Hay fever; Nasal congestion - allergies
The allergic process, called atopy, occurs when the body overreacts to a substance that it senses as a foreign “invader”. The immune system works continuously to protect the body from potentially dangerous intruders such as bacteria, viruses, and toxins. However, for reasons not completely understood, some people are hypersensitive to substances that are typically harmless. When the immune system inaccurately identifies these substances (allergens) as harmful, an allergic reaction and inflammatory response occurs.
There are many types of IgE antibodies, and each are associated with a specific allergen. This is why some people are allergic to cat dander, while other people are not bothered by cats buts are allergic to pollen. In allergic rhinitis, the allergic reaction begins when an allergen comes into contact with the mucus membranes in the lining of the nose.
Seasonal allergic rhinitis occurs only during periods of intense airborne pollen or spores. It is commonly, although inaccurately, called hay fever. No fever accompanies this condition, and the allergic response is not dependent on hay. In general, triggers of seasonal allergy in the U.S. include:
Allergens in the House. Allergens in the house can trigger attacks in people with year-long allergic rhinitis, called perennial rhinitis. Household allergens include:
Aging Process. The elderly are at risk for chronic rhinitis as the mucus membranes become dry with age. In addition, the cartilage supporting the nasal passages weakens, causing changes in airflow. In such cases, therapy involves avoiding possible allergens and airborne irritants as well as measures to keep the nasal passages moist. Decongestants are not helpful.
Irritative Rhinitis. Irritative rhinitis is caused by an overreaction to irritants, such as cigarette smoke, dozens of other air pollutants, strong odors, alcoholic beverages, and exposure to cold. The nasal passages become red and engorged. This reaction is not the same as an allergic reaction, although both are associated with increased numbers of white blood cells called eosinophils.
Vasomotor Rhinitis. Vasomotor rhinitis, another type of nonallergic rhinitis, is caused by oversensitive blood vessels and nerve cells in the nasal passages. It occurs in response to irritants, including smoke, environmental toxins, changes in temperature and humidity, stress, and even sexual arousal. Symptoms of vasomotor rhinitis are similar to most of those caused by allergies but eye irritation does not occur.
Blockage in the Nose from Polyps or Structural Abnormalities. A number of conditions may block the nasal passages. Surgery may be helpful for certain cases.
Drugs. A number of drugs can cause rhinitis or worsen it in people with conditions such as deviated septum, allergies, or vasomotor rhinitis:
Estrogen in Women. Elevated levels of estrogen appear to increase mucus production and swelling in the nasal passages and can cause congestion. This effect is most apparent in women during pregnancy. In such cases the condition usually clears up after delivery. Oral contraceptives and hormone replacement therapies that contain estrogen have also been associated with nasal congestion in some women.
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