Q: Every time I visit India, I get sneezing and running nose problem due to dust allergy. This time I saw the doctor and he gave me Allegra 180 mg and my sneezing stopped but I got severe cough. I could not sleep at night and I had breathing problems. In another city I saw another doctor and he gave me some antibiotics but the cough wouldn't stop. He did TLC/DLC and the esnophilia was 8%. After 10 days or so my chest started paining a lot when coughing. Now I am back in Malaysia and saw the doctor here who have me some antibiotic. The cough is better now though not cured but the left side of my lower chest has intense pain. I had X-ray done and the doctor said it is normal. Do you think I should worry about the lower chest pain on left side? The pain really hurts me a lot. Is there anything I could do about it?

A:You suffer from a condition known as Allergic rhinitis, in other words it is also known as Hay fever. Allergic rhinitis is a reaction of the lining of the nose to particles in the air. Allergic rhinitis occurs when the nose and usually also the ears, eyes, sinuses, and throat come into contact with allergy-causing substances. The allergy-causing substances are called allergens. The most common allergens are pollens, molds, dust, and animal dander. Some allergens are present only during certain seasons, for example, ragweed in the fall. The allergic reaction they cause is called seasonal allergic rhinitis or hay fever. Other allergens are present year-round, such as the mites in house dust. These allergens cause a type of rhinitis called perennial allergic rhinitis. When the lining tissues of the nose and sinuses come into contact with allergens, a chemical called histamine is released from cells in these tissues. Histamine causes the nose lining to swell, itch, and produce excess mucus. Common symptoms of allergic rhinitis are: -itchy, runny nose -sneezing -nasal and head congestion. The first step in treatment is to try to avoid contact with the things you are allergic to. For example, using an air conditioner and special filters rather than an attic fan lessens the amount of pollen that gets into your home. Putting plastic covers on mattresses may help you avoid dust and mold. You may also cover pillows with plastic. The second step is treatment with medicine. Your health care provider may suggest that you first try decongestants for mild symptoms. You may have some side effects from decongestants, such as a rapid heart rate or trouble sleeping. Sometimes these medicines can also raise your blood pressure. Antihistamine medicines can help treat and prevent allergy symptoms. There are different types of antihistamines. Drowsiness is a common side effect of many of them. This may not be a problem if a dose at bedtime is all you need. Or you might try the medicine for several days despite the drowsiness. Often the drowsiness goes away after you have taken the drug for 3 to 5 days. Some non sedating antihistamines are available that usually don't cause drowsiness. They work well for most people, but they tend to cost more than other antihistamines. Some people take antihistamines only on the days they are having symptoms. Others start the medicine at the beginning of their usual allergy season and continue taking it until the season is over. It is safe to take antihistamines and decongestants together if you do not have a medical reason for not taking either type of medicine. Your health care provider may prescribe a steroid nose spray. A nonprescription nose spray containing a medicine called cromolyn is also available. Depending on your other allergy symptoms, the nose spray may be the first and only medicine you need. If your symptoms are severe in spite of medicines, your health care provider may suggest allergy shots. A mixture is prepared that contains the allergens identified in your allergy tests. The mixture is injected into your skin in tiny but increasing amounts over the course of many months. Over time, the shots make you less sensitive to the allergens. Usually after 4 to 6 months of allergy shots you will begin to have relief from your allergies. However, you will probably need to continue the shots for 2 to 3 years or longer. Proper treatment of allergy symptoms is the best way to prevent complications of allergic rhinitis, such as ear and sinus infections. If you have had allergies since you were a child, you will probably have them the rest of your life. New allergies can develop any time, even if you have not had allergies before. Allergy symptoms depend not only on the season and weather but also on location. This means your allergies may wax and wane, depending on where you are living.