Have you ever wondered if your runny nose, sneezing and itchy-watery eyes were related to your asthma? It turns out that your hay fever, referred to as seasonal allergic rhinitis by your doctor, is a significant risk factor for the development of asthma.
Asthma and hay fever often exist together; as much as 80% of asthmatics have some form of hay fever.
Do You Have Hay Fever Symptoms?
As with asthma symptoms, hay fever symptoms will vary from person to person. Many patients report symptoms associated with their eyes, throat, ears, and sleep in addition to a runny nose. To formally diagnose you, your doctor will want to know:
- Seasonal versus perennial: Do the symptoms occur with a particular season or year-round?
- Symptom frequency: Intermittent (less than 4 days per week, and for less than 4 weeks a year) versus persistent (more than 4 days in a week or more than 4 weeks in a year)
Some of the symptoms you and your doctor are likely to discuss include:
- Nose: Blocked, itchy nose; sneezing; facial pain or pressure; and post nasal dripping that may cause you to cough or frequently clear your throat
- Eyes: Red, itchy eyes; feeling of a foreign body or grittiness in the eyes; under-eye darkness and swelling (allergic shiners)
- Throat and ears: Voice changes and hoarseness; sore or scratchy throat; congestion and popping of the ears.
- Sleep: Frequent nighttime awakenings; need for mouth breathing; daytime tiredness and difficulty completing tasks or work.
Accurate Diagnosis of Hay Fever Is Essential
In order to make a diagnosis of hay fever, you doctor will take a history, perform a physical exam, and possibly order some tests.
A discussion between you and your doctor about the previously mentioned symptoms and your experience with them is the cornerstone of hay fever diagnosis. Your doctor will also likely ask you about:
- any skin allergies and conditions such as rashes, hives, and itchy skin or eczema
- allergic symptoms occurring at any particular time or place
- a family history of allergies
- shortness of breath
- chest tightness
- chronic cough
Your doctor may also ask questions to make sure your rhinitis does not have another cause, such as:
- common cold
- non-allergic rhinitis
- atrophic rhinitis
- rhinitis medicamentosa
- medication usage (some birth control pills, blood pressure medications, and psychiatric medications may be to blame)
- hormonal changes due to pregnancy or hypothyroidism
- nasal polyp
Your doctor will examine several different parts of your body to help confirm your hay fever diagnosis and make sure something else is not causing your symptoms. The exam may include:
- Nose: Looking for swollen nasal tissue that may look pale or blue; looking for any anatomical defects like a deviated nasal septum
- Eyes: Looking for allergic shiners and to check to see if the eyes are swollen, watery, or red
- Sinus: Pain or tenderness over the sinuses may indicate a sinus infection instead of hay fever.
- Mouth: Examining the mouth can exclude conditions like tonsillitis and uncover evidence of chronic mouth breathing.
- Chest and Lungs: Looking for signs of infection or asthma
- Skin: Looking for other signs of allergy, such as hives or eczema
If your doctor suspects a hay fever diagnosis based on history and physical exam, he may either recommend treatment or additionally perform some diagnostic testing to confirm the diagnosis. Further diagnostic testing in hay fever is generally useful if:
- The diagnosis is not clear after the medical history and physical exam.
- Symptoms remain despite adequate treatment, or you do not respond to treatment like your doctor thinks you should.
- You and your doctor are unable to identify potential allergens in your home, office, and school settings.
- The hay fever appears to be work related.
If your doctor feels that you might benefit from testing for hay fever, he may order:
- IgE Level: This blood test cannot make a diagnosis of hay fever, but elevated IgE levels related to specific allergens can help make the diagnosis.
- Skin testing: This prick method of allergy testing is one of the most common diagnostic tests used to detect allergy to a particular substance.
- Improve asthma control
- Decrease airway hyper-responsiveness
- Decreases ER visits
- Possibly prevent development of asthma
American Academy of Allergy Asthma & Immunology. Accessed September 7, 2009. Diseases 101: Rhinitis and Sinusitis
Weber, RW. Allergic Rhinitis. Primary Care Clinics In Office Practice. Volume 35 (2008): 1-10.