Allergy Disorders

Allergies are a common cause of inflamed sinuses and headaches as well as runny or itchy nose, sneezing, itchy or watery eyes, blocked or itchy ears, rashes and wheezing. Allergies are in essence an overreaction by the body’s immune system to one or more objects in the environment, called allergens.

Common allergens include:

  • dust
  • pollen
  • animal dander
  • mold
  • certain foods

Nasal endoscopy, blood tests or skin “scratch” tests are often all that is needed to determine the presence and cause of an allergy. Then the physician and patient can work together to plan treatment and management of symptoms.

Is it sinus or allergy or what?

“Sinus” – or more properly sinusitis – is irritation of the delicate mucous producing membrane lining the sinus cavities around the nose. The same membranes line the nose, mouth, throat, air passages in the lungs, surface of the eye and the narrow Eustachian tubes from the nose to behind the eardrums.

Irritation can be caused by viruses such as in colds and flu, or by bacteria. Often it is caused by allergy or similar conditions. True allergy is an abnormal response by the body’s immune system to living things (called allergens) in the air.

Hay fever is allergy to pollens. But allergy can also be caused by dust, molds, animal hair or dander (dead skin) and feather or down bedding. Similar reactions can be produced by chemicals such as smog, tobacco smoke, perfumes, new paint or carpet, common cleaners, etc.

Patients with indigestion, reflux (GERD) or hiatal hernia can also have the same complaints. Another non-allergic source of the same symptoms is sensitivity to climate – either hot/cold or humid / dryness.

Additionally, nasal stuffiness can be caused by a variety of anatomic problems including deviation of the septum that divides the right and left sides of the nose, and by the growth of ‘polyps’ which are an excessive swelling of the tissues, as well as blockage by other growths.

Effective treatment will depend on the cause:
Antihistamines help with itching and sneezing.
Decongestants are for stuffiness.

Many medications are combinations of both. Nasal steroid sprays often help shrink swollen irritated tissue and polyps. As opposed to steroid pills, the sprays do not get into the circulation to affect the body and some are even approved for children to use daily for years without any problem.


Over-the-counter decongestant sprays/drops are to be avoided as much as possible since the rebound effect in the membranes can cause people to be essentially addicted in as little as 3 days.

Saline (salt water) sprays can be used as often as necessary. Each of these types of medicine have potential side effects and (other than saline) potential reactions with other medications, even non-prescription ones. Therefore, they should not be used for prolonged periods without consulting a physician.

Allergy shots help the body to be less sensitive to the true allergens in the environment. First, simple skin tests are done to determine both the identity and degree of sensitivity to specific allergens. Then a customized solution is prepared for each patient. This often allows the patient to significantly reduce or even eliminate the regular use of medications.

The best way to handle any medical problem
Prevention or Avoidance.
Some simple things you can do for yourself :

  • Take your antihistamine at least 1 hour before doing cleaning or yard work and wear a pollen mask and long-sleeve clothing that you put in the wash when you are done.
  • Also shower after exposure to allergens.
  • Vacuum well, including under furniture, or use a dust-collecting cloth. Don’t just “dust” which spreads more allergens into the air.
  • Do not allow pets indoors, or at least not into the bedroom.
  • Keep all scents in a drawer rather than sitting out. No smoking in the house (preferably not at all).
  • Do not use down or feather bedding and enclose pillows, mattress and box springs in a plastic barrier.
  • Keep windows and doors closed during heavy pollen season and when smog levels are high.
  • Change heating and air conditioning filters regularly – monthly if necessary. Also consider a humidifier when the weather is dry but be alert for mold growth in the humidifier. Air purifiers (especially with HEPA filters) can also be very helpful. Notice if your symptoms are worse in a particular room at home or work and check to determine what the source of irritation may be – dust, mildew from indoor plants or other sources, animal hair or dander, perfume, chemicals for cleaning or hobbies, etc.
  • Similarly, if you can pinpoint when your symptoms first began, try remembering what may have changed in your environment about that time