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If every spring your nose runs, your eyes itch and water, and you sneeze all day, you probably have allergic rhinitis. Hay fever is another name for this disorder that affects at least 20,000,000 Americans. You may have to do some detective work to uncover the everyday things that are causing your allergic symptoms.

The classic symptoms of allergic rhinitis are sneezing, nasal itching and congestion, and a thin, watery nasal discharge. Sore throat may also be present. It's due to a combination of post-nasal drip and the mouth breathing necessitated by nasal obstruction. When the eyes are involved (called allergic conjunctivitis) they itch, sting, and tear. Itching on the roof of the mouth and in the ears, ears that feel clogged and won't pop, mild dizziness, headache, even a sense of laziness or torpor may accompany these symptoms of the eye and nose.

A child suffering from allergic rhinitis will sniff and snort in an effort to breathe freely. To relieve nasal itching, he may push up the tip of the nose with the back of the hand, the so-called allergic salute.

Allergic rhinitis may be chronic (perennial), episodic, or seasonal. In the episodic form, symptoms occur when a person is exposed to the allergenic substance only intermittently. A friend's pet is a good example of this type of rhinitis, if you don't have the same kind of pet at home.

Seasonal allergic rhinitis is due to allergy to pollens or outdoor mold spores. Pollen is the male sex cell of flowering plants. Usually only plants whose pollen is carried by the wind (as opposed to on the backs of insects) make enough pollen to provoke symptoms in susceptible persons. Consequently, the plants to which most people develop allergy (trees, grasses, weeds) have inconspicuous flowers. Few persons are allergic to plants with bright, showy blooms like roses or tulips. A point of confusion may be the symptoms caused by flowers with a strong scent, like night-blooming jasmine. These symptoms of congestion and runny nose are due to vasomotor rhinitis.

When symptoms occur in January or February the usual culprits are juniper, cypress, oak, ash, or alder pollens. Many other trees cause problems from late winter through June. Olive and privet are closely related and pollinate from May until August. Persons suffering from late-March until June or July are usually allergic to grass pollens while those with late summer and fall symptoms often have weed or mold allergy. Because coastal California has a long growing season, persons allergic to many types of pollen may suffer symptoms from early winter until late autumn.

In perennial rhinitis, symptoms are present year-round and are usually due to things present in the home or occasionally in the diet. Symptoms are typically worse at night and upon arising in the morning. In addition to the usual complaints, perennial rhinitis may produce chronic symptoms that, at first, may not seem allergic. Sinus headache, loss of the senses of smell and taste, lack of energy from poor sleep, and malocclusion of the teeth are some examples.

The most common cause of perennial allergy complaints is the dust mite which live primarily in bedclothes, carpeting, and upholstered furniture. Pets are another significant cause. The worst offenders are cats and dogs but small rodents, rabbits, and birds may also be troublesome. Indoor mold spores, mildew, and foods are less frequent causes of chronic symptoms.

Environmental control measures for the patient with perennial allergy are effective, safe, and have no side effects. When dust mites are the allergic culprits, encasement of the mattress, avoidance of feather pillows and down comforters and removal of the bedroom carpet are helpful. In the long run, they are affordable, not time-consuming tasks. Frequent vacuuming and damp mopping offer little more than drudgery. Presoaking washable bedclothes in a dilute solution of eucalyptus oil acts as an effective and safe miticide. Tannic acid sprays may be applied to carpeting to denature mite allergens but must be reapplied every few months and may stain light-colored yarns. If mold or mildew form on window-sills, outside walls, or on bathroom tile, wash monthly with Chlorox® or Tilex®. Use the bathroom exhaust fan when showering. Repair leaks and replace dry rot.

Relocate the dog and cat to Wyoming, or at least to the garage. The dander left behind will take six to eight months to decompose despite shampooing of the carpet. High efficiency, HEPA air filters can decrease airborne mold and dander but you'll need a unit adequate to the size of the space to be cleaned operating it at least 12 hours daily.

Irritants exacerbate allergy symptoms. If unable to quit, family members who smoke should do so outdoors. Go easy on perfumes and colognes and avoid flowers with strong aromas.

Obviously, you can't rid the great outdoors of pollen, so you'll need to adjust your activities during your allergy season. Always remember to take your allergy medication before going outside. With allergy problems, an ounce of prevention is worth a pound of cure. When driving, keep windows closed. Use the air conditioner to filter out pollen and air pollutants. Pollen is released from plants before noon. Pollen counts fall in the evening as the air cools. Keep windows closed during the day to reduce pollen contamination of the house.

There are several types of drugs for the treatment of allergic rhinitis. Antihistamines, available since 1943, are safe and effective. Their major drawbacks are sedation and prolonged reaction time. Many patients do well with over-the-counter (OTC) preparations containing chlorpheniramine maleate 4 mg or diphenhydramine 25 mg. These are available alone or combined with a decongestant. Other side effects of this class of drugs include occasional emotional stimulation, dry mouth, and upset stomach. Urinary retention may occur in persons over fifty-five. Several new prescription antihistamines (Claritin, Allegra) are non-sedating and lack the other side effects of OTC products.

Two different types of medication are work through spraying directly into the nose. Nasocrom (cromolyn) is a non-steroidal OTC nasal spray whose only common adverse effect is local irritation. Corticosteroid sprays are the most effective medications for allergic rhinitis but are not as good for AC. Nosebleeds are an occasional problem but serious side effects are virtually unknown. Corticosteroid sprays should be used with a doctor's supervision. There are a variety of eye drops available for treating AC. Vasoconstrictor nasal sprays, like Afrin and Dristan, are NOT recommended. Regular use of these agents results in dependence and a rebound effect leading to greater congestion.

Immunotherapy, or allergy shots, involves a series of injections of those substances which trigger allergic symptoms. They are tailor-made for the individual. immunotherapy is effective in about 90% of patients after about two years of treatment. When effective, shots are administered for at least five years.

Immunotherapy is not without risk. Local reactions resembling a mosquito bite are common. Systemic reactions, a severe allergic reaction, may consist of hives, wheezing, difficulty breathing, and even low blood pressure. Such reactions occur about once every 1000 injections. Death, may occur, but is exceedingly rare. About one to two deaths occur nationwide due to immunotherapy annually. Immunotherapy is also inconvenient requiring frequent visits to the physician's office, at least for the first few months. They are also not immediately effective. Patients should be prepared for a six to twelve month delay before noticing beneficial effects.

For these reasons, a combination of sensible environmental control and medication is the preliminary approach to the control of allergic rhinitis. Immunotherapy is reserved for patients with perennial symptoms or intractable seasonal symptoms, those with intolerance to many medications, or who cannot modify their surroundings. Nevertheless, immunotherapy can be extraordinarily effective. It should not be rejected because of a fear of needles or pain.

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The information above represents the writer's opinions and is not meant as a substitute for evaluation by a physician. The reader is advised to seek sound medical evaluation and guidance before undertaking treatment for any medical condition.