Bless you! http://www.telegraphindia.com/1141117/jsp/knowhow/story_19048878.jsp#.VG64v4vLe9g Your Health DR GITA MATHAI Winter brings in its wake runny noses, sneezing, itchy eyes and sometimes even wheezing. Is it the flu? Or is it allergic rhinitis (a runny nose caused by allergy)? Distinguishing between the two is sometimes difficult. But remember there is always fever with flu whereas in allergies there is no rise in temperature. Allergies occur because the body reacts to foreign particles — pollen, dust, cockroach dander, birds, cats, dogs or even strong odours like room fresheners, paint and mosquito repellents. As soon as the allergen comes into contact with the lining of the nose, IgE (immunoglobin E) is produced. This attaches itself to mast cells present in the nose. In an attempt to rid the body of the offending compound, the mast cells release histamine and other inflammatory chemicals. These are responsible for the symptoms of allergy. The eyes and nose water, and there may be incessant sneezing. IgE is specific; each type is produced in response to a particular allergen. This is why some people are allergic to cats and others to paint. Some people are not allergic at all as their IgE levels are low. The tendency to have allergies runs in families. Some people are unfortunate and sneeze all year round. They have perennial rhinitis with chronic nasal congestion. Perennial rhinitis increases with age as the nasal mucous membrane progressively becomes thin and dry. Also, constant exposure to irritants like cigarette smoke and air pollution can cause the nasal passages to become irritated, engorged and leak fluid. Estrogens can cause nasal congestion and sneezing. This may be distressing during pregnancy or during certain phases of the menstrual cycle. Synthetic estrogens (in oral contraceptives or hormone replacement therapy) can produce a similar effect. Other medicines like antidepressants, sedatives like alprazolam and blood pressure medications can cause nasal congestion as a side effect. To keep allergies away: • Avoid obvious allergens like cigarette smoke and strong odours • Keep the house dust and mold free • Make sure that pests like cockroaches or bed bugs are eliminated • Wash the nostrils morning and evening using a solution of half a teaspoon of salt and a pinch of baking soda in a cup of water • Spay the nostrils with a non absorbable steroid spray morning and evening • Take steam inhalations Antihistamines are the mainstay of therapy for allergic rhinitis. They dry the secretions so that the symptoms disappear. The older antihistamines like diphenhydramine (benedryl) caused drowsiness, but the newer second generation antihistamines are much better. Leukotriene antagonists like montelukast can be used in combination with antihistamines for added benefits and quicker results. If the symptoms are very severe then it may be possible to identify the allergen. There are centres that specialise in allergy testing. The skin is pricked and exposed to small amounts of suspected allergens. If a bump appears at the site of testing, the test is positive. Desensitisation is attempted by injecting increasing doses of the allergen at specific intervals. A third of the patients benefit to some extent but many require maintenance injections. Dr Gita Mathai is a paediatrician with a family practice at Vellore. Questions on health issues may be emailed to her at yourhealthgm@yahoo.co.in