Seasonal Allergies
Dr. Allen Marshall discusses seasonal allergies, and the steps you can take to prevent or alleviate your symptoms.
Featured Speaker:
Learn more about Allen Marshall, MD
Allen Marshall, MD
Dr. Marshall received his medical degree from the University of North Carolina School of Medicine. He also holds a Bachelor of Science degree in biology from Davidson College in Davidson, NC. He completed his residency in the department of Otolaryngology- Head and Neck Surgery at UNC.Learn more about Allen Marshall, MD
Transcription:
Seasonal Allergies
Caitlin Whyte, (Host): I know we're still deep in the heart of winter, but I'm already looking forward to those first days of spring. But along with those longer days and flower buds comes those seasonal allergies. Here to talk to us more about those allergies and how to fix them is Dr. Allen Marshall, a WakeMed ENT Physician.
This is WakeMed Voices, a podcast by WakeMed Health and Hospitals. I'm your host, Caitlin Whyte. So, doctor let's dive in to just some basics to start off this conversation. My first question is kind of a two-parter. Basically what are seasonal allergies? And you know, we hear so much about spring and summer allergies, but are there winter fall allergies?
Allen Marshall, MD (Guest): So, seasonal allergies, people are usually referring to the pollens and things that come out with a different, particularly spring and fall. And those would be the most common things are trees and grasses. And but then there's all types of other allergies that are present year round, like dust mites and molds and animal dander and things like that. And those would be the ones that would be more common in the winter time because you're indoors more and you're less likely to be in a place where they were those allergies are not.
Host: So, getting a bit deeper into you know, how allergies work, tell us what chronic nasal obstruction is.
Dr. Marshall: Chronic nasal obstruction can be caused by just an anatomic problem, or it can also be exacerbated by allergy. So, the inside of the nose is quite complex and there's ways that it can obstruct; both allergic and non allergic. So, the nasal septum is the wall that divides the two nasal passages. And it's not uncommon for people to have a deviated nasal septum. And so the more deviated or crooked that is, the more obstructive it becomes and can cause chronic stuffy nose or chronic nasal blockage. But that can also be exacerbated by the changes that come with allergy. So, if you're exposed to something that you're allergic to, the histamine response will result in because it will in nasal congestion and increased mucus production. And so, that will make the nasal blockage worse.
Host: And so, when it comes to treatment, you know, if I come in, I have, I'm suffering from these kinds of things, what's the first round of treatment look like?
Dr. Marshall: Well, there's a lot of over the counter options. Primary treatment for nasal allergy is a topical nasal steroid. So, some of the common ones people have heard of are like Flonase or Nasacort, but that's a family of medications that all work the same way basically to reduce the intra-nasal inflammation and also help kind of dry the nose up and cut down on mucus production.
But another really great treatment is just something simple like a nasal saline, wash and irrigation. A lot of people use a Neti Pot, which I think is a great tool. It's a great way to wash the nose, remove the allergens from the nose, the salt in the waters acts as a great natural decongestant and kind of helps pull the mucus out and open the sinus passages as well. There's also oral medications. Oral anti-histamines are common, and that will reduce the histamine response that comes with allergy exposure. And there's other parts of the inflammatory pathway that you can target. There's medications that fight against the leukotriene pathway. So, anti leukotriene medications that can also be effective in combating the allergy response.
Host: Now if those over the counter treatments don't work, are there more serious surgical options?
Dr. Marshall: Surgery doesn't cure allergy, but it certainly does make a life with allergies better. So, the way, and the way that works is that you can change that intra-nasal anatomy so that you can accommodate the changes that come with allergy and breathe better and live a happier life that way. So, if you do have a deviated nasal septum, the starting point for your nasal passages could be quite small. And then just with a little bit of allergic change, you suddenly developed a complete nasal blockage. So, if there's a way to open the nasal passage, make it bigger to begin with then you'll do better when those allergy seasons come along.
So, the common operations, so that one would be a septoplasty, which would be a surgery to address the deviated portions of the nasal septum. That's an outpatient surgery that is a common operation typically takes about an hour and go home the same day. And then generally to recovery for something like that it's about a week or two. There's another structure inside the nose called the nasal turbinates. And these are like filters inside the nose that help draw out dust and allergens. And they also warm and humidify the air that you breathe. Well over time, and especially when a patient that has allergy, the turbinates can swell and the more swollen they are, the more obstruction they cause.
And so there's another surgery we can do to address that. And that's called an intra-nasal turbinate reduction or a submucosal turbinate resection. These procedures are just targeted at removing tissue, but at the same time, maintaining the important function of the turbinates. So, that those two things together are septoplasty and a turbinate reduction and a great option to surgically treat nasal obstruction that comes with allergy.
Host: Do you see many patients who have to get to that level of surgery or are most seasonal allergies kept at bay with just these over the counter, Neti Pot options?
Dr. Marshall: But certainly surgical treatment for chronic nasal obstruction is very, very common. It's one of the more common things that we do. And so, and that, not all those patients suffer from allergies, but some of them just have an anatomic blockage that they elect to have corrected, but certainly if the same patients also have allergy. It makes it a better situation for them as well.
Host: Great doctor, any other tips or just, you know, words of help for those suffering from seasonal allergies?
Dr. Marshall: Well, you know, it's, it's a tough problem to have, I mean, there, it should be mentioned that, immunotherapy, which is allergy shots are another treatment option, but that would just be another way to compliment, but the medical and surgical treatments as well. So, that's something to know about and yeah, the allergy avoidance is an important part of this. So, if you, if you can identify the things that you're allergic to and be knowledgeable about when those things are prevalent in the environment, then you can avoid them by staying more indoors during those times, or keeping your windows closed or, you know, washing your clothing and that kind of thing.
Host: Well, thanks for joining us, Dr. Marshall and giving us some ways to combat those seasonal allergies this year. To learn more about WakeMed ENT Services, visit wakemed.org. And thank you for listening. I'm Caitlin Whyte with WakeMed Voices brought to you by WakeMed health and Hospitals in Raleigh, North Carolina.
Seasonal Allergies
Caitlin Whyte, (Host): I know we're still deep in the heart of winter, but I'm already looking forward to those first days of spring. But along with those longer days and flower buds comes those seasonal allergies. Here to talk to us more about those allergies and how to fix them is Dr. Allen Marshall, a WakeMed ENT Physician.
This is WakeMed Voices, a podcast by WakeMed Health and Hospitals. I'm your host, Caitlin Whyte. So, doctor let's dive in to just some basics to start off this conversation. My first question is kind of a two-parter. Basically what are seasonal allergies? And you know, we hear so much about spring and summer allergies, but are there winter fall allergies?
Allen Marshall, MD (Guest): So, seasonal allergies, people are usually referring to the pollens and things that come out with a different, particularly spring and fall. And those would be the most common things are trees and grasses. And but then there's all types of other allergies that are present year round, like dust mites and molds and animal dander and things like that. And those would be the ones that would be more common in the winter time because you're indoors more and you're less likely to be in a place where they were those allergies are not.
Host: So, getting a bit deeper into you know, how allergies work, tell us what chronic nasal obstruction is.
Dr. Marshall: Chronic nasal obstruction can be caused by just an anatomic problem, or it can also be exacerbated by allergy. So, the inside of the nose is quite complex and there's ways that it can obstruct; both allergic and non allergic. So, the nasal septum is the wall that divides the two nasal passages. And it's not uncommon for people to have a deviated nasal septum. And so the more deviated or crooked that is, the more obstructive it becomes and can cause chronic stuffy nose or chronic nasal blockage. But that can also be exacerbated by the changes that come with allergy. So, if you're exposed to something that you're allergic to, the histamine response will result in because it will in nasal congestion and increased mucus production. And so, that will make the nasal blockage worse.
Host: And so, when it comes to treatment, you know, if I come in, I have, I'm suffering from these kinds of things, what's the first round of treatment look like?
Dr. Marshall: Well, there's a lot of over the counter options. Primary treatment for nasal allergy is a topical nasal steroid. So, some of the common ones people have heard of are like Flonase or Nasacort, but that's a family of medications that all work the same way basically to reduce the intra-nasal inflammation and also help kind of dry the nose up and cut down on mucus production.
But another really great treatment is just something simple like a nasal saline, wash and irrigation. A lot of people use a Neti Pot, which I think is a great tool. It's a great way to wash the nose, remove the allergens from the nose, the salt in the waters acts as a great natural decongestant and kind of helps pull the mucus out and open the sinus passages as well. There's also oral medications. Oral anti-histamines are common, and that will reduce the histamine response that comes with allergy exposure. And there's other parts of the inflammatory pathway that you can target. There's medications that fight against the leukotriene pathway. So, anti leukotriene medications that can also be effective in combating the allergy response.
Host: Now if those over the counter treatments don't work, are there more serious surgical options?
Dr. Marshall: Surgery doesn't cure allergy, but it certainly does make a life with allergies better. So, the way, and the way that works is that you can change that intra-nasal anatomy so that you can accommodate the changes that come with allergy and breathe better and live a happier life that way. So, if you do have a deviated nasal septum, the starting point for your nasal passages could be quite small. And then just with a little bit of allergic change, you suddenly developed a complete nasal blockage. So, if there's a way to open the nasal passage, make it bigger to begin with then you'll do better when those allergy seasons come along.
So, the common operations, so that one would be a septoplasty, which would be a surgery to address the deviated portions of the nasal septum. That's an outpatient surgery that is a common operation typically takes about an hour and go home the same day. And then generally to recovery for something like that it's about a week or two. There's another structure inside the nose called the nasal turbinates. And these are like filters inside the nose that help draw out dust and allergens. And they also warm and humidify the air that you breathe. Well over time, and especially when a patient that has allergy, the turbinates can swell and the more swollen they are, the more obstruction they cause.
And so there's another surgery we can do to address that. And that's called an intra-nasal turbinate reduction or a submucosal turbinate resection. These procedures are just targeted at removing tissue, but at the same time, maintaining the important function of the turbinates. So, that those two things together are septoplasty and a turbinate reduction and a great option to surgically treat nasal obstruction that comes with allergy.
Host: Do you see many patients who have to get to that level of surgery or are most seasonal allergies kept at bay with just these over the counter, Neti Pot options?
Dr. Marshall: But certainly surgical treatment for chronic nasal obstruction is very, very common. It's one of the more common things that we do. And so, and that, not all those patients suffer from allergies, but some of them just have an anatomic blockage that they elect to have corrected, but certainly if the same patients also have allergy. It makes it a better situation for them as well.
Host: Great doctor, any other tips or just, you know, words of help for those suffering from seasonal allergies?
Dr. Marshall: Well, you know, it's, it's a tough problem to have, I mean, there, it should be mentioned that, immunotherapy, which is allergy shots are another treatment option, but that would just be another way to compliment, but the medical and surgical treatments as well. So, that's something to know about and yeah, the allergy avoidance is an important part of this. So, if you, if you can identify the things that you're allergic to and be knowledgeable about when those things are prevalent in the environment, then you can avoid them by staying more indoors during those times, or keeping your windows closed or, you know, washing your clothing and that kind of thing.
Host: Well, thanks for joining us, Dr. Marshall and giving us some ways to combat those seasonal allergies this year. To learn more about WakeMed ENT Services, visit wakemed.org. And thank you for listening. I'm Caitlin Whyte with WakeMed Voices brought to you by WakeMed health and Hospitals in Raleigh, North Carolina.