Although a first episode of allergic rhinitis may take place at any age (even in one's eighties), it most commonly occurs in the teen years, particularly between the ages of twelve and fifteen. The symptoms may be maddening at times and often include severe nasal congestion and stuffiness, and fits of sneezing. Ten or more sneezes at a time are not uncommon. Victims may also have a profuse watery mucus discharge and an annoying postnasal drip. To make matters worse, intense itching in and around the nose, on the roof of the mouth, and deep within the ears is also common. Younger children who have these itchy-nosed allergies exhibit the characteristic "fingers pointing upward and palm flat against the nose" position of the hand, commonly called the "allergic salute" by pediatricians.
Other symptoms include a sore, scratchy, or itchy throat; red, itchy, watery eyes; and inflammation of the conjunctiva, the membrane that protects the eye. Congestion of the eustachian tubes, small canal-like structures that connect the middle ear with the area in back of the nose and throat, can result in an annoying feeling of ear pressure the kind you experience when changing altitudes in a plane and diminished hearing. It may even give rise to an outright earache. Finally, victims may suffer with headaches and complain of fatigue and irritability. In general, on any given day the severity of the symptoms of seasonal allergic rhinitis depends on the amount of pollen in the air and, of course, on the degree of sensitivity of the individual.
Many of the common signs and symptoms are easily explainable. Nasal swelling, congestion, runny nose, and loss of smell and taste are believed to be the result of histamine (as well as other mediators) via its effects on blood vessels and tissues. As in the case of the common cold, the diminished sense of taste and smell are explained by the fact that excessive secretions interfere with contact between the tiny molecules of food or fragrances and the tips of the nerves responsible for taste and smell perception.
Red, itchy, swollen, and watery eyes are likewise believed to be linked to the release of histamine by mast cells within the delicate membranes of the conjunctivae. Conscious or unconscious rubbing in response to the itching, which so often accompanies the symptoms, only worsens the redness and irritation. Not surprisingly, contact lens wearers have even a harder time because pollen particles trapped between the contact lens and the eye typically trigger numerous tiny allergic reactions. Not uncommonly, lens wearers have "bloodshot" eyes and complain of burning, grittiness, dryness, and significantly reduced lens comfort and wearing time.
The earaches and stuffed ears, as well as the crackling and popping sounds that commonly accompany allergic rhinitis, are also easily explained. Under ordinary circumstances, the eustachian tubes adjust to any changes in outside air pressure by opening and closing automatically. This occurs, for example, whenever you dive into water or ascend or descend in an elevator or airplane. When they are swollen from allergy, however, the eustachian tubes malfunction, giving rise to sensations of crackling and popping or painful pressure in the ears. If the problem persists, inflammatory fluid within the surrounding blood vessels may leak into the canals; if it accumulates sufficiently, it can lead to hearing difficulties and even secondary bacterial invasion.
