Ask the Doctor
By Dr. Choi In-chul

The Beat April 2003


When is the hay fever season in Korea? What causes the allergic reaction? What are some useful remedies for people suffering from allergies?


Many people here suffer from allergic rhinitis, which is clinically subdivided into two types, seasonal and perennial, based on the etiology and timing of symptoms. Seasonal allergic rhinitis, commonly known as hay fever, is caused mainly by pollens from various kinds of plants like grass, weeds, ragweeds, and various trees. Therefore its symptoms tend to aggravate during the time of spread of specific responsible pollens, usually from early spring through fall.
On the other hand, perennial rhinitis, which accounts for about seventy to eighty percent of allergic rhinitis in Korea, shows no such seasonal variation, and symptoms persist throughout the year. Perennial rhinitis is caused by debris and droppings of house dust mites (Dermatophagoides), which feed on human and animal dander and infest bedding, couches, carpets and upholstery.
Some patients have both types and show seasonal aggravation of chronic persistent rhinitis. The nasal mucosa (lining membrane) of a rhinitis patient becomes so sensitive that nonspecific irritations other than allergens (like tobacco smoke, aerosol, paints, dusts, or strong perfumes or odors) can intensify rhinitis symptoms. Other causes include animal dander and urine, molds, cockroaches, and foods. Associated nasal polyps may aggravate rhinitis symptoms.
Allergy is immune reaction -- the body’ defense mechanism to differentiate between self and non-self and to attack and eliminate non-self -- against a specific antigen or allergen. When a genetically susceptible person comes into contact with a specific allergen or antigen, immune cells (lymphocytes) in the body recognize the allergen as non-self and produce a protein molecule called immunoglobulin E (Ig E) to eliminate the allergen from the body on invasion next time. Ig E is then attached to the surface auses the emptying of active chemicals contained within mast cells, which in turn precipitate immunological reaction manifesting itself in symptoms such as sneezing, nasal discharge, and stuffy nose.
Medical treatment is mainly symptomatic: antihistamines, oral or nasal decongestants, and nasal sprays (corticosteroid, cromolyn sodium) are usually prescribed to relieve symptoms. Desensitization treatment, in which a patient is given at regular intervals diluted allergen in gradually increasing doses, may be of some value for a few patients, but it takes a long time(three to five years) and a lot of money. At home, patients may feel better when they irrigate the nose with saline using an irrigator or syringe or simply a small dish at times of aggravation. In addition, steam inhalation may be beneficial.
Environmental control is of utmost importance to prevent allergy or alleviate symptoms, though its effect is limited because of the ubiquity of allergens all around us. Patients with perennial rhinitis should try to control house dust by removing carpets, fabric sofas, and curtains from the home, frequently ventilating and cleaning rooms with a vacuum cleaner or air cleaner with special filters. Basking in the sun and hot laundering of bedding, and maintaining an indoor humidity level below 50% and a room temperature of 15 degrees Celsius can suppress the growth of mites. Special casing made of synthetic material or allergen-proof fabric is recommended for mattresses and pillows for mite control.
For seasonal rhinitis, patients are advised to close the windows of the home and cars, and stay indoors at times of spread of pollens. They should wear a mask, a hat, and glasses when they are outdoors. On returning home, they should wash their hands and brush their teeth. They should not hang laundry or bedding outdoors, or mow lawns in high pollen season. And they may as well get rid of indoor plants.
For further information, I refer you to: http://www.aaaai.org/patients/publicedmat/tips/default.stm.
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