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Stop sneezing and sniffling.

Approximately 50,000,000 Americans suffer from itchy and inflamed nasal passages caused by allergic rhinitis. For many, these symptoms often are compounded by difficulty in breathing, headache, and heightened fatigue.

Allergies and the common cold produce similar symptoms--sneezing, stuffiness, runny nose, itching, and postnasal drip. A multitude of viruses can cause the common cold and its nasal symptoms, as well as fever, sore throat, aches, and chills. A physician easily can distinguish between allergy and cold by checking the color of the nasal tissue and the nature of the mucous discharge. Once the diagnosis of allergy has been made, skin tests with suspected allergens help the doctor make a specific diagnosis and pinpoint the allergens responsible.

Patients who suffer from allergic rhinitis may be sensitive to one or more substances--such as pollen, dust mites, mold spores, and animal dander--that serve as nasal irritants and/or allergy triggers. Avoiding exposure to these triggers, which vary from person to person, is of prime importance in preventing an allergic reaction. Since most common ones are in the air, it is not always easy to avoid them and still lead a normal, active life.

The underlying process reponsible for allergic rhinitis is inflammation. When exposed to airborne allergens, IgE antibodies in the cells of the lining of the sinuses and nasal passages bind with them. IgE leads to the breakdown of some of the millions of mast cells in the nasal tissues and the release of chemical mediators such as histamine and prostaglandins. These mediators cause inflammation of the lining of the nose, congestion, itchy palate, and watery eyes.

For years, antihistamines--so called because they work to block the release of the chemical mediator histamine, thought to be a primary mediator in sinus allergies--and decongestants were considered to be first-line treatment. Though they help treat some of the symptoms of allergic rhinitis-mucous discharge and watery eyes--these medications are less effective in reducing inflammation, the underlying cause.

Recently, other chemical mediators have been discovered, including leukotrienes, which allergists believe are responsible for recruiting additional inflammation-causing cells. Today, prescription medications containing corticosteroids are in widespread use to block the formation and release of histamine, leukotrienes, and other inflammation-causing chemicals from cells. In addition, they reduce the number of inflammatory cells in the nasal passages and decrease the sensitivity of the nerves in the nose that cause sneezing. Applied topically at recommended dosages to the nasal passages via a pump spray or nasal aerosol, corticosteroids act locally and appear to have few side effects other than irritation of the nasal mucous membrane.

For some patients, allergy shots (immunotherapy) may be helpful, particularly if medications fail to relieve symptoms. The injection of small amounts of an allergen under the skin on a regular basis can desensitize patients to allergens. Desensitization appears to be most effective when done year-round rather than just before or during the allergy season. The average treatment lasts three to five years. The allergens used most often for desensitization are those that are in the air and can not be avoided, such as pollens and dust mites. Desensitization is not recommended for allergies to foods.
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Title Annotation:allergies
Publication:USA Today (Magazine)
Date:Feb 1, 1993
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