MARTINSBURG – We all know West Virginia is wild and wonderful, but unfortunately for some of us with the wild comes the un-wonderful allergies. Allergic rhinitis is the body’s, specifically the nose’s, response to environmental triggers. Typical symptoms include but are not limited to runny nose, nasal congestion, facial pressure, itchy, watery eyes and sore throats.
In this part of the country, environmental allergies are especially bad because we have four beautiful seasons and, consequently, four strong allergy seasons. In the spring, trees are the biggest cause for allergy symptoms. In the late spring and early summer, grass pollen is the big contributor to elevated pollen counts. In the late summer and early fall, ragweed is the biggest offender contributing to what we commonly call hay fever. In the winter, when we spend less time outdoors, indoor allergens like dust mites and molds are unavoidable.
Treatment of allergic rhinitis is aimed at symptom control and avoidance of triggers of those symptoms. There are many treatment options for allergic rhinitis. The two main classes of medications used to treat allergic rhinitis are antihistamines and steroid nasal sprays. If all medical options have been exhausted and symptoms are still severe, allergy testing and allergy shots may be necessary.
Allergic rhinitis symptoms are frequently mistaken for sinus infections. Acute sinusitis is an acute infection of the sinuses which is most often caused by common viruses and is, therefore, more accurately termed acute viral sinusitis. However, the environment created by the acute viral sinusitis is perfect for bacteria to thrive in, and the acute viral sinusitis can become super-infected by bacteria and turn into acute bacterial sinusitis.
Acute viral sinusitis is a self-limited process and gets better on its own in one to two weeks. Antibiotics only help bacterial infections and are not effective in acute viral sinusitis. This why most physicians do not treat “colds” that have only been symptomatic for a few days. If symptoms persist for longer than two weeks, the infection has most likely become bacterial and antibiotics are warranted. It is rare that one course of antibiotics will not be enough to effectively treat a severe case of acute bacterial sinusitis. These infections are usually marked by severe nasal congestion, a decreased sense of smell and thick, colored nasal drainage. If not completely treated, these infections can last for longer than three to four weeks and what was originally acute bacterial sinusitis becomes chronic sinusitis.
Most often chronic sinusitis can successfully be managed with medications including antibiotics, a nasal steroid spray and saline irrigations; however, if this is ineffective then surgery is sometimes necessary.
Each case is evaluated based upon the risks and benefits of the procedure as well as the severity of the symptoms, findings of imaging studies such as a CAT scan, and the general health of the patient. Surgery for chronic sinusitis is almost always done with minimally invasive techniques that target the specific sinuses that are involved without any external incisions. It is tolerated well by the vast majority patients, and is performed in the office or as an outpatient procedure.
Like any medical problem, the treatment of allergic rhinitis, acute sinusitis and chronic sinusitis is best managed with the help of a qualified team of healthcare providers.
— Dr. Sohrab Shahab is a board-certified otolaryngologist in Martinsburg. His office, West Virginia University Hospital-East’s Ear Nose and Throat clinic, is located in the McCormack Center, Suite 3200, on the City Hospital campus. For more information, call 304-262-9400. There’s a bit of Hollywood-style glitz ahead for those who want to say a special thanks this year to their secretaries, administrative assistants and other office workers.