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Allergic rhinitis is one of the most prevalent chronic diseases in the United States and has a big impact in Central Texas with allergies occurring nearly year round. Classic symptoms such as sneezing, runny nose and nasal congestion are common, but allergies can also target other areas of the body causing eye itching, rashes, hearing loss, dizziness, throat pain, hoarseness and cough. More extreme exacerbations of allergy frequently lead to sinusitis, ear infections and asthma, requiring emergency room evaluations or trips to the physician’s office. The severity of symptoms leads to significant work impairment affecting productivity and missed days while caring for self or child.

“Cedar fever,” “hay fever” and “sinus” are common terms people use to describe allergic rhinitis. It becomes symptomatic when a person’s body is over responding to the allergen and this “healthy” response can lead to misery and infection. The solution is to figure out what can turn off the allergic response or avoid the allergen altogether. While a three-month winter vacation to Hawaii would be a great prescription to avoid cedar season, it is not practical for most of us. Finding an over-the-counter solution is one possible way to suppress the symptoms.  This includes antihistamines and nasal steroids that can be safely used in combination. Some people can use decongestants but should be careful of side effects that can increase blood pressure, anxiety and insomnia. Many people prefer to avoid medications and choose a more natural method to control their allergies. Immunotherapy via allergy shots or sublingual drops are current treatments that build up the immune system and help reduce allergy symptoms. This type of intervention can take a few weeks to several months before it is effective.

Balloon sinuplasty has been in the news recently and is indicated for recurrent and milder forms of chronic sinusitis rather than allergic rhinitis. However, many allergy patients do suffer from sinus problems and require this type of intervention. Physicians have been safely providing treatment for the full spectrum of sinonasal disorders with allergy shots/drops, balloon sinuplasty and minimally invasive surgery.

By: Robert Butler, MD, FACS, FAAOA

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