Symptoms and causes of seasonal allergic rhinitis, the connection between hay fever and plant flowering in summer. Hay fever: causes, symptoms, diagnosis and treatment Hay fever, what is the diagnosis?

Seasonal allergies to pollen from various plants are a common ailment in adults and children. The medical name of the disease is hay fever.

What are the causes of the disease? Is it possible to prevent the appearance of negative symptoms? How to treat hay fever in adults and children? The answers are in the article.

Hay fever: what is it?

An immediate allergic reaction develops in people who are sensitive to pollen components of certain plants. Seasonality of the disease is a characteristic sign of hay fever: lacrimation, damage to the conjunctiva, cough and runny nose appear during the flowering period of poplar, ragweed, wormwood, and quinoa.

The name “hay fever” was not given to the allergic reaction by chance: it affects not only the respiratory tract, eyes, and nasal passages, which are in direct contact with the allergen, but also other organs. In severe cases of spring catarrh, Quincke's edema develops, negative reactions appear on the skin, and sometimes internal organs swell.

The ICD code for hay fever is J30–J39 (disease block “Other diseases of the upper respiratory tract”).

ICD-10 is used in international practice for clear systematization and analysis of diseases.

Reasons for the development of an allergic reaction

The disease develops when the body is oversensitized to the action of a tiny irritant - pollen from wind-pollinated plants. The size of the allergen is no more than 0.04 mm; inhalation or contact of the smallest particles on the conjunctiva, nasal passages, and oral mucosa is sufficient to penetrate the body.

Hay fever in children

High sensitivity to pollen often provokes the following upper respiratory tract lesions in young allergy sufferers:

• tracheitis. The main symptom is a painful, “barking”, dry cough;
• allergic pharyngitis. Granularity of the pharynx, itching and sore throat, cough without sputum discharge;
• laryngitis. The voice is hoarse, the child is periodically tormented by a cough, and expectoration is difficult.

Weak children show skin signs of seasonal allergies:

• hives;
• Quincke's edema;
• atopic and contact dermatitis.

With a severe reaction to pollen, diseases of the internal organs develop:

• hepatitis;
• colitis;
• cystitis;
• myocarditis.

With hay fever in children, seizures or Meniere's syndrome are rarely recorded. An aggravated reaction to pollen in young patients, just like in adults, manifests itself in the summer.

Treatment is carried out with antihistamines, drugs from the glucocorticosteroid group, taking into account age. You cannot give a small allergy sufferer the same compounds that your neighbor’s child takes: the body’s reaction is individual, and dangerous manifestations are possible, especially before one year of age. When treating infants, it is recommended to mix the drops with mother's milk or formula to reduce the risk of side effects.

It is important to choose the appropriate form of medication. For example, the drug Zodak for allergies has three varieties: drops, tablets and medicinal syrup, but up to two years only drops are allowed to be used.

Allergists offer several preventive measures to prevent hay fever or reduce the risk of developing the disease. Some actions are available to a specific person; to eliminate other factors, the participation of sanitary services and green management workers is required.

Doctors distinguish two types of prevention:

• primary. The task is to prevent negative reactions and remove harmful factors. Beneficial actions: hardening the body, rational nutrition, reasonable physical activity, limiting contact with allergens. Greening populated areas with non-allergenic plants and controlling weeds, especially ragweed, is the task of public utilities;
• secondary. Responsibility lies with the patient and the allergist observing a patient diagnosed with hay fever. Objectives: reduce negative symptoms during seasonal exacerbations or prevent their occurrence, prescribe and take a course of medications in a timely manner that reduce the influence of allergens.

Hay fever is quite difficult to overcome; many patients visit an allergist for many years, monitor the course of the disease, and adapt to life complicated by seasonal allergies. When selecting optimal medications and following all recommendations for the patient, negative signs appear with less force. The use of specific immunotherapy in the absence of contraindications increases the chances of cure. Patience, a positive attitude towards the result, and trust in the doctor improve the outcome of therapy.

Next video. Elena Malysheva and the TV show “Live Healthy” about the manifestations and treatment of hay fever:

Itching and burning in the nose and eyes, swelling and redness of the mucous membranes, copious mucus secretion and exhausting sneezing - all this is an allergy, or, to speak correctly about this particular form, allergic rhinoconjunctivitis. This disease is a form of eye and nasal allergies. With it, as a result of allergens, the mucous membranes of the nose and conjunctiva become inflamed. It can be either permanent or seasonal. In the latter case, it is called allergic hay fever or hay fever.

Features of the disease

If allergic rhinoconjunctivitis occurs regularly throughout the year, then its source is nearby. Most often, the condition is caused by an allergy to mites that live in house dust; the dust itself, including book dust; mold and fungi; household chemicals; epidermis and skin secretions of pets; food products; medications. In this case, rhinoconjunctivitis can make itself felt sporadically, but with constant contact with the allergen it can become a constant companion in life.

If we are talking about seasonal hay fever, then it usually manifests itself in the spring and summer, since the main allergen is plant pollen. The condition worsens when going outside, going into nature, outside the city, where there are especially many flowering plants.

When the disease lasts a long time and there is no treatment, it can be fraught with deterioration of smell and hearing, headaches, and nosebleeds. In the worst case, Quincke's edema will occur or bronchial asthma will develop. It is especially important to recognize the disease in time and begin treatment in children, since the growing body is the most vulnerable.

Causes and symptoms of allergic hay fever

Rhinoconjunctivitis is caused by exposure to an allergen on the mucous membranes of the eyes and nose. Seasonal hay fever occurs in spring, summer or early autumn. The period is determined by which flowering plant you are allergic to. In spring, this is pollen from trees that bloom first: alder, birch, hazel and others. At the beginning of summer, the main allergen is cereal pollen. Various weeds bloom throughout the summer. And at the end and beginning of autumn, the time comes for the flowering of wormwood varieties, the pollen of which is a very strong allergen.

The body of an allergic person perceives pollen as hostile penetration and produces a lot of histamine, a hormone that protects against harmful substances. It is because of histamine that unpleasant symptoms appear. Most often, allergies are inherited, that is, there must be a genetic predisposition to it. The disease first makes itself felt between the ages of 10 and 20 years. However, sometimes it manifests itself in very young children, and in other cases it is “silent” for many years.

Additional risk factors are:

• weak immunity;
• unfavorable environmental conditions;
• bad habits, especially smoking;
• Unhealthy Lifestyle;
• nutrition poor in nutrients.

In addition, people who are under stress and regularly experience great mental and psychological stress are more susceptible to hay fever. The crazy pace of life, coupled with stress and air pollution, makes city dwellers more likely to suffer from allergies than residents of rural areas. Despite the fact that there are fewer flowering plants in the city.

Hay fever is accompanied by the following symptoms:

• itching in the nasal passages;
• sneezing;
• runny nose;
• swelling of the nasal mucosa;
• itching and redness of the conjunctiva.

A skin rash may occur. Hay fever is also accompanied by headaches, weakness, apathy, suffocation, and itching in the throat. A person becomes irritable, gets tired quickly, and his performance decreases.

Diagnostics

At the first symptoms of allergic rhinoconjunctivitis, you should consult a doctor. Firstly, make sure that it is allergic. After all, similar symptoms accompany many viral infections, for example, the same flu. Secondly, to identify the allergen and begin treatment.

During an exacerbation of hay fever, the nasal mucosa and conjunctiva of the eyes are examined. If necessary, a study of mucous secretions and an x-ray of the sinuses is carried out to determine their condition. A blood test is also prescribed.

During remission, it is important to identify the allergen that causes hay fever. To do this, an allergist performs skin tests with pollen and other substances. Possible allergens are applied to a special patch and placed on the patient’s forearm. After a few hours, a reaction occurs, on the basis of which the doctor makes a conclusion.

Treatment

Treatment of hay fever involves two forms: alleviating the condition during exacerbation and preventing relapses during remission. In the first case, medication is required. Here are the antihistamines prescribed for hay fever:

1. Antihistamine tablets. There are first and second generations. The former cause drowsiness, apathy, and require taking several times a day. The latter, as a rule, have a prolonged action (one tablet per day is enough) and do not have side symptoms. However, in any case, they should not be abused.
2. Local medications. This group includes drops - eye and nasal, as well as gels. These drugs may be antihistamines. More often they are made on the basis of cromoglycic acid, a powerful antiallergic agent. Additionally, vasoconstrictors and other drugs may be prescribed.
3. Local glucocorticoids. These are hormonal drugs - nasal sprays. They relieve inflammation well, while being poorly absorbed into the blood. However, hormonal drugs are addictive, so they are used last.

Allergen-specific immunotherapy (ASIT) allows you to get rid of allergy symptoms for many years. After the doctor uses tests to determine the main allergen, he begins to regularly introduce it in safe doses into the patient’s body. This is done so that the immune system gets used to the presence of this substance and stops reacting to it. Treatment is long, from several months or more. However, after it is carried out, you can forget about the manifestations of allergies for years. Important: such treatment is carried out only outside the period of exacerbation.

Hay fever in children

Timely treatment of hay fever in children is especially important. If you do not pay attention to alarming symptoms, they can develop into asthma in a child. Therefore, it is necessary to relieve the allergic condition in a timely manner.

The main symptoms in children are the same as in adults. This is allergic rhinoconjunctivitis: sneezing, itching in the nose and eyes, swelling. In addition, some babies have more severe allergies. With digestive disorders: nausea, vomiting, abdominal pain and changes in stool. Rhinoconjunctivitis can develop from allergic to bacterial. In this case, the discharge from the nose and eyes becomes purulent.

It is important to consult a doctor at the first symptoms. If you confuse hay fever with an acute respiratory infection and self-medicate, there will be no effect. And the wrong medications will also worsen the child’s condition.

It is possible to detect a baby’s predisposition to allergic hay fever before the first symptoms make themselves felt. Children with allergies are especially at risk. Boys are also more likely to get sick than girls. If a child also often develops inflammatory diseases of the nasopharynx and respiratory tract that do not go away for a long time, it is better to play it safe in advance and consult with an allergist.

When the diagnosis of “allergic hay fever” is confirmed in a child, the main allergen is identified. Unlike adults, this is done not by test samples, but by blood tests. Having discovered the cause, it is important to limit the patient’s contact with the source.

Treatment of hay fever in children with antihistamines differs from treatment in adults only in dosages. Upon reaching eight to nine years of age, a child can undergo ASIT in a slightly different form than an adult. Alternative treatment methods: acupuncture, homeopathy give good results in the treatment of hay fever in children. However, such methods should be started only after consulting a doctor.

How to relieve the condition without drugs

During an exacerbation of hay fever, it is important to limit contact with the allergen. Ideally, go to a place where there is no plant that causes such a reaction, and return when it stops blooming. If this is not possible, then try to go out less often and not travel outside the city or into nature. Especially in dry, windless weather, when the concentration of pollen in the air is high. You can walk during and after rain with almost no danger.

When going outside, you should try to ensure that clothes cover most of the body, especially for children. Sunglasses will be a good idea to reduce the contact of pollen with the mucous membrane of the eyes. Arriving home, you should change into clean clothes, thoroughly wash your face and hands, it is advisable to rinse your nose and gargle with clean water or saline solution. Pollen accumulates in the hair, so during periods of exacerbation it is better to wash it every day and also shower more often.

It is also recommended to frequently wet clean the house, especially if rhinoconjunctivitis is caused not only by pollen, but also, for example, by ordinary dust. But, on the contrary, it is worth ventilating the room as little as possible during the flowering of allergenic plants. It is ideal to do this during and after rain, when all the pollen is “nailed” in drops to the ground. Clothes need to be washed frequently, especially those that are intended to be worn outdoors. You can't dry it outdoors; it's better to do it indoors.

After the period of exacerbation of seasonal hay fever ends, you can return to your previous lifestyle. However, if rhinoconjunctivitis is all-season and is caused not by pollen, but by other allergens, frequent cleaning, washing, and rinsing the nasopharynx should become constant companions of life.

Prevention of hay fever

Prevention of hay fever can be primary and secondary. The purpose of the first is to prevent the onset of the disease if there is a predisposition to it, but symptoms have not yet arisen. The second is needed for those who are already sick with hay fever. The idea is to prevent it from getting worse when hay fever begins. Namely: minimize contact with the allergen, start taking medications on time.

To prevent the disease from occurring, the best prevention is a healthy lifestyle. If you are at risk of allergic hay fever, it is important to stop smoking. Tobacco smoke has a depressing effect on the mucous membranes of the respiratory tract. The ciliated epithelium changes and is no longer able to retain particles of dust and pollen, preventing them from entering the body.

Alcohol destroys the immune system and reduces the body's ability to resist harmful influences. Strong immunity is important. It will be strengthened not only by the absence of bad habits, but also by physical activity, hardening procedures and proper nutrition.

Seasonal hay fever often causes cross food allergies. A negative reaction is given by products whose proteins are similar in structure to pollen proteins. So, if allergies are caused by tree pollen, then nuts, carrots, apples and other fruits become forbidden foods. If cereal pollen is to blame, it is bread, cereals, muesli, legumes. In the case of weeds, honey, halva, mustard and mayonnaise, and citrus fruits become allergens.

The diet for hay fever, especially during the period of exacerbation (or the possibility of its occurrence), should be built without these products. In general, nutrition should be nutrient-dense and balanced. Vitamin C, which is abundant in bell peppers, strawberries, sorrel, and citrus fruits, will help strengthen the immune system.

Allergic hay fever and accompanying rhinoconjunctivitis are an unpleasant condition, but not fatal. If you lead a healthy lifestyle and take timely measures to avoid illness, then you can live peacefully with it, without denying yourself anything.

Published November 13, 2017Updated October 01, 2019

Definition of disease. Causes of the disease

Hay fever (hay fever) is a seasonal disease that is caused by increased sensitivity to pollen from various plants.

The main manifestations of hay fever are inflammation of the mucous membranes, mainly of the respiratory tract and eyes, associated with the flowering period of certain plants. Theoretically, an allergic reaction can exist to the pollen of any plant, but, as a rule, it is provoked by the pollen of wind-pollinated plants. There are several thousand common plant species on Earth, and only about 50 of them produce allergenic pollen. Plants with bright colors and a pleasant smell rarely cause allergies.

Today, the percentage of the world's population suffering from hay fever varies from 0.2% to 39%. The incidence of hay fever throughout the world doubles every 10 years; people aged 10 to 40 years are more often affected. Seasonal allergic rhinitis is very common during adolescence. According to international studies, it affects 40% of young people in the United States. As a rule, it begins at the age of 8-11 years. Boys get sick more often in childhood than girls, but by adulthood the incidence rates level out between the sexes.

The prevalence of hay fever is influenced by a number of factors:

• natural and climatic conditions (the prevalence of hay fever is much higher in the southern regions);
• the prevalence of certain plant species and the degree of their allergenic activity;
• environmental conditions (urban residents get sick 6 times more often).

Pollen is the male reproductive cells of plants, which are represented by many pollen grains that have features that can be distinguished by an experienced eye by examining the pollen under a microscope (various configurations, sizes, spines, ridges, ridges, pores), specific to specific plant species. The diameter of pollen grains of allergenic plants averages from 20 to 60 microns.

Taking into account the concentration of pollen in the air is called pollen monitoring; it is carried out in many large cities of Russia, and the data is posted on the website in the public domain.

Among the most common plants, birch pollen has the most pronounced allergenic activity. And it is not at all necessary to be in a forest or park for symptoms to occur. The fine pollen of this tree is scattered over tens of kilometers.

Pollen from allergenic representatives of cereal grasses has a diameter of 20-25 microns.

The most allergenic cereals in Russia:

• Timothy grass;
• cocksfoot;
• meadow fescue;
• meadow bluegrass (this inconspicuous grass with “spikelets” grows on almost any natural lawn).

Weeds are also wind-pollinated, and their pollen is carried over long distances. These include Asteraceae:

• ambrosia;
• chamomile (wormwood);
• goosefoot (white pigweed, tumbleweed);
• quinoa.

Pollen from wormwood and ragweed has the most pronounced allergenic activity.

The wormwood pollen allergen can cause cross-reactions (reactions to other allergens with a similar structure) with allergens of ragweed, sunflower, dandelion, coltsfoot, and birch pollen.

In central Russia, plant dusting occurs during three main periods:

A competent interview with an allergist-immunologist can significantly narrow the list of planned laboratory tests. In European countries, diagnosis is somewhat more difficult, because dusting of different plants occurs almost simultaneously.

The common opinion of patients about the existence of an allergy to poplar fluff is not entirely correct, since the period of formation of this fluff coincides with the period of maximum concentrations of grass pollen, and the fluff is only a carrier of these pollen grains, as if wrapping them around itself, and transports them, being itself only a mechanical stimulus.

If you notice similar symptoms, consult your doctor. Do not self-medicate - it is dangerous for your health!

Symptoms of hay fever

Pollen allergy manifests itself with all signs of inflammation - redness, swelling, itching, copious mucous discharge, as well as:

• itching and redness of the eyes (conjunctiva and sclera);
• lacrimation (the discharge from the conjunctiva of the eyes is initially transparent, and then, due to infection, it can become purulent and thick);
• photophobia;
• a feeling of “sand” in the eyes (both eyes are more often affected, but to varying degrees);
• nasal congestion;
• severe itching in the nose and nasal throat;
• sneezing with the separation of liquid nasal secretions (up to painful attacks; sneezing attacks can alternate with attacks of almost complete nasal congestion; the intensity of rhinitis symptoms at night is usually greater than during the day);
• pain in the ears if the auditory tubes are involved in the process;
• hoarse voice;
• increased sensitivity to irritants: cold, strong odors, road and house dust;
• cough;
• wheezing in the chest;
• attacks of suffocation (one of the most severe manifestations of hay fever is bronchial asthma).

More rare symptoms of hay fever:

• skin rash, itching;
• a sore throat;
• abdominal pain, heartburn;
• loose stools;
• heartache.

All of the listed complaints, as a rule, are combined with general complaints (headache, weakness, fatigue, general malaise, dizziness, drowsiness, memory loss, fever, which in some cases is interpreted as manifestations of an acute respiratory disease).

Hay fever is characterized by an improvement in the patient's condition on rainy, cloudy, windless days, which does not happen with acute respiratory viral infections and acute respiratory infections.

Pathogenesis of hay fever

The pathogenesis of hay fever is based on an immediate allergic reaction. After the allergen enters the mucous membrane of any organ (most of it settles on the nasal mucosa), antibodies (immunoglobulins E) are produced, which, combining with allergens (plant pollen) upon repeated contact, cause IgE-dependent activation of tissue basophils ( mast cells). As a result, a number of biologically active substances are released: histamine, leukotrienes, prostaglandins, bradykinins, platelet activating factor.

An allergic inflammatory reaction occurs: mucus production increases, the function of the ciliated epithelium of the respiratory tract decreases. Histamine dilates blood vessels, resulting in lower blood pressure. Due to the fact that the arterioles of the brain dilate, the pressure of the cerebrospinal fluid increases and a headache appears. When the concentration of histamine in the blood increases, a rash may appear on the skin, body temperature may rise, and breathing may be difficult due to swelling of the mucous membrane of the respiratory tract and spasm of smooth muscles. There is frequent heartbeat (tachycardia), increased salivation, etc. This action of histamine explains a significant part of the general symptoms of hay fever.

Classification and stages of development of hay fever

There is no generally accepted classification of hay fever today. Based on the severity of symptoms and their impact on the quality of life of patients, there are 3 types of hay fever:

Complications of hay fever

Untimely diagnosis and treatment of the rhinoconjunctival form of hay fever (when only the structures of the nose and eyes are involved) can lead to or worsen the course of an existing one. Complications include hearing impairment, proliferation of the nasal mucosa (formation of polyps), which may subsequently require surgical intervention.

Long-term swelling of the mucous membrane of the nasal passages and constant breathing through the mouth in a small child can lead to a characteristic facial expression with a raised upper lip and the formation of a malocclusion in the future. Impaired nasal breathing significantly reduces the attention of children and can lead to a decrease in school performance.

Diagnosis of hay fever

Today, many research methods are known for diagnosing hay fever. They are all complementary; it is difficult to focus on one parameter or one deviation from the norm during examination.

The most basic and most important is history taking: detailed questioning of the patient about the symptoms, their severity, duration, previously taken medications for this issue and assessment of their effectiveness, in the patient’s opinion. Frequency of complaints, difference in well-being when changing place of stay, region (for example, a sharp improvement in well-being on a business trip, on vacation). It is clarified whether there are any blood relatives with allergic diseases - this increases the risk of such diseases. Competent questioning allows you to further minimize the financial costs of searching for the causative allergen and do without intermediate tests.

During an external examination, the so-called “classic” symptoms attract attention - “allergic fireworks”, “allergic glasses”, swelling under the eyes, a constantly open mouth, “sniffing” of the nose, redness around the wings of the nose.

Basic laboratory indicators include a general blood test, where an indirect sign of allergic changes in the human body will be an increase in the level of eosinophils, total immunoglobulin E (igE), or a more modern indicator - eosinophil cationic protein.

Great assistants to the allergist-immunologist are otorhinolaryngologists (ENT doctors) which, upon examination, can clearly describe the amount, nature of nasal secretion, and color of the mucous membrane. The presence of a deviated nasal septum may explain why one half of the patient’s nose breathes worse; nasal polyps are seen by an ENT specialist in most cases without special equipment. The middle ear may show fluid or other signs of Eustachian tube dysfunction. At the discretion of the ENT specialist, an endoscopic examination of the ENT organs (examination using a flexible endoscope) or computed tomography of the paranasal sinuses (a very informative X-ray examination, where the structures of the nose can be viewed “layer by layer”, in sections) is performed.

If there is an eye clinic, a consultation may be required ophthalmologist.

Study of smears and swabs from the nasal cavity allows you to distinguish between allergic and infectious rhinitis. In case of allergy, eosinophilic infiltration is characteristic, while in case of bacterial infection, neutrophils are detected. The most informative are smears taken under the control of an endoscope, and not taken “blindly” from the nostril.

To accurately determine the active allergen, skin testing with a set of pollen allergens, common in the patient’s area of ​​residence. Allergy skin tests are performed during periods when there is no contact with pollen. This is a simple and quick test, but it has limitations and contraindications:

• period of exacerbation of the underlying disease;
• hives or asthma attacks;
• taking antihistamines;
• use of systemic hormones in the treatment (for example, Prednisolone);
• ARVI, influenza, severe diseases of the cardiovascular system, liver, kidneys and other organs;
• pregnancy;
• tuberculosis process at any stage.

A water-salt extract of allergens is applied to the injured skin of the forearm in a certain way (for example, with a scarifier), and after 20 minutes the skin’s reaction to this “provocation” is assessed and conclusions are drawn. Temporary exposure of the allergen to the skin “requires” immobility from the patient (you need to sit quietly), which limits this diagnosis in young children.

Determination of specific immunoglobulins E (igE)

You can diagnose without damaging the skin using a blood test. To do this, the patient only needs to donate blood from a vein. Next, an analysis is carried out in the laboratory (radioisotope, chemiluminescent or enzyme immunoassay)

Molecular allergology -uh This is the most modern method of diagnosing allergic diseases, it allows you to increase the accuracy of diagnosis and prognosis for allergies and plays an important role in 3 key points:

1. differentiation of true sensitization and cross-reactivity in polysensitized patients (if allergic manifestations are present to several allergens at once);
2. assessing the risk of developing acute systemic reactions instead of weak and local ones in food allergies, which reduces the patient’s unreasonable anxiety;
3. identification of causative allergens for allergen-specific immunotherapy (ASIT).

The most common chip technology is the Immuna Solid phase Allergen Chip (ISAC). This is the most comprehensive platform that includes more than 100 allergenic molecules in a single study.

The results of all these tests (skin and laboratory) must be compared with the clinical picture of the disease, since the presence of sensitization to allergens is not necessarily accompanied by clinical manifestations.

Treatment of hay fever

Hay fever is treated in an outpatient setting.

The main types of treatment for hay fever:

1. prevention of contact with an allergen;
2. pharmacotherapy;
3. allergen-specific immunotherapy;
4. patient education.

Preventing contact with allergens

Elimination of allergens reduces the severity of hay fever and the need for drug treatment. Well-known events are:

• moving to another climatic zone during the flowering period of causally significant plants;
• exclusion of cross-reacting foods from the diet;
• carrying out daily wet cleaning;
• the use of special filters, for example, HEPA fine air purification, which retain up to 99.97% of all particles measuring 0.3 microns or more;
• For patients with allergic conjunctivitis, it is not unreasonable to recommend wearing sunglasses for the purpose of mechanical protection as an obstacle when pollen gets on the conjunctiva. In addition, you should stop wearing contact lenses during the flowering period of the “culprit” plant;
• local application of saline solutions to the nasal mucosa leads to dilution and removal of the allergen;
• the use of tear substitutes (drugs such as “artificial tears”) helps moisturize the surface of the eyes and wash out the allergen.

Pharmacotherapy

The volume of drug therapy and the choice of drugs depends on the severity of clinical manifestations and is determined only by a doctor.

The list of drugs for this disease includes:

• Aantihistamines (H1 blockers prevent the release of new histamines and are most effective in preventing immediate allergic reactions). There are I and II generations of these drugs. Injection solutions are available only in the first generation, while in the second generation they are tablets. There are also local drops for the nose and eyes;
• Decongestants (more common name vasoconstrictors ). Provide short-term vasoconstriction and, accordingly, reduce swelling of the mucous membrane. This category of drugs can be used very short-term due to the existing “withdrawal phenomenon” - inflammation and dryness after cessation of therapy. They are ineffective for severe allergic diseases;
• Cromony for the treatment of allergic rhinitis and conjunctivitis. Used topically. Today they are mainly used in pediatrics;
• Topical glucorticosteroids (GKS) can be applied to the nose, eyes and bronchi (in the form of dosed inhalations of aerosol or powder);
• Leukotriene receptor antagonists - a relatively new class of funds. Reduce the severity of allergic inflammation;
• Barrier method used to prevent the “sticking” of allergens to the nasal mucosa;
• Inhalation therapy P It is used in case of involvement of the bronchi in an allergic reaction, with obstruction of the bronchi. Bronchodilators (beta2-agonists) and corticosteroids are used.

Specific immunotherapy (ASIT, SLIT) aims to reduce the specific sensitivity of a particular patient to a specific causative allergen. This is achieved by introducing the allergen, starting with small doses, with a gradual increase. This therapy can be carried out with water-salt allergens, adjuvant allergen vaccines (subcutaneous injections). There are also preparations for sublingual (sublingual) use: drops or tablets that contain a certain dose of the allergen. ASIT of the future is cutaneous methods, moreover, with several allergens at once, but for now both doctors and patients can only dream about this.

Forecast. Prevention

The clinic of allergic conditions should not be underestimated, since over time the symptoms may worsen, and the amount of required drug therapy may increase significantly. It is advisable to prevent the progression of the disease, for example, to prevent the formation of bronchial asthma.

For the purpose of prevention, a number of measures can be recommended for people with hay fever:

• Avoid walking in parks and forests during the flowering period of the “culprit” plant. Upon returning from the street, if possible, take a shower or wash, washing off allergens from your skin and hair. Wear sunglasses to protect your eyes;
• follow an allergenic diet with the exclusion of food products that have a similar allergenic structure to the causative plant (cross-allergy). Definitely give up honey;
• when ventilating the room, you can place a damp cloth (gauze) on the window opening, which will collect pollen grains, but it will need to be rinsed periodically;
• refuse to ventilate on hot days, or do it at night between 3-5 am, when the concentration of pollen in the air is significantly lower;
• install supply ventilation with HEPA filters;
• use air purifiers (available in hardware stores);
• carry out wet cleaning of the living space, minimize “soft” surfaces in the house or apartment (carpets, upholstered furniture, curtains retain allergens, including pollen);
• do not plan surgical interventions or visits to the dentist during the period of active plant dusting;
• refuse treatment with herbal medicines (which contain herbs).

There is the concept of “pre-season prevention”, when the doctor prescribes a number of medications in advance that reduce the severity of clinical manifestations during the flowering period of the allergen plant. In any case, in order to select a list of required measures, the volume of drug therapy and management tactics for each individual patient, it is necessary to seek advice from an allergist-immunologist.

And other related areas.

Causes of hay fever

There are hundreds of thousands of plants that produce pollen. However, after numerous studies, it was found that about 50 of them can cause allergic reactions.

Plant pollen is very small in size, and therefore is easily able to penetrate and penetrate the mucous membranes of the eyes and upper respiratory tract. In addition, in one day one of the small plants is capable of releasing a huge amount of pollen grains.

People are not equally sensitive to pollen from different plants. So, for some, a few tiny pollen particles, for example, from birch, are enough, and they instantly have an allergic reaction. While others are completely insensitive to birch tree pollen.

The disease is based on increased sensitivity to plant pollen. There are special receptors in the mucous membrane of the nose, eyes, pharynx, and larynx. As well as immune cells (macrophages, neutrophils) containing a large amount of biologically active substances (histamine, bradykinin). When pollen comes into contact with mucosal receptors, the latter activate macrophages, and they, in turn, release histamine into the surrounding space. Histamine has the property of increasing the permeability of blood capillaries and dilating them. As a result, a lot of water enters the peripheral tissues from the blood and a large amount of mucus is released. Along with water, other active substances penetrate from the blood, supporting and intensifying allergic reactions. All this creates conditions for swelling of the mucous membranes, nasal congestion, sneezing, watery eyes and other manifestations of an allergic reaction.

The causative factors, as mentioned above, are pollen from various plants, be it trees, shrubs, flowers, and other weeds. There is a pattern between the periods of the seasons and the time of maturation of pollen of different plants. Thus, three peak values ​​are identified according to the frequency of occurrence of hay fever

1. The first peak period occurs between the months of April and May. During this period, the appearance of hay fever from pollen of woody plants predominates: oak, ash, birch, walnut, poplar, maple.

Graph showing increased sensitivity to pollen of various trees, depending on the seasons.

1. The second period of rise in allergic phenomena occurs in the summer. From June to August, cereal plants begin to bloom. These include grasses such as wheatgrass, rye, bluegrass, corn, bromegrass, and many others. In June, the amount of poplar fluff in the air increases, so many people often associate allergic reactions that appear at this time with fluff, and not pollen. Poplar fluff, unlike plant pollen, does not cause a pronounced clinical picture of hay fever.

1. The third period of increasing incidence of hay fever occurs in autumn. During this period, an increased concentration of pollen from various weeds prevails in the air. It is believed that pollen from plants such as ragweed, dandelion, hemp, quinoa and others has the greatest allergenic activity.

Symptoms of hay fever

Associated primarily with damage to the upper respiratory tract, as well as the mucous membrane of the eyes. Clinical symptoms begin to appear in childhood, from about 5-6 years of age, when the child just begins to attend school.

The most typical clinical symptom is rhinoconjunctival syndrome. This syndrome combines signs of allergic reactions, both from the mucous membrane of the eyes and from the mucous membrane of the nose and upper respiratory tract.

The disease begins with damage to the mucous membrane of the eyes. Signs of conjunctivitis appear:

• Itching, burning on the inside of the eyes
• The patient feels as if he has some kind of foreign body in the eye
• After some time, lacrimation and photophobia appear

When examining the eyes, you can easily see pronounced redness of the conjunctiva and swelling of the eyelids. Unlike other inflammatory eye diseases, hay fever usually affects both eyes at the same time.
In parallel with conjunctivitis, the patient develops signs of rhinitis (inflammation of the nasal mucosa). Rhinitis is characterized by:

• Palpable itching in the area of ​​the nose and the junction of the nasal cavity and the pharyngeal cavity (nasopharynx).
• Characteristic is the presence of frequent bouts of sneezing. In some cases, the number of sneezes reaches up to 10-20 times in a row.
• Sneezing is accompanied by copious mucus discharge from the nose (rhinorrhea).
• Pain in the sinuses (maxillary - on the sides, frontal - on top of the nose).

In addition to disruption of the respiratory functions of the nose, patients experience pain in the parotid region and a crackling sound in the ears when chewing food. Ear symptoms are often accompanied by nausea and sometimes vomiting. These symptoms are due to the fact that the nasal cavity is closely connected with the oral and middle ear and therefore the pathological process of one of them will affect other neighboring areas.

As pollen disappears from the surrounding air (during rain, winter), all of the above symptoms weaken or disappear altogether.

Manifestations of the disease depend on the degree of sensitivity of each person individually. For example, in one person, pollen causes ordinary conjunctivitis (inflammation of the mucous membrane of the eyes) with the appearance of symptoms such as lacrimation, photophobia and other characteristic symptoms. In others, hay fever can manifest itself as generalized swelling of the upper respiratory tract (mucous membrane of the nose, larynx, trachea), with the onset of a suffocating state (loss of consciousness, fainting, a sharp drop in blood pressure).

The severity of symptoms and the course of the disease largely depend on the amount of pollen inhaled. The more pollen that gets into the respiratory tract and the mucous membrane of the eyes, the more pronounced the symptoms of the disease will be.

There is an obvious connection between the incidence of hay fever and other diseases of allergic origin. It is noted that among patients with bronchial asthma, in 40% of cases, a concomitant disease is detected - hay fever. Of those who suffer from hay fever, there are people who are allergic to certain foods, house dust, and medications.

Diagnosis of hay fever

Diagnosis of such a disease does not present great difficulties, since the connection between the appearance of allergic symptoms and contact with pollen particles is obvious. The importance is that it is necessary to accurately establish the connection, ask the patient in detail about the history of the disease, what preceded the appearance of the first symptoms, and how they manifested themselves.

Allergological examination of patients is mandatory in the program, upon detection of which one allergen caused this reaction. An allergy examination consists of applying a known allergen in a very small dose to the patient’s skin or under the skin (scratch, injection) and after some time the local manifestations are assessed. If a person has an increased reaction in the form of local redness of the skin, swelling, or itching, it means that he either has hay fever or simply has an increased sensitivity to this substance. It all depends on the size of local allergic changes, as well as in conjunction with symptoms and other laboratory tests.

Laboratory diagnostics

For laboratory diagnostics, blood must be taken from the patient for examination. The presence of an increased number of eosinophils (one of the blood elements) suggests that this organism is predisposed to allergies. The normal range of eosinophils in the blood ranges from 1 to 5 percent of the total number of blood cells.

Immunological diagnostics is nothing more than taking blood tests for the content of specific proteins (class E immunoglobulins), which appear in large quantities during the development of allergic reactions in the body.
So, in order to make a correct diagnosis, the doctor must first study in detail the history of the disease, become familiar with the symptoms of the disease, and laboratory tests.

Treatment of hay fever

If a person has acquired increased sensitivity to pollen allergens, then it is practically impossible to reduce it. Based on this fact, the only reliable way to prevent and treat hay fever is to have as little contact as possible with plant pollen. Treatment of hay fever is the only thing that helps the patient get rid of the endless runny nose, lacrimation and other symptoms. Only treatment, together with preventive measures, will help get rid of annoying symptoms.

Children under 18 years of age are usually under the supervision of two specialists - a general practitioner and a pediatrician.

In case of crises and significant disturbances in the general condition of patients, intensive therapy is prescribed, aimed at relieving swelling of the mucous membranes of the eyes and nasal cavity, reducing mucus secretion, and improving respiratory function.

• Antihistamines are drugs that directly destroy the pathological chain that leads to the appearance of symptoms of the disease. In acute conditions they are administered intravenously and intramuscularly. When general well-being improves, they switch to the enteral route of administration (through the mouth). Antihistamine drugs include suprastin, diazolin, tavegil, loratadine, and many others. The dose and regimen are prescribed by the attending physician.

• Vasoconstrictors, such as naphthyzine, oxymetazoline, galazolin, are also widely used as drugs against hay fever. Topical vasoconstrictors belong to a group of substances that affect adrenergic receptors, which are widely located in the nasal mucosa. Stimulation of adrenergic receptors leads to a narrowing of peripheral blood vessels, relieves swelling, reduces symptoms of allergies, nasal congestion and facilitates breathing. They are usually used as nasal drops several times a day.

For symptoms of conjunctivitis, a solution of albucid is instilled into the eyes to avoid secondary infection and the development of a purulent process.

During the period of remission, that is, when the main symptoms of the disease subside, a type of treatment such as specific hyposensitization is prescribed. This term refers to the gradual adaptation of the body to small doses of allergens. The patient is prescribed daily administration of small doses of purified pollen allergens, which do not cause a violent pathological reaction in the body. But, at the same time, resistance to certain types of allergenic substances develops, and the patient feels completely healthy. Hyposensitization is carried out in courses from several weeks to several months until a lasting positive effect is achieved.

Prevention of hay fever

Preventive measures are perhaps the only simple and at the same time, reliable way to avoid the occurrence of allergic reactions, as well as their complications. Specific tasks for preventing the occurrence of not only hay fever, but also other allergic diseases are to avoid contact with allergens, to prevent pollen and other small dust particles from entering the nasal and oral cavities.

Preventive measures, in turn, are divided into primary ones, which must be carried out for people susceptible to various allergic diseases, as well as categories of people at risk. These are gardeners, beekeepers, agricultural workers, and people of other professions whose activities are related to plants and flowers.

Primary preventive measures include:

• First of all, protect the primary contact of a pregnant woman with pollen allergens, eliminate occupational hazards, and also observe a work and rest schedule and eat healthy food.
• For younger and older children, periodic preventive monitoring is necessary to identify acute respiratory diseases, the chronic course of which often leads to increased sensitivity of the body to allergens.
• Reducing contact with allergenic substances (chemical products, exhaust gases, household allergens).

Secondary preventive measures, by their nature, also contain actions aimed at preventing the occurrence of allergic reactions. But unlike primary prevention, in this case we are talking about patients with hay fever who have been ill for more than one year and practically themselves must know and implement more stringent measures to prevent contact with allergens of plant origin.

Recommendations for people suffering from hay fever and other allergic diseases should be constantly followed, regardless of where the person is, at work, at home, or on vacation. The following conditions must be met:

At home and in the workplace in the office

• Ventilate the premises and wet clean at least once a day.
• Books, bedding, especially feather pillows and duvets are stored and maintained in appropriate conditions where the risk of spreading dust particles is minimal. For example, bed linen is in durable covers, and books are in a lockable cabinet.
• Minimum carpets and furniture clutter. The premises should be spacious, easily ventilated and cleaned.
• The use of synthetic air fresheners, perfumes, and other odorous substances is limited.
• Do not have pets in your house or apartment, as wool has a strong allergenic property.
• In the off-season, the risk of mold fungi appearing on the walls and ceiling increases (they have allergenic properties). From this we can conclude that the fight against mold plays an important role in preventing the occurrence of allergic reactions.

Outdoors and outdoors, it is impossible to protect a person from the harmful effects of the environment, therefore it is necessary to try not to be in crowded places, in the company of people who smoke, if possible, not to be exposed to prolonged exposure to exhaust gases, close the windows in the car when driving on the road.

• People who are hypersensitive to plant pollen should limit their stay in places with large concentrations of various types of plants (gardens, fields).
• Wearing sunglasses reduces the risk of allergies for those categories of people who have increased sensitivity to the sun (photosensitivity).
• Timely treatment of acute diseases of an infectious-allergic nature will prevent the possibility of developing hypersensitivity to various allergens and in particular to plant pollen.

• Pre-season preventive preparation of the body by taking medications that reduce susceptibility to pollen allergens. There are several of the most active drugs from this group. These include intal (cromoglycic acid) and zaditen (ketotifen). The mechanism of action of both is focused on the fact that they stabilize the membranes of cells responsible for the release of biologically active substances. In other words, the body’s resistance to the perception of allergens of any origin increases.

What diet should you follow for hay fever?

Before prescribing the optimal diet for hay fever, it is necessary to establish the type allergies for pollen.

There are the following types of hay fever:

• allergy to tree pollen;
• allergy to grass pollen;
• allergy to weed pollen.

Allergy to tree pollen
This type of hay fever most often occurs in the spring, in late April - early May. Among the tree representatives whose pollen most often causes allergic reactions are birch, oak, maple, poplar and alder.

If you are allergic to tree pollen, the patient is advised to exclude from the diet such foods as:

• Birch juice;
• apricots, peaches;
• plums;
• hazelnut;
• cherries, sweet cherries;
• nuts ( e.g. almonds, hazelnuts);
• carrot;
• apples, pears;
• cucumbers, tomatoes;
• herbs and spices ( e.g. curry, cumin).

Allergy to grass pollen
This type of hay fever is usually observed in late spring - early summer ( from late May to early July). At the same time, pollen from such cereal grasses as wheat, barley, rye, wheatgrass, oats, timothy grass, and feather grass can cause hay fever.

If you are allergic to grass pollen, the patient should refrain from taking:

• cereal products ( e.g. rice balls, oatmeal);
• bakery products;
• pasta;
• kvass;
• alcoholic drinks;
• beans;
• peanuts;
• corn;
• sorrel;
• citrus fruits ( for example, orange, tangerine);
• strawberries, wild strawberries;
• herbal medicines, which include cereal herbs.

Allergy to weed pollen
Typically, this type of hay fever occurs between the end of July and the beginning of September. Representatives of weeds that most often cause allergic reactions are ragweed, quinoa, and wormwood.

If you are allergic to weed pollen, the patient is advised to exclude from the diet such foods as:

• sunflower seeds;
• sunflower oil;
• citrus fruits ( for example, oranges, tangerines, lemons);
• melons ( for example, watermelons, melons);
• greenery ( for example, parsley, dill, celery);
• spices ( e.g. anise, cumin, chicory);
• herbal remedies from dandelion, wormwood, chamomile, calendula, yarrow.

It is also necessary to exclude foods of plant origin from the diet ( for example, honey, halva, sunflower oil). Any of the above products can aggravate the course of this disease.

Most people suffering from hay fever also have a so-called “cross allergy”, the manifestations of which are provoked by certain foods. Based on this, it would be advisable to follow a hypoallergenic diet, in which the patient should refrain from eating foods that most often cause allergies.

Among the foods that most often cause allergic reactions are the following:

• dairy ( for example, whole cow's milk, cheese, chicken eggs);
• nuts;
• mushrooms;
• red berries ( e.g. strawberries, raspberries);
• citrus fruits ( );
• red vegetables ( e.g. tomatoes, beets, carrots);
• chocolate;
• cocoa;
• Exotic fruits ( e.g. pineapple, mango);
• seafood;
• smoked meats;
• canned and pickled foods.

For hay fever, it is recommended to eat foods with low levels of allergens, such as:

• dairy products ( for example, natural yogurt, kefir, cottage cheese);
• stewed or boiled lean meat;
• dried fruits.

Why is hay fever dangerous during pregnancy?

During pregnancy, a physiological decrease in immunity occurs in the female body. This is necessary so that the pregnant woman’s immune system does not reject the foreign organism, that is, the fetus. Any pathological process ( in this case hay fever) in this condition can lead to serious complications. Thus, an ordinary allergy to pollen, which usually manifests itself as a simple seasonal runny nose, during pregnancy can be bacterial in nature. Often, against the background of hay fever, pregnant women experience inflammatory diseases such as otitis media ( ear infection) or sinusitis ( inflammation of the maxillary paranasal sinus).

Also during pregnancy, due to an allergic reaction to pollen, a woman may experience complications such as:

• tracheitis ( inflammation of the trachea);
• swelling of the vocal cords;
• frequent migraines;
• Meniere's syndrome, in which the amount of endolymph increases in the cavity of the inner ear ( special liquid);
• allergic inflammation of the pia mater.

Much less often, hay fever can provoke serious allergic diseases in a pregnant woman. This is due to the fact that when fighting allergens, the body’s immune system sometimes destroys its own cells.

In this regard, a pregnant woman may experience complications such as:

• allergic cystitis ( cystitis);
• allergic colpitis ( inflammation of the vaginal mucosa);
• allergic myocarditis ( inflammation of the muscular lining of the heart);
• allergic vulvitis ( inflammation of the external female genitalia);
• allergic gastritis ( inflammation of the gastric mucosa);
• allergic hepatitis ( liver inflammation).

It should be noted that the manifestation of hay fever during pregnancy can negatively affect the unborn child. Often, after birth, such children experience various allergic pathologies.

To avoid any complications during pregnancy if you have hay fever, you must follow the following recommendations:

• Avoid contact with plants as much as possible.
• Always wear sunglasses on clear days.
• Wear a medical mask in dry, windy weather.
• Shake off street clothes before entering the house.
• When you come home, you should change clothes.
• Wet clean your home daily.
• To increase humidity, you can hang a cloth soaked in water around the rooms.
• Strictly adhere to a hypoallergenic diet. Eliminate foods such as carrots, nuts, and stone fruits from your diet ( e.g. peaches, apricots, apples, cherries), cereal products ( for example, corn, bread, various cereals), melons ( for example, zucchini, melon, eggplant), sunflower seeds and sunflower oil, citrus fruits ( for example, tangerines, oranges), honey, herbal seasonings.
• Avoid herbal medicine.
• Avoid contact with household allergens, such as dust, animal hair, down pillows, cigarette smoke, strong odors of deodorants and perfumes.
• From time to time, rinse the nasal passages with sea water or saline.
• Avoid stressful situations.
• Treat respiratory diseases in a timely manner.
• Treat hay fever strictly under the supervision of a doctor.

If hay fever is present, in order to prescribe appropriate treatment, a woman must first undergo a blood test ( immunoglobulin E is detected) to confirm the diagnosis. It should be noted that performing allergy skin tests during pregnancy is strictly not recommended.

A pregnant woman is usually prescribed third-generation antihistamines, as they are more effective and have less negative effects on the body.

For hay fever during pregnancy, a woman may be prescribed antihistamines in the form of tablets ( for example, Telfast, Claritin), sprays ( for example Cromohexal) or powders ( for example, Nazaval).

How to treat hay fever in children?

Treatment of hay fever in children includes three stages:

• treatment of the acute period;
• anti-relapse therapy;

Treatment of the acute period
First of all, it is necessary to protect the child from contact with the allergen. It is recommended to spend more time indoors where pollen concentrations are significantly reduced. At home, you should close the windows, hang a cloth soaked in water around the rooms, or turn on the air conditioner. To relieve symptoms ( for example, allergic rhinitis, angioedema (Quincke's edema) or urticaria) use antihistamines and vasoconstrictors.

Pharmacological group	Name of the drug	Mechanism of therapeutic action	Directions for use and doses
Antihistamines	Claritin	By suppressing the activity of histamine, they prevent the development of allergies. Relieves spasm of smooth muscles and prevents the development of edema. They also have antipruritic and antiexudative effects.	Children over twelve years of age should take the drug orally, one tablet ( 10 mg) or two teaspoons of syrup once a day. For children aged two to twelve years, the dose of the drug is one teaspoon of syrup ( 5 ml) once a day.
	Zodak		Children over twelve years of age should take the drug orally, two scoops ( the total is 10 ml) syrup once a day. For children from six to twelve years of age, the drug is prescribed one measuring spoon ( 5 ml) syrup twice a day. For children from one year to six years, the dose of the drug is half a measuring spoon ( 2.5 ml) syrup twice a day, morning and evening.
Vasoconstrictors	Nazol	They have a vasoconstrictor effect. Reduce redness of the nasal mucosa. Relieves swelling and facilitates nasal breathing.	For children over twelve years of age, the drug should be sprayed into each nasal passage two to three times, twice a day. For children aged six to twelve years, the dose of the drug is one spray into each nasal passage, twice a day. The interval between applications should be at least twelve hours.
	Naphthyzin		For children over fifteen years of age, the drug is prescribed one to three drops of 0.05 - 0.1% solution in each nasal passage, three to four times a day. For children aged six to fifteen years, the dose of the drug is two drops of a 0.05% solution in each nasal passage, two to three times a day. The course of treatment with vasoconstrictors should not exceed three days.

In case of severe hay fever, hormonal preparations (glucocorticosteroids) are also used topically in the form of drops and nasal spray, which are dispensed strictly as prescribed by the doctor.

In order to alleviate the course of acute hay fever, it is necessary to monitor the child’s nutrition. Since many plant-food products, like plant pollen, have the same antigenic structure, most children suffering from hay fever are allergic to various foods. To avoid the development of allergic reactions to food products, the child is prescribed a certain hypoallergenic diet.

Foods that need to be excluded from the diet	Foods that are recommended to be included in the menu
nuts; milk; Exotic fruits ( for example pineapple); chocolate, cocoa; eggs; mushrooms; fish and fish roe; citrus fruits ( for example, oranges, tangerines); melons ( for example, watermelons, melons); vegetables, fruits and red berries ( e.g. tomatoes, apples, strawberries); bananas; eggplant; smoked products; canned goods; sweets ( for example, halva, sweets); herbs and spices.	boiled beef or chicken; lactic acid products ( for example, cottage cheese, kefir, yogurt); dried fruits; green and white vegetables and fruits ( e.g. green peppers, cucumbers, potatoes, apples, pears); vegetable soups; White bread; fruit compotes; baked apples; sugar.

Anti-relapse therapy
To prevent repeated manifestations of allergic reactions during the flowering period of plants, the child is prescribed a course of anti-relapse treatment, which uses antihistamines and cromones. In each specific case, anti-relapse therapy is prescribed individually.

At this stage of treatment for hay fever, a gradually increasing dose of allergy vaccine is introduced into the child’s body. This is done in order to reduce the body's sensitivity to allergens. To determine the main allergen that caused hay fever, an allergist performs a specific allergological diagnosis, which includes such activities as collecting an allergic history, conducting skin tests with allergens and laboratory tests.

A course of allergen-specific immunotherapy is carried out exclusively in the autumn-winter period. If therapy is carried out during the flowering period of plants, that is, during the period of exacerbation of the disease, then the child may have serious allergic complications.

Today, there are various ways to administer allergen vaccines into a child’s body. In pediatric practice, oral administration is widely used ( through the mouth), in which the risk of developing anaphylactic reactions is minimal.

How to treat hay fever with folk remedies?

There are a large number of different folk remedies used in the treatment of hay fever. Some of them can alleviate the course of the disease, others may not bring the desired result or aggravate the course of hay fever. The positive effect of treatment will always depend on the individual characteristics of the body.

Among the many folk remedies used for hay fever, the following components have proven themselves well:

• horsetail;
• series;
• calendula;
• chamomile;
• celery root;
• nettle;
• mumiyo ( mountain resin).

Folk remedy	Useful and healing properties	Preparation and method of use
Horsetail	It has anti-edematous, anti-inflammatory and restorative effects.	Twenty grams of horsetail should be poured into one glass ( 200 ml) boiling water and leave for twenty to thirty minutes. You should drink the infusion half a glass ( 100 ml) three times a day, after meals.
Series	Increases the body's resistance to allergens. Promotes rapid recovery and renewal of the skin. It has a pronounced anti-inflammatory and antiallergic effect.	It is necessary to pour one tablespoon of dry string into a fireproof container ( eight - ten grams) and pour one glass of grass ( 200 ml) hot boiled water. Then you should cover the prepared solution with a lid and steam for twenty to thirty minutes. After the broth has cooled, it needs to be strained and squeezed out. Then you need to add enough boiled water to the resulting decoction so that the total volume is two hundred milliliters. It is recommended to drink one hundred grams of the decoction after meals, three times a day.
Calendula	It has analgesic, anti-inflammatory and antiseptic effects. Reduces allergic manifestations.	Ten grams of calendula inflorescences must be poured into half a glass ( 100 ml) hot boiled water and let it brew for one to two hours. The infusion should be taken one tablespoon two to three times a day.
Chamomile	It has antispasmodic, anti-inflammatory and carminative effects.	You need to pour ten grams of chamomile flowers into a glass ( 200 ml) hot boiled water and keep the broth in a water bath for half an hour. After this, you should wait until the finished broth cools down. You need to take the product two to four times a day, one tablespoon.
Celery root	Has a beneficial effect on the nervous system. Has a general strengthening effect.	Ten grams of crushed celery roots should be poured into one and a half liters of boiling water and left for four hours. After time, the infusion must be strained. It should be taken one tablespoon, thirty minutes before meals, four times a day.
Nettle	It has a general strengthening, vitamin and decongestant effect.	Ten grams of nettle should be poured into one glass ( 200 ml) boiling water and leave for half an hour. It is recommended to take the infusion warm, half a glass ( 100 ml) four to five times a day.
Mumiyo	Reduces swelling due to allergies, and also has a general strengthening effect.	It is necessary to dissolve one gram of mumiyo in one liter of water. The solution should be taken for at least ten days, half a glass ( 100 ml) once a day.

The use of folk remedies as a treatment for hay fever involves the following actions:

• Before using any folk remedy for the treatment of hay fever, you must inform your doctor.
• It should be remembered that the herbal ingredients used in the recipe for folk remedies can also provoke allergic reactions, thereby aggravating the course of the existing disease. If you feel the slightest deterioration, you should immediately consult a doctor.
• If the main allergen of hay fever is wormwood pollen, then taking those folk remedies that include plants such as calendula, chamomile, coltsfoot, string, and elecampane is strictly contraindicated. If you are allergic to tree pollen, you should not treat with alder cones or birch buds. It is also not recommended to take honey products as honey contains about ten percent pollen.
• When treating hay fever with folk remedies, you should not stop taking medications.

When does hay fever worsen?

Hay fever, as is known, is an allergic disease caused by plant pollen. This disease is also called seasonal allergies, since the manifestation of allergic reactions is observed precisely during the flowering period of plants.

The Central Russian region is characterized by three seasonal periods of plant flowering:

• spring period;
• summer period;
• summer-autumn period.

Spring flowering period of plants
During this period of time ( usually from April to May) dusting of wind-pollinated trees occurs. Representatives of this group of plants are trees such as maple, birch, oak, alder, and poplar. The pollen of all of the above trees has allergenic properties and during the flowering period can cause hay fever in humans.

Summer flowering period of plants
Starting from the end of May and ending in July, cereal grasses begin to dust. The most dangerous plants during this period of time are wheat, hedgehog rye, barley, oats, timothy, and wheatgrass. Contact with grass pollen during the summer flowering period of plants can cause hay fever in humans, as well as provoke an exacerbation of the disease in chronic allergy sufferers.

Summer-autumn period of flowering plants
During this period of time, dusting of weeds occurs. As a rule, the peak of allergy exacerbations occurs in August – October. Allergic reactions during the summer-autumn period of flowering plants can be triggered by pollen from grasses such as ragweed, wormwood, and quinoa.

For all periods of flowering plants, exacerbation of hay fever is typical in windy and dry weather.

With an exacerbation of hay fever, the patient may experience the following symptoms:

• irritability;
• fatigue;
• inflammation of the skin, manifested by redness of the skin, papular rashes and swelling;
• eczema, in which a rash appears on the patient’s body, causing a burning sensation and itching;
• allergic conjunctivitis ( inflammation of the outer membrane of the eye), in which the patient's eyes itch and become red, the eyelids swell, spontaneous lacrimation occurs, and photophobia occurs;
• allergic rhinitis ( runny nose), in which repeated sneezing occurs, mucous discharge from the nose is observed, a feeling of nasal congestion and itching appears;
• a sore throat, frequent dry and unproductive cough with attacks of suffocation;
• fever.

During the period of exacerbation of hay fever, it is recommended to perform the following actions:

• contact with allergens should be avoided, for example, during the flowering period of plants, refrain from traveling to nature;
• take medications strictly as prescribed by the doctor;
• It is necessary to carry out wet cleaning in the house daily;
• It is recommended to shower more often;
• During the daytime, all windows and doors should be closed, and it is recommended to hang a cloth soaked in water around the rooms or turn on the air conditioner ( for air humidification);
• in dry, windy weather it is recommended to spend more time at home;
• Ventilation of premises should be done at night or immediately after rain.

How to treat hay fever?

If the eyes are damaged due to a pollen allergy, the patient may experience the following symptoms:

• redness, peeling, itching and swelling of the eyelids;
• lacrimation;
• photophobia;
• sensation of a foreign body and a feeling of stinging in the eyes;
• When an infection occurs, purulent discharge will occur.

Before starting treatment, you need to make sure that the cause of the above manifestations is hay fever and not another eye disease. To do this, the doctor collects an anamnesis, during which he asks the patient about the history of the disease ( for example, what preceded the appearance of the first symptoms, and where the patient was at that time). After which the patient's blood is drawn for subsequent laboratory diagnostics. To increase the reliability of laboratory analysis, fingerprint smears are taken from the conjunctiva of the lower eyelid or the cornea of ​​the patient’s eyes. In both cases, hay fever reveals a high content of eosinophils ( an increased level of eosinophils will indicate the presence of an allergic reaction in the body).

After confirming the presence of an allergy to pollen, the patient is individually prescribed medication depending on the symptoms and severity of the disease.

For hay fever of the eyes, a person may be prescribed the following medications:

• Naphthyzin;
• Histimet;
• Dexamethasone;
• Garazon.

Name of the drug	Description	Directions for use and doses
Naphthyzin	Vasoconstrictor. It is used in the form of a 0.05% aqueous solution. Causes pupil dilation, eliminates swelling of the conjunctiva, and reduces symptoms of eye irritation.	Having pulled back the lower eyelid, you need to drop one or two drops of the drug into each eye. The procedure should be repeated one to three times a day.
Histimet	Antihistamine eye drops 0.5 mg/ml. Provides antihistamine ( blocks histamine production) and antiallergic effect ( reduces allergies).	The drug should be instilled one drop into each eye two to three times a day.
Dexamethasone	Glucocorticosteroid for local use. It has antipruritic, anti-inflammatory and antiallergic effects. This drug is usually prescribed for severe hay fever, as well as in cases where the drugs used from other groups have not brought the desired effect.	For adults, the drug should be instilled into the conjunctival sac, one to two drops four times a day for two days, with gradual withdrawal over one to two weeks. For children aged six to twelve years, the drug is prescribed one drop in each eye two to three times a day for seven to ten days. Long-term use of the drug may cause an increase in intraocular pressure.
Garazon	Glucocorticosteroid in combination with an aminoglycoside and an antibiotic. Has anti-allergic and anti-inflammatory effects. This combination drug is especially effective for purulent discharge from the eyes.	The drug should be instilled into the conjunctival sac, one to two drops three to four times a day.

In addition to drug treatment during the flowering period of plants, the patient will need to follow the following recommendations:

• You should not go out into nature or visit parks.
• In dry and windy weather, it is recommended to stay at home with all doors and windows closed. To make breathing easier, you can turn on the air conditioner or hang wet sheets around the rooms.
• It is recommended to take a shower and wet clean your home every day. The room should be ventilated at night or after rain.
• It is necessary to follow a hypoallergenic diet.
• At the slightest deterioration in health, you should immediately consult a doctor.

What drops are prescribed for hay fever?

For hay fever, drops from the following pharmacological groups can be prescribed:

• antihistamines;
• glucocorticosteroids;
• vasoconstrictor drugs.

Antihistamines
It is the main pharmacological group prescribed for hay fever. These drugs block the release of histamine from mast cells and basophils, thereby reducing and eliminating the manifestation of allergic reactions ( for example, reduce itching, rhinorrhea, conjunctivitis).

Currently, there are the following groups of antihistamines:

• First generation antihistamines (e.g. Meclozine, Clemastine). They have a pronounced sedative effect and also have a shorter duration of action.
• Second generation antihistamines (for example, Cetirizine, Antazoline, Azelastine). The occurrence of side effects when taking these drugs is reduced, and they also have a therapeutic effect on the body within twenty-four hours.
• Third generation antihistamines (for example Levocetirizine). They are highly effective and have significantly fewer side effects.

Drops	Name of the drug	Characteristics of the drug	Mode of application
Drops for oral administration	Cetirizine hexal	The active ingredient is cetirizine. Second generation antiallergic drug.	Adults and children over six years of age need to take twenty drops orally daily. For children, this dose can be given at one time or divided into two doses of ten drops in the morning and evening. Children from two to six years old should take ten drops orally at a time or divide the intake into two parts, that is, five drops in the morning and evening.
	Xizal	The active substance is levocetirizine dihydrochloride.	Adults and children over six years of age are recommended to take twenty drops once a day ( drops can be mixed with a small amount of water). Children from two to six years old are recommended to take ten drops, divided into two doses, five drops in the morning and evening.
	Fenistil	The active ingredient is dimethindene maleate.	Adults and children over twelve years of age are recommended to take twenty to forty drops three times daily. Children from three to twelve years old need to take fifteen to twenty drops three times a day. Children from one to three years should take ten to fifteen drops three times a day.
Nasal drops	Sanorin-Analergin	The active ingredients are antazoline mesylate and naphazoline nitrate.	For adults and children over sixteen years of age, the drug is prescribed in the amount of two to three drops in each nasal passage three to four times a day. Children under sixteen years of age should instill one or two drops into each nasal passage three to four times a day.
	Prevalin	Ingredients: bentonite, emulsifiers and oils.	Adults and children over twelve years of age need to make one to two injections into each nasal passage two to three times a day. For children from six to twelve years of age, the drug is also prescribed in the amount of one to two injections up to three times a day. Before use, the bottle must be shaken several times.
Eye drops	Opatanol	The active ingredient is olopatadine hydrochloride.	Place one drop in each eye twice a day. The bottle of drops must be shaken before use.
	Spersallerg	The active ingredients are antazoline hydrochloride and tetrizoline hydrochloride.	It is recommended to instill one drop of the drug two to three times a day.
	Okumetil	Active ingredient: diphenhydramine hydrochloride, zinc sulfate and naphazoline hydrochloride.	One drop should be instilled into each eye two to three times a day.
	Allergodil	The active ingredient is azelastine hydrochloride.	Adults and children after four years of age need to instill one drop in the morning and evening ( the frequency can be increased to four times a day).
	Optikrom	The active ingredient is cromoglycic acid.	One or two drops of the drug should be instilled into each eye three to four times a day.

Glucocorticosteroids
These drugs are hormonal, therefore they are taken only in severe cases of hay fever, and also when other drugs used have not brought the desired results. Glucocorticosteroids have an anti-inflammatory and anti-allergic effect, and also help reduce and eliminate such manifestations of hay fever as nasal congestion, runny nose, itching and others. These drugs can be given orally, by injection, or by topical application ( e.g. drops, sprays and inhalations).

Name of the drug	Mode of application
Budesonide	Adults and children over eighteen years of age are advised to administer two to three drops into each nasal passage twice a day.
Fluticasone	Adults and children over twelve years of age are recommended to take two sprays into each nostril once a day. If necessary, the number of administrations can be increased to twice a day.
Mometasone	In the form of inhalations, adults and children over twelve years of age should take two inhalations into each nostril once a day. After achieving the desired effect, the dose is reduced to one inhalation.
Flunisolide	Adults and children over fourteen years of age are recommended to take two sprays into each nasal passage twice a day. Children from six to fourteen years old should use one spray in each nostril.

Vasoconstrictor drugs
Drugs from this group have a vasoconstrictor effect, reducing redness and swelling of the mucous membranes of the nose and eyes. They are not recommended to be used for more than five days, as a person becomes addicted and the therapeutic effect may be reversed.

Name of the drug	Active substance	Mode of application
Naphthyzin	Naphazoline	Place one to three drops into each nasal passage three to four times a day.
Galazolin	Xylometazoline	For adults and children over six years of age, drops of 0.01% should be administered two to three drops into each nasal passage two to three times a day. Children from two to six years old should administer 0.05% drops one to two drops into each nasal passage once or twice a day.
Nazivin	Oxymetazoline	For adults and children over six years of age, 0.05% drops are recommended to be administered one to two drops into each nasal passage two to three times a day. Children from one to six years of age should take 0.025% drops one to two drops two to three times a day. For children from birth to four weeks, 0.01% drops are recommended to be administered one drop two to three times a day, and for children from five months to a year it is recommended to be administered one to two drops two to three times a day.

Can hay fever cause bronchial asthma?

Allergic bronchial asthma is hereditary, that is, a person can inherit this pathology if one of his parents had or continues to have asthma ( the probability is 20 – 30%). If both parents are sick, the risk of allergic bronchial asthma in the child increases to 75%. Moreover, such children have hypersensitivity to certain allergens, which may also include plant pollen.

The main symptoms of atopic bronchial asthma are:

• paroxysmal dry cough;
• attacks of suffocation, in which the patient takes a forced half-sitting position;
• wheezing – creaking or whistling sounds in the chest during breathing;
• feeling of chest congestion;
• shortness of breath that occurs during physical exertion.

The following treatment methods for allergic bronchial asthma exist:

• environmental control;
• drug treatment;
• allergen-specific immunotherapy.

Environmental control
It is very important for the patient to limit contact with allergens.

To do this, during the flowering period of plants, the patient must follow the following recommendations:

• stay indoors more often, especially in dry and windy weather;
• close doors and windows during the daytime;
• to increase the air humidity in the room, it is recommended to hang sheets soaked in water around the rooms or use air conditioning;
• Do wet cleaning at home every day;
• You should shower as often as possible;
• put hypoallergenic covers on mattresses and pillows, as dust mites usually live in them;
• contact with pets as little as possible;
• refrain from trips to nature.

Drug treatment

Groups of drugs	Representatives	Description
Beta-agonists	Salbutamol Fenoterol Ventolin	The drugs stop attacks of bronchial asthma, relieving the symptoms of suffocation.
Mast cell membrane stabilizers	Intal Tailed	They have anti-inflammatory and therapeutic effects. The medicinal properties of these drugs are aimed at preventing the development of the late and early stages of the asthmatic reaction.
Antihistamines	Zyrtec	Has antihistamine and antiallergic effects. This drug is usually prescribed for mild allergic bronchial asthma.
Glucocorticosteroids for local use	Pulmicort	The drug reduces the severity of bronchial edema and sputum formation. Has anti-anaphylactic and anti-inflammatory effects.
Leukotriene receptor blocker	Singular	Relaxes bronchospasm. Usually prescribed for the relief of seasonal allergic rhinitis and cough.
Combination drugs	Seretide Symbicort	These drugs contain a long-acting inhaled bronchodilator and an inhaled glucocorticosteroid in one bottle.

The dose of drugs, as well as the duration of treatment, is determined by the doctor depending on the severity of the disease and the individual characteristics of the patient’s body.

There are four degrees of severity of atypical bronchial asthma:

• Mild intermittent severity, in which symptoms of the disease appear less than once a week.
• Mild persistent severity when manifestations of allergic bronchial asthma are observed more than once a week, but less than once a day.
• Moderate severity, in which symptoms appear daily and attacks occur at night more than once a week.
• Severe severity when the symptoms of atypical bronchial asthma become permanent, significantly complicating the patient’s motor activity.

Allergen-specific immunotherapy
A small dose of the allergen is introduced into the patient's body, which is gradually increased until the patient becomes immune to the allergens. This procedure is carried out exclusively during the period of time when the dusting season of plants is over - as a rule, this is autumn or winter.