Have you noticed that there are more people around you who are “coughing like crazy” recently? According to the daily pollen concentration monitoring by the Pollen Research Unit of the Department of Allergic Diseases of Beijing Jitan Hospital, the spring pollen season has started in Beijing since February 21 and will reach its peak in mid-March.
Yes, you may have allergies and not a cold.
Can allergies be cured? Is it necessary to test for allergens? Why did you never have allergies as a child but have reactions as an adult? How should I deal with allergies? Are “folk remedies” reliable? We have collected your most concerned questions and asked several medical experts to answer them.
Q1: What is allergy? What are the causes?
Every year when spring blooms, itchy eyes, red eyes, itchy nose and more than just sneezing also come, which is the annoying allergy.
Dr. Zhou Jichao, deputy director of ophthalmology at Beihang Hospital, introduced that eye allergy is called seasonal allergic conjunctivitis and nasal allergy is called seasonal allergic rhinitis, commonly known as hay fever. Allergic conjunctivitis and rhinitis are self-limiting diseases, most of which do not leave any serious sequelae, but they tend to recur periodically or even year-round.
Seasonal allergic conjunctivitis and rhinitis are both hypersensitivity disorders caused by type I hypersensitivity reactions, mostly in the spring and fall, and are the most common allergic diseases of the eyes and nose. According to statistics, at least 15% of the population suffers from this type of disease, and in the past decades, systemic allergic diseases have shown a trend of increasing incidence year by year, with half of the population developing ocular and nasal symptoms.
Allergy, with genetic and environmental factors, is a common problem.
According to Dr. Cheng Yang of the Department of Respiratory and Critical Care at Beijing Jishuitan Hospital, studies have shown that if one parent suffers from allergic diseases, the probability of the next generation suffering from allergic diseases is around 50 percent; if both Parents suffer from allergic diseases, the probability of the next generation suffering from allergic diseases is as high as 75 percent.
Environmental allergens include seasonal allergens and perennial allergens. Seasonal allergens are mainly airborne pollen – tree pollen such as poplar, willow, pine, cypress and elm in spring, and grass pollen such as Artemisia and Humulus pollen in summer and autumn. Allergic rhinitis begins to develop during the pollen dispersal season. Perennial allergens mainly include dust mites, molds, etc.
Q2: What is the principle of allergy?
Rui Wu, deputy chief physician of the Department of Respiratory and Critical Care Medicine at Beihang Hospital, uses pollen allergy as an example. Pollen is like an antigen that is inhaled into the body and stimulates the inflammatory cells of the human organism, releasing inflammatory mediators. The effect on the human mucosa is that the integrity of the mucosal epithelium is damaged and the nerve exposure under the mucosa is activated, leading to a series of inflammatory reactions, such as an increase in the number of mucus cells, fat gain, and the production of a large amount of mucus.
For the nasal mucosa, it is frequent sneezing and clear water nasal discharge more than once, which may require half a packet or a packet of paper a day. For the airway, because of the presence of smooth muscle in the airway, in addition to the congestion and edema of the airway mucosa and increased sputum secretion, the smooth muscle contraction leads to tracheal spasm, causing the patient to suffer from asphyxiating shortness of breath and cough.
Clinically, 40% of patients with rhinitis are combined with asthma, and in turn, 80% of patients with asthma will be combined with rhinitis. Therefore, rhinitis and asthma belong to the same airway and the same disease. When rhinitis combined with asthma occurs, asthma needs to be treated at the same Time as rhinitis.
Q3: What are the manifestations of allergy? How to distinguish it from cold?
Wang Xueyan, director of the Department of Allergic Reactions at Beijing Severance Hospital, introduced that the most common symptoms of pollen allergy are itchy nose, nasal congestion, sneezing and runny nose. Some people experience itchy corners of the eyes when they reach the pollen period. Some people have mainly eye symptoms, some have mainly nasal symptoms, and a few people have mainly skin symptoms. In addition, there are some rare symptoms, such as stomach pain, increased frequency of stools, weakness and sleepiness in this season, which are often easily misdiagnosed and mistreated.
Common allergic rhinitis is very similar to the cold, how to distinguish between the two?
Cheng Yang said that allergic rhinitis is not a cold. The cause of the two is different, allergic rhinitis is an allergic disease, the cold is a viral infection of the upper respiratory tract; the onset cycle is different, the cold usually lasts about 1 week, but allergic rhinitis can last for weeks to months, and can even be perennial.
In terms of clinical manifestations, in addition to sneezing and runny nose, colds are accompanied by systemic symptoms such as fever, headache and general muscle aches, but allergic rhinitis is usually not accompanied by these symptoms. In addition, laboratory tests are more helpful to differentiate allergic rhinitis from colds.
Q4: Allergy, how to deal with it?
Cheng Yang introduced 4 methods.
(1) Get rid of allergens in the environment: reduce outdoor activities during the pollen dispersal season, wear masks, windproof eye masks and nasal filters; for those who are allergic to dust mites, keep the room dry and ventilated, and dry and wash clothes and bedding regularly; for those who are suspected of being allergic to animals, avoid contact with animals.
(2) Drug therapy: including antihistamines, local or systemic glucocorticoids, decongestants, anticholinergics, leukotriene receptor antagonists, anti-IgE monoclonal antibodies, etc. Patients should not use drugs at random, but need to be selected at the discretion of a medical professional.
(3) Specific immunotherapy: that is, desensitization therapy, which gradually improves the patient’s tolerance to allergens by exposing the patient to allergen extracts repeatedly, thereby reducing allergy symptoms.
(4) Nasal saline rinse: as an adjunctive treatment option, it can increase the effectiveness of other treatments, is effective, and is simple and inexpensive.
Zhang Yinghong, deputy chief physician of the Department of Otorhinolaryngology of the Third North Medical Hospital, reminds that for those with a clear attack cycle, medication can be reasonably applied 2 weeks in advance of the predicted attack for prevention, which can reduce the probability of an attack, and even if an attack occurs, it is possible to reduce the extent of the lesion.
Wang Xueyan introduced that at present, the most effective treatment for pollen allergy is specific immunotherapy, that is, after identifying the patient’s allergens, the corresponding antigens are injected for desensitization. The treatment process can take up to two to three years, but with persistence, 70% to 80% of patients’ conditions will be effectively controlled, generally no longer develop or reduce symptoms, reduce the use of drugs, and also reduce the proportion of allergic rhinitis developing into asthma.
Q5: Can allergic rhinitis be cured?
Cheng Yang introduced that under the existing medical conditions, allergic rhinitis cannot be completely cured. Nevertheless, active treatment is still needed.
Proper treatment can effectively relieve the symptoms of allergic rhinitis and improve the quality of Life of patients. More importantly, allergic rhinitis may be combined with chronic sinusitis, otitis media, and in severe cases, it can even lead to a variety of diseases such as bronchial asthma. Some studies have shown that the incidence of asthma among patients with allergic rhinitis is 4-20 times higher than that of normal people. Active treatment of allergic rhinitis can prevent a series of serious complications.
Q6: Why did allergies not occur when I was a child but appeared when I grew up?
Cheng Yang said that allergic rhinitis only occurs in adulthood, not necessarily because the body becomes worse. It may seem sudden, but in fact the body functions may have changed very early. Once the environmental allergens are encountered, the symptoms start to show up. With environmental factors and lifestyle changes, the incidence of allergic rhinitis does tend to increase gradually.
Wang Xueyan introduced that allergies are also closely related to human resistance. Some bad modern lifestyles, such as dieting and weight loss, excessive fatigue, stress, long hours playing computer games, etc., can lead to a decrease in resistance and aggravate allergic reactions. Urban environment such as the improvement of vegetation and greenery will also have an impact.
Q7：Does everyone need to be tested for allergens? Is it harmful to the body?
Wang Xueyan introduced that different pollens have different prevalence times, and allergens can be targeted for prevention after clarification.
There are two ways to check allergens: in vivo test and in vitro test, which are not harmful to human body. However, not everyone can do it. Patients who are in acute onset and are taking medication cannot be tested, firstly, the medication will affect the test results, and secondly, exposure to allergens will aggravate the symptoms of patients who have severe reactions.
In clinical practice, doctors will judge patients according to the time of onset, season, severity, and exposure to substances, and then conduct targeted allergen testing, not generalized testing.
Q8: Do “folk remedies” work?
A Tianjin citizen said that in order to deal with allergies, her Family has given a lot of folk remedies since she was a child, and Wang Xueyan expressed concern about this.
She said that some folk remedies mix a variety of hormones and antihistamines, while some are not clear what substances they are. Some prescriptions are effective, but due to non-standardized medical treatment, there are safety risks, some of which can cause hypertension, gastric ulcers and even femoral necrosis in some patients. When allergies occur, patients should go to a standardized hospital to clarify the cause, the drug, and the side effects after medication.
Q9: How can I tell if my child is allergic?
Wang Xueyan said that although children’s language expression is not as good as adults, parents must consider allergy factors when symptoms such as squeezing eyes, scratching eyes, rubbing nose, sneezing, running clear snot, coughing, etc. appear and are related to the season.
On a daily basis, you can observe whether your child has similar symptoms every fixed period. If so, the child should be taken to a doctor to diagnose the allergen.
It is worth noting that some children are allergic to birch pollen. In addition to preventive treatment, it is important to pay attention to eating less apples because there is a cross-reaction between the two, which can aggravate the occurrence of allergy symptoms. You can eat them after the pollen period, or you can let your child gradually adapt and resume a normal diet through the small incremental amount method.
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