever . It is the most common allergic disease and is called allergic rhinitis by professionals. And the pollen sources are numerous. Most allergic people react to early flowering trees and shrubs such as hazelnut, alder and birch. But also the grass, herbal and grain pollen torment many. In addition, if someone reacts to several types of pollen that occur at different times , in the worst case, it means hay fever from February to October. However, most pollen allergy sufferers are less likely to face it: the core phases of hay fever are spring and summer.
Why so many people contract hay fever is unclear. The only certainty is that there is a genetic bias for allergies. However, this alone does not explain why the case numbers have risen so much in recent years, so external influences have to play a role in addition to the genes. About twice as many urban and rural children suffer from hay fever. Especially children who grow up on farms have a significantly lower risk of allergies. Apparently their immune system has enough to do because of the increased germ burden that life with animals entails – and develops less hypersensitivity.
trigger
Depending on which allergic disease is present, the allergens trigger their action in different places: in hay fever on the nasal mucosa and on the conjunctiva of the eyes, allergic asthma in the bronchi. Also in atopic dermatitis , inhalant allergens can worsen skin eczema . The culprits are tiny and practically invisible: pollen are globules with a diameter of about 50 microns. By comparison, human hair has an average diameter of 100 microns.
Find out which individual pollens of trees, grasses and herbs cause allergies.
symptoms
The symptoms of grasshopper are similar to those of a cold . However, it is typical for a pollen allergy that the symptoms occur again and again at the same seasons and subside. In addition, the itching in the nose, throat and eyes is not typical for a viral infection. The following symptoms of the nose, eyes and bronchi may or may not be present in every individual.
Typical symptoms of pollen allergy include cold symptoms such as:
- Swollen nasal mucosa
- Clogged and / or runny nose
- Sneeze
- Itching and / or burning
Many pollen allergy sufferers also have problems with their eyes:
- The eyes redden and / or itch.
- The eyes are watering.
- The eyelids swell.
- The affected person is sensitive to light.
- In some cases, the ocular symptoms occur even without a cold. Doctors call this form of hay fever then allergic conjunctivitis (allergic conjunctivitis).
In addition, about 40 percent of pollen allergy sufferers experience bronchial complaints because they develop allergic asthma . This includes:
- difficulty in breathing
- Dry cough
- Rattling or whistling breath
Less common are symptoms like:
- Swelling of the face
- wheals
- Itchy skin
- Headache and migraine
- digestive problems
Hay fever in everyday life
It is often underestimated how much a hay fever restricts the quality of life of the allergic person, because he is much more than just a cold. In addition to the actual symptoms, many patients also suffer from their consequences: they sleep poorly, are tired during the day, can not concentrate well and learn badly. In particularly severe cases, those affected can not work at all or go to school. Her social life also suffers from severe restrictions.
In many patients, the pollen allergy also extends to food. Many nuts, grains, fruits or vegetables are biologically closely related to flower seeds, so birch pollen allergy sufferers often respond to foods such as apples, pears, prunes and almonds. One speaks of so-called cross – allergies .
diagnosis
First, the doctor will ask you exactly what your symptoms are: what are your symptoms? When did they start? How could they be triggered? Are there any similar complaints or allergies in the family? To prepare for this, you can download a “checklist for the doctor’s visit” in the stern.de allergy advisory board .
Thereafter, the allergist will examine the nose, throat and eyes. Talking about the information from the interview and the first results of a hay fever test, he can use skin or blood tests to test this and narrow down the variety of pollen that can be used.
Scratching on the surface: the skin test (prick test)
The doctor punctures various bee pollen extracts with a small lancet superficially into the skin of the patient. After ten to twenty minutes, redness or wheals develop in those areas where an allergic reaction is actually occurring. However, the prick test alone can not provide a reliable diagnosis, because other diseases or drugs can make the skin react more or less sensitive. Only if the previous survey has provided evidence of hay fever, which supports the findings.
Before the skin test, the doctor must describe how severe the allergic reaction of the patient can be. After all, the test provokes a defense reaction of the body – in rare cases to an allergic shock or severe respiratory distress. At-risk patients should only be tested in hospitals so that they can be treated immediately in an emergency.
This gets under your skin: the blood test (IgE test)
A blood test is useful if the previous studies did not give a clear diagnosis or if small children are too afraid of the prick test. In the laboratory, the blood is examined for certain antibodies, so-called immunoglobulins E (IgE), which forms the immune system in hay fever against components of the flower pollen.
If the IgE level is increased overall (total IgE), this alone is not enough to diagnose an allergy. Even smoking or a worm disease can increase the amount of IgE in the blood. More meaningful is a targeted examination of the blood for specific antibodies against pollen antigens (specific IgE). If these antibodies are found, this is an important indication of hay fever. But here too, a clear diagnosis is only possible if the medical history and the other test results also fit.
On confrontation course: the provocation test
In a provocation test, the doctor will check if the allergens suspected from the results of blood or skin tests are actually responsible for the symptoms. He brings the nasal mucosa or the conjunctiva of the eye with the pollen extracts in contact, which come as an allergen trigger in question. That may be especially important
- if the test results still do not quite fit the times when the symptoms occur and
- if it is important for the therapy to determine the trigger of the symptoms exactly. This may be, for example, if the previous results found a hypersensitivity to several types of pollen whose flight times overlap. The provocation test can then identify the “main culprit” who is actually responsible for the hay fever symptoms during this period.
Because of the sometimes severe allergic reaction, which can provoke a provocation test, the examination should be carried out only in the presence of a doctor, preferably stationary in a clinic.
Beware of confusion
Hay fever can easily be confused with other allergic types of cold that are caused by dust mites , dander or hair of animals or molds . Especially if the patient’s symptoms not only occur during the typical pollen season, are probably other allergens than only pollen behind it.
In addition, other factors also cause symptoms of hay fever, such as viral infections, bacterial infections and changes in the nasal skeleton, side effects of medications, food intolerances or hormonal changes, for example, during pregnancy or menopause. If such causes are suspected, a comprehensive examination of the ENT can provide clarity, including endoscopy of the sinuses or computed tomography.
therapy
If the hay fever is treated incorrectly or not at all, it can expand. On the one hand, there is a risk that the immune system will be allergic to more and more substances – that is, then new sensitization – or, more dangerous, the hay fever will become allergic asthma . Left untreated, 40 percent of pollen allergy sufferers experience this so-called “level change”: the defense reaction spreads from the upper to lower respiratory tract, ie from the nose and throat into the bronchi. The right and early treatment with medication can not only fight sniffling, tears and itching, but also prevent this level change.
Finding the right remedy
For hay fever, especially antihistamines or asthma drugs are used. Which active ingredients in which dose and combination help particularly well, is different for each patient. It often takes patience and trust in the attending physician until the optimal therapy is found.
Antihistamines is a generic term for drugs that suppress an excessive defense reaction of the immune system by suppressing the normal effect of the histamine histone tissue. Above all, they fight the symptoms – they do not have a long-term, protective or even healing effect. Antihistamines are available as tablets, syrup, juice, nasal sprays and eye drops. They can cause side effects and cause dry mouth, dizziness, headache and tiredness. Often it then helps to switch to another antihistamine.
Stronger asthma medications
Cortisone or theophylline also have an effect on particularly severe and asthmatic complaints.
Cortisone (glucocorticosteroids) can suppress the allergic inflammation of the bronchi and minimize the constant readiness for defense reaction. With continuous therapy with cortisone pollen allergy sufferers with asthmatic complaints need less other allergy medications. However, cortisone does not provide fast relief. It takes several days, sometimes weeks, for patients to feel the first improvement. Basically, cortisone should be inhaled better than in the form of tablets. The sprays have fewer side effects and act specifically where they are needed: in the airways.
The side effects of cortisone drugs are rare in the treatment of hay fever. Unwanted effects usually only occur with long-term use. Cortisone inhalation preparations may cause hoarseness and / or fungal infection of the oral mucosa. This can be best prevented by brushing your teeth, mouthwashes or inhalation before eating. Higher doses of tablets, which cause cortisone to work throughout the body, can have serious side effects:
- increase in weight
- Increase in blood sugar levels
- Degradation of bone substance (osteoporosis) and mineral deficiency (especially potassium)
- The function of the adrenal cortices is impaired.
- The danger of developing a Gray or Green Star is growing.
- Labile emotional state, such as depression, irritability or even euphoria
- Growth delays in children
- Rarely in pregnancy are malformations of the child.
Theophylline dilates the bronchi. It is therefore used for the long-term treatment of more severe asthmatic complaints. Theophylline may have serious side effects: headache, restlessness, seizures, nausea, arrhythmia, blood pressure may drop, but blood sugar levels may increase, as well as insomnia, vomiting, diarrhea. In addition, the effect of theophylline is easily affected by age, cigarette smoke or other drugs. Between desired effect and the side effects is only a fine line, sometimes not even that, therefore, should the doctor at the beginning of the therapy regularly control the effect, but above all determine the concentration in the blood.
Immunotherapy: the vaccine against allergy
The goal of a specific immunotherapy is to get rid of the overzealous defense reaction of the immune system. It is also known under the terms hyposensitization or allergy vaccination. For this purpose, the patient is injected with the smallest amounts of an extract of the allergy-causing pollen – in weekly increasing dose. After the maximum level is reached, he receives another dose every four to eight weeks, so that the immune system does not forget the appropriate response to bee pollen again. The therapy lasts three years.
The extract does not always have to be sprayed. Sensitive patients may also resort to the so-called sublingual immunotherapy and let the drops or tablets melt under the tongue. Their effectiveness has been increasingly explored in recent years. For the allergy to pollen in adults, it is considered safe. However, use in children is not recommended.
It is important that the therapy is initiated in the fall, when no more pollen fly. This allows the body to gradually get used to the allergens without being constantly exposed to them in everyday life. When the pollen count starts again in spring, the immune system is already prepared. In order not to double it, however, the doctor reduces the dose of the therapy during this time or even interrupts it until the next fall.
Eight out of ten pollen allergy sufferers respond to the treatment: they need fewer allergy medicines, often no more – on average only half. The threatening change of levels of the defense reaction in the bronchi can be prevented. In children and adolescents, specific immunotherapy usually works best.
Tips
During the flight time of the allergenic pollen you can reduce the complaints with a few tricks. They all aim to minimize exposure to pollen during its flight times. Doctors call this avoidance allergen avoidance. It is an important pillar of hay fever therapy.
expert advice
stern.de allergy experts answer your questions.
How can I protect myself or my child from hay fever?
In addition to the genetic predisposition, there is a particularly large risk factor: smoking parents during and after pregnancy, the risk increases greatly that the children develop asthma or develop allergies.
Breastfeeding offers special protection against hay fever and other allergies. Children from families with allergies should therefore be given mother’s milk – at least four months long. If it is not possible to breastfeed, low allergen baby food can also limit the risk of allergies. Talk to your doctor about it.
How can I tell a cold from an allergic cold?
The symptoms are actually very similar. However, symptoms of allergic cold usually occur out of the blue. They can die away just as quickly – but they keep coming back. In the case of a cold, on the other hand, you already feel days or at least hours in advance that “something is brewing” and they will not be able to get rid of it for at least a week. In an allergy, the nasal secretion is also mostly watery and clear, not slimy – or tough as a cold. Also, there is no fever and no sore throat in allergic rhinitis. Especially typical symptoms of allergy are the itchy nose, burning eyes and heavy sneezing.