Possible complications of hay fever
Sinus infection
When severe hay fever is not controlled quickly enough, a bacterial infection can result from the inflammation in the nasal and sinus mucous membranes (the tissues that line the nasal and sinus passages). Sinus infections usually require a combination of prescription treatments, including antibiotics and a medication to reduce the congestion. You can also help yourself by employing the following measures:
• Keep a kettle boiling in an enclosed space and breathe in the hot, moist air.
• Apply a hot pack to the areas around the sinuses – gel packs that you can heat up in hot water are available from many chemists. Don’t allow the pack to get too hot – it should be bearable.
People with allergies are more likely to develop sinusitis than any other group.
Ear infection
A condition known as otitis media – the medical term for a particular type of ear infection – can occur in the space behind the eardrum (the middle ear), causing ear pain and a ‘plugged’ sensation in the ears. The condition arises due to a series of events which begins with throat inflammation restricting the opening of the Eustachian tube. The Eustachian tube is a narrow passage that leads from the back of the throat to the cavity of the middle ear. It enables pressure on each side of the eardrum to be equalized to enable normal hearing. When the Eustachian tube suffers partial blockage, air is prevented from travelling up it and a slight vacuum in the middle ear results. The vacuum draws fluid from the tissues into the middle ear, causing temporary hearing loss. The fluid is liable to infection in the form of otitis media.
Approximately 80 per cent of otitis media cases clear up within three days, during which time you can use over-the-counter painkillers such as paracetamol or ibuprofen to control the symptoms. If the pain is severe, or getting worse after three days, don’t hesitate to visit your doctor, who will prescribe a course of antibiotics. A child under the age of 16 with otitis media should always be seen by a doctor, not simply given over-the-counter medication.
Recurrent bouts of otitis media can eventually lead to hearing loss. However, this can normally be prevented by the use of antibiotic medication.
Rebound nasal congestion
When a decongestant spray is used for more than a few days, the result, ironically, can be increased nose blockage rather than the reverse. Continued use of the spray may then cause chronic inflammation in the delicate mucous membranes – a condition known as rhinitis medicamentosa – which makes it difficult to breathe through your nose at all. If you get into this situation, stop using the spray immediately; you will have to put up with a severely blocked nose until such time as you return to the state you were in before you started using the spray. To be safe, never use a decongestant spray for more than three days.
Nosebleeds
A small number of people with hay fever experience nosebleeds. Fortunately, this is usually a passing problem, occurring on and off over a few weeks. If the bleeds are persistent and really bother you, ask to be referred to an ear, nose and throat specialist at your local hospital. Inflammation may have caused some of the delicate blood vessels in your nose to become particularly fragile and the specialist may offer to remove them by means of cauterization.
This is a minor surgical procedure. If you have just undergone cauterization and you use a nasal spray to deliver medication, avoid damaging the affected nasal membranes by making sure you don’t push the nozzle of the applicator against the area. If you are in any doubt, it is probably best to avoid using the spray for two to three weeks after surgery. Your specialist will be able to advise you about this.
Facial changes
Inflammation and congestion in the mucous membranes of the nose and sinuses can give rise to facial swelling, nose redness and puffy eyes. In children with hay fever, frequent wiping can cause a crease across the top of the nose.