Hay fever & allergic rhinitis

Hayfever was first described several hundred years ago and results from seasonal allergic symptoms due to grass pollen allergy. It is one form of allergic rhinitis which means allergic inflammation of the nasal lining. This has been classified in recent treatment guidelines by the World Health Organization.

Nasal symptoms: classically nasal allergy can cause itching, sneezing running or nasal blockage. It is frequently associated with asthma and/or allergic conjunctivitis (itchy, watery, inflamed eyes).

When symptoms occur may give a clue about the allergen responsible:

  • Spring symptoms (April-May in UK): tree pollen allergy
  • Summer symtoms (May-July in UK): grass pollen allergy
  • All year symptoms: house dust mite allergy

    The ARIA guidelines subdivide rhinitis into persistent (everyday) or intermittent and severe (interferes with daily life) or mild/moderate (symptoms are a nuisance but do not prevent daily life). Severe rhinitis has considerable impact on quality of life: for example students with severe hayfever have been shown to drop a grade in summer time exams.

  • Investigation of rhinitis

    History should describe symptoms, severity and frequency, as well as associations with work, medication and the presence of asthma or allergic eye disease. The seasonal link will guide which allergen is responsible.

    Skin Prick tests will then confirm which allergens may be playing a role in symptoms. This is important as allergen avoidance and/or allergen specific therapy may be appropriate.

    ENT examination: if there are any unusual features an expert ENT opinion should be sought.

    Treatment of hayfever and allergic rhinitis