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This type of allergy causes cold-like signs and symptoms, such as a runny nose, itchy eyes, congestion, sneezing and sinus pressure. But unlike a cold, hay fever isn’t caused by a virus. Hay fever is caused by an allergic response to outdoor or indoor allergens, such as pollen, dust mites or pet dander.

Hay fever can make you miserable and affect your performance at work or school and interfere with leisure activities. But you don’t have to put up with annoying symptoms. Learning how to avoid triggers and finding the right treatment can make a big difference.

Symptoms of Hay Fever

Hay fever signs and symptoms usually start immediately after you’re exposed to a specific allergy-causing substance (allergen) and can include:

Runny nose and nasal congestion

Watery or itchy eyes

Sneezing

Cough

Itchy nose, roof of mouth or throat

Sinus pressure and facial pain

Swollen, blue-colored skin under the eyes (allergic shiners)

Decreased sense of smell or taste

Time of year can be a factor

Your hay fever symptoms may start or worsen at a particular time of year, triggered by tree pollen, grasses or weeds, which all bloom at different times. If you’re sensitive to indoor allergens, such as dust mites, cockroaches, mold or pet dander, you may have year-round symptoms. Many people have allergy symptoms all year long, but their symptoms get worse during certain times of the year.

The effects of age
Although hay fever can begin at any age, you’re most likely to develop it during childhood or early adulthood. It’s common for the severity of hay fever reactions to change over the years. For most people, hay fever symptoms tend to diminish slowly, often over decades.

Is it hay fever? Or is it a cold?

Signs and symptoms can be different. Here’s how to tell which one’s causing your symptoms:

Hay fever Signs and symptoms: Runny nose with thin, watery discharge; no fever

Colds: Runny nose with watery or thick yellow discharge; body aches; low-grade fever

Onset of Hay fever is Immediately after exposure to allergens while that of cold is 1-3 days after exposure to a cold virus

Duration for hay fever is as long as you’re exposed to allergens while that of colds is  3-7 days

When to see a doctor

See your doctor if:

You think you may have hay fever

Your symptoms are ongoing and bothersome

Allergy medications aren’t working for you

Allergy medications work, but side effects are a problem

You have another condition that can worsen hay fever symptoms, such as nasal polyps, asthma or frequent sinus infections

Many people — especially children — get used to hay fever symptoms. But getting the right treatment can reduce irritating symptoms. In some cases, treatment may help prevent more-serious allergic conditions, such as asthma or eczema.

You may want to see an allergy specialist (allergist) if:

Your symptoms are severe

Hay fever is a year-round nuisance

Allergy medications aren’t controlling your symptoms

Your allergy medications are causing troublesome side effects

You want to find out whether allergy shots (immunotherapy) might be an option for you

Causes of Hay Fever

During a process called sensitization, your immune system mistakenly identifies a harmless airborne substance as something harmful. Your immune system then starts producing antibodies to this harmless substance. The next time you come in contact with the substance, these antibodies recognize it and signal your immune system to release chemicals, such as histamine, into your bloodstream. These immune system chemicals cause a reaction that leads to the irritating signs and symptoms of hay fever.

Seasonal hay fever triggers include:

Tree pollen, common in the spring, Grass pollen, common in the late spring and summer, Ragweed pollen, common in the fall

Spores from fungi and molds, which can be worse during warm-weather months

Year-round hay fever triggers include:

Dust mites or cockroaches

Dander (dried skin flakes and saliva) from pets, such as cats, dogs or birds

Spores from indoor and outdoor fungi and molds

Hay fever doesn’t mean you’re allergic to hay. Despite its name, hay fever is almost never triggered by hay, and it doesn’t cause a fever.

Risk Factors of Hay Fever

The following factors may increase your risk of developing hay fever:

Having other allergies or asthma
Having a blood relative (such as a parent or sibling) with allergies or asthma
Living or working in an environment that constantly exposes you to allergens — such as animal dander

Complications

Problems that may be associated with hay fever include:

Reduced quality of life. Hay fever can interfere with your enjoyment of activities and cause you to be less productive. For many people, hay fever symptoms lead to absences from work or school.
Poor sleep. Hay fever symptoms can keep you awake or make it hard to stay asleep.
Worsening asthma. If you have asthma, hay fever can worsen signs and symptoms, such as coughing and wheezing.
Sinusitis. Prolonged sinus congestion due to hay fever may increase your susceptibility to sinusitis — an infection or inflammation of the membrane that lines the sinuses.
Ear infection. In children, hay fever often is a factor in middle ear infection (otitis media).

Tests and Diagnosis

Your doctor will ask detailed questions about your personal and family medical history, your signs and symptoms, and your usual way of treating them. Your doctor will also perform a physical examination to look for additional clues about the causes of your signs and symptoms. He or she may also recommend one or both of the following tests:

Skin prick test. During skin testing, small amounts of material that can trigger allergies are pricked into the skin of your arm or upper back and you’re observed for signs of an allergic reaction. If you’re allergic, you develop a raised bump (hive) at the test location on your skin. Allergy specialists usually are best equipped to perform allergy skin tests.
Allergy blood test. A blood test, sometimes called the radioallergosorbent test (RAST), can measure your immune system’s response to a specific allergen. The test measures the amount of allergy-causing antibodies in your bloodstream, known as immunoglobulin E (IgE) antibodies. A blood sample is sent to a medical laboratory, where it can be tested for evidence of sensitivity to possible allergens.

Treatment and Drugs

The best hay fever treatment is to avoid the substances that cause your reaction. However, this isn’t always possible, and you may need additional treatments along with strategies to prevent exposure.

If your hay fever isn’t too severe, over-the-counter medications may be enough to ease your symptoms. For more bothersome symptoms, you may need to take prescription medications. Many people get the best relief from a combination of allergy medications. It may take trying a few before you figure out what works best for you.

If your child has hay fever, talk with your doctor about the best treatment. Some medications are approved for use in children, while others are approved only for adults. If you want to try an over-the-counter medication for your child, be sure to read the labels carefully.

Medications for hay fever include:

Nasal corticosteroids. These prescription nasal sprays help prevent and treat the nasal inflammation, nasal itching and runny nose caused by hay fever. For many people they’re the most effective hay fever medications, and they’re often the first type of medication prescribed. Examples include fluticasone propionate (Flonase), triamcinolone (Nasacort AQ), mometasone (Nasonex) and budesonide (Rhinocort). Nasal corticosteroids are a safe long-term treatment for most people. Side effects can include an unpleasant smell or taste and nose irritation. Steroid side effects are rare.
Antihistamines. These preparations are usually given as pills. However, there are also antihistamine nasal sprays and eyedrops. Antihistamines can help with itching, sneezing and runny nose but have less effect on congestion. They work by blocking histamine, a symptom-causing chemical released by your immune system during an allergic reaction. Older over-the-counter antihistamines such as diphenhydramine (Benadryl) work as well as newer ones, but some types can make you drowsy. Newer oral antihistamines are less likely to make you drowsy. Over-the-counter examples include loratadine (Claritin, Alavert), cetirizine (Zyrtec Allergy) and fexofenadine (Allegra). The prescription antihistamine nasal sprays azelastine (Astelin, Astepro) and olopatadine (Patanase) can relieve nasal symptoms. Antihistamine eyedrops help relieve eye itchiness and eye irritation caused by hay fever.
Decongestants. These medications are available in over-the-counter and prescription liquids, tablets and nasal sprays. Over-the-counter oral decongestants include Sudafed and Drixoral. Nasal sprays include phenylephrine (Neo-Synephrine) and oxymetazoline (Afrin). Oral decongestants can cause a number of side effects, including increased blood pressure, insomnia, irritability and headache. Don’t use a decongestant nasal spray for more than two or three days at a time because it can actually worsen symptoms when used continuously (rebound congestion).
Cromolyn sodium. This medication is available as an over-the-counter nasal spray that must be used several times a day. It’s also available in eyedrop form with a prescription (Crolom). It helps relieve hay fever symptoms by preventing the release of histamine. Cromolyn sodium doesn’t have serious side effects, and it’s most effective when you begin using it before your symptoms start.
Leukotriene modifier. Montelukast (Singulair) is a prescription tablet taken to block the action of leukotrienes — immune system chemicals that cause allergy symptoms such as excess mucus production. It’s especially effective in treating allergy-induced asthma. It’s often used when nasal sprays can’t be tolerated, or when you have mild asthma. It can cause headaches. In rare cases, montelukast has been linked to psychological reactions such as agitation, aggression, hallucinations, depression and suicidal thinking. Seek medical advice right away for any unusual psychological reaction.
Nasal ipratropium. Available in a prescription nasal spray, ipratropium (Atrovent) helps relieve a severe runny nose by preventing the glands in your nose from producing excess fluid. It’s not effective for treating congestion, sneezing or postnasal drip. Mild side effects include nasal dryness, nosebleeds and sore throat. Rarely, it can cause more-severe side effects, such as blurred vision, dizziness and difficult urination. The drug is not recommended for people with glaucoma or men with an enlarged prostate.
Oral corticosteroids. Corticosteroid medications in pill form, such as prednisone, are sometimes used to relieve severe allergy symptoms. Because the long-term use of corticosteroids can cause serious side effects such as cataracts, osteoporosis and muscle weakness, they’re usually prescribed for only short periods of time.

Other treatments for hay fever include:

Allergy shots (immunotherapy). If medications don’t relieve your hay fever symptoms or cause too many side effects, your doctor may recommend allergy shots (immunotherapy or desensitization therapy). Over a period of three to five years, you’ll receive regular injections containing tiny amounts of allergens. The goal is to get your body used to the allergens that cause your symptoms, and decrease your need for medications. Immunotherapy may be especially effective if you’re allergic to cat dander, dust mites, or pollen produced by trees, grass or weeds. In children, immunotherapy may help prevent the development of asthma.
Rinsing your sinuses. Rinsing your nasal passages with distilled, sterile saline (nasal irrigation) is a quick, inexpensive and very effective way to relieve nasal congestion. Rinsing directly flushes out mucus and allergens from your nose. Look for a squeeze bottle or a neti pot — a small container with a spout designed for nose rinsing — at your pharmacy or health food store. Use water that’s distilled, sterile, previously boiled and cooled, or filtered using a filter with an absolute pore size of 1 micron or smaller to make up the saline irrigation solution.

Also be sure to rinse the irrigation device after each use with similarly distilled, sterile, previously boiled and cooled, or filtered water and leave open to air-dry

Ascariasis is a type of roundworm infection. These worms are parasites that use your body as a host to mature from larvae or eggs to adult worms. Adult worms, which reproduce, can be more than a foot (30 centimeters) long.

One of the most common worm infections in people worldwide, Most infected people have mild cases with no symptoms. But heavy infestation can lead to serious symptoms and complications.

Ascariasis occurs most often in children in tropical and subtropical regions of the world — especially in areas with poor sanitation and hygiene.

Symptoms of Round worm infection

Most people infected with ascariasis have no symptoms. Moderate to heavy infestations cause various symptoms, depending on which part of your body is affected.

In the lungs
After you ingest the microscopic ascariasis eggs, they hatch in your small intestine and the larvae migrate through your bloodstream or lymphatic system into your lungs. At this stage, you may experience signs and symptoms similar to asthma or pneumonia, including:

Persistent cough
Shortness of breath
Wheezing
After spending six to 10 days in the lungs, the larvae travel to your throat, where you cough them up and then swallow them.

In the intestines
The larvae mature into adult worms in your small intestine, and the adult worms typically live in the intestines until they die. In mild or moderate ascariasis, the intestinal infestation can cause:

Vague abdominal pain
Nausea and vomiting
Diarrhea or bloody stools
If you have a large number of worms in your intestine, you might have:

Severe abdominal pain
Fatigue
Vomiting
Weight loss or malnutrition
A worm in your vomit or stool
When to see a doctor
Consult your doctor if you have persistent abdominal pain, diarrhea or nausea.

Causes

Ascariasis isn’t spread directly from person to person. Instead, a person has to come into contact with soil mixed with human feces that contain ascariasis eggs or infected water. In many developing countries, human feces are used for fertilizer, or poor sanitary facilities allow human waste to mix with soil in yards, ditches and fields.

Small children often play in dirt, and infection can occur if they put their dirty fingers in their mouths. Unwashed fruits or vegetables grown in contaminated soil also can transmit the ascariasis eggs.

Life cycle of a worm
Ingestion. The microscopic ascariasis eggs can’t become infective without coming into contact with soil. People can accidentally ingest contaminated soil through hand-to-mouth contact or by eating uncooked fruits or vegetables that have been grown in contaminated soil.
Migration. Larvae hatch from the eggs in your small intestine and then penetrate the intestinal wall to travel to your lungs via your bloodstream or lymphatic system. After maturing for about a week in your lungs, the larvae break into your airway and travel up your throat, where they’re coughed up and swallowed.
Maturation. Once back in the intestines, the parasites grow into male or female worms. Female worms can be more than 15 inches (40 centimeters) long and a little less than a quarter inch (6 millimeters) in diameter. Male worms are generally smaller.
Reproduction. Male and female worms mate in the small intestine. Female worms can produce 200,000 eggs a day, which leave your body in your feces. The fertilized eggs must be in soil for at least 18 days before they become infective.
The whole process — from egg ingestion to egg deposits — takes about two or three months. Ascariasis worms can live inside you for a year or two.

Risk Factors

Age. Most people who have ascariasis are 10 years old or younger. Children in this age group may be at higher risk because they’re more likely to play in dirt.
Warm climate. In the United States, ascariasis is more common in the Southeast, but it’s more prevalent in developing countries with warm temperatures year-round.
Poor sanitation. Ascariasis is widespread in developing countries where human feces are allowed to mix with local soil.

Complications of Round worm infection

Mild cases of ascariasis usually don’t cause complications. If you have a heavy infestation, potentially dangerous complications may include:

Slowed growth. Loss of appetite and poor absorption of digested foods put children with ascariasis at risk of not getting enough nutrition, which can slow growth.
Intestinal blockage and perforation. In heavy ascariasis infestation, a mass of worms can block a portion of your intestine, causing severe abdominal cramping and vomiting. The blockage can even perforate the intestinal wall or appendix, causing internal bleeding (hemorrhage) or appendicitis.
Duct blockages. In some cases, worms may block the narrow ducts of your liver or pancreas, causing severe pain.

Tests and Diagnosis

In heavy infestations, it’s possible to find worms after you cough or vomit, and the worms can come out of other body openings, such as your mouth or nostrils. If this happens to you, take the worm to your doctor to identify it and prescribe the proper treatment.

Stool tests
Mature female ascariasis worms in your intestine begin laying eggs. These eggs travel through your digestive system and eventually can be found in your stool.

To diagnose ascariasis, your doctor will examine your stool for the microscopic eggs and larvae. But eggs won’t appear in stool until at least 40 days after you’re infected. And if you’re infected with only male worms, you won’t have eggs.

Blood tests
Your blood can be tested for the presence of an increased number of a certain type of white blood cell, called eosinophils. Ascariasis can elevate your eosinophils, but so can other types of health problems.

Imaging tests
X-rays. If you’re infested with worms, the mass of worms may be visible in an X-ray of your abdomen. In some cases, a chest X-ray can reveal the larvae in your lungs.
Ultrasound. An ultrasound may show worms in your pancreas or liver. This technology uses sound waves to create images of internal organs.
CT scans or MRIs. Both types of tests create detailed images of your internal structures, which can help your doctor detect worms that are blocking ducts in your liver or pancreas. CT scans combine X-ray images taken from many angles; MRI uses radio waves and a strong magnetic field.

Treatment and Drugs

Typically, only infections that cause symptoms need to be treated. In some cases, ascariasis will resolve on its own.

Medications
Anti-parasite medications are the first line of treatment against ascariasis. The most common are:

Albendazole (Albenza)
Ivermectin (Stromectol)
Mebendazole
These medications, taken for one to three days, kill the adult worms. Side effects include mild abdominal pain or diarrhea.

Bed-wetting is also known as nighttime incontinence or nocturnal enuresis. Generally, bed-wetting before age 7 isn’t a concern. At this age, your child may still be developing nighttime bladder control. If bed-wetting continues, treat the problem with patience and understanding. Bladder training, moisture alarms or medication may help reduce bed-wetting.

Symptoms of Bed Wetting

Bed-wetting is involuntary urination while asleep after the age at which staying dry at night can be reasonably expected.

Most kids are fully toilet trained by age 5, but there’s really no target date for developing complete bladder control. Between the ages of 5 and 7, bed-wetting remains a problem for some children. After 7 years of age, a small number of children still wet the bed.

When to see a doctor

Most children outgrow bed-wetting on their own — but some need a little help. In other cases, bed-wetting may be a sign of an underlying condition that needs medical attention.

Causes

No one knows for sure what causes bed-wetting, but various factors may play a role:

A small bladder. Your child’s bladder may not be developed enough to hold urine produced during the night.
Inability to recognize a full bladder. If the nerves that control the bladder are slow to mature, a full bladder may not wake your child — especially if your child is a deep sleeper.
A hormone imbalance. During childhood, some kids don’t produce enough anti-diuretic hormone (ADH) to slow nighttime urine production.
Stress. Stressful events — such as becoming a big brother or sister, starting a new school, or sleeping away from home — may trigger bed-wetting.
Urinary tract infection. This infection can make it difficult for your child to control urination. Signs and symptoms may include bed-wetting, daytime accidents, frequent urination, red or pink urine, and pain during urination.
Sleep apnea. Sometimes bed-wetting is a sign of obstructive sleep apnea, a condition in which the child’s breathing is interrupted during sleep — often due to inflamed or enlarged tonsils or adenoids. Other signs and symptoms may include snoring, frequent ear and sinus infections, sore throat, or daytime drowsiness.
Diabetes. For a child who’s usually dry at night, bed-wetting may be the first sign of diabetes. Other signs and symptoms may include passing large amounts of urine at once, increased thirst, fatigue and weight loss in spite of a good appetite.
Chronic constipation. The same muscles are used to control urine and stool elimination. When constipation is long term, these muscles can become dysfunctional and contribute to bed-wetting at night.
A structural problem in the urinary tract or nervous system. Rarely, bed-wetting is related to a defect in the child’s neurological system or urinary system.

Risk Factors of Bed Wetting

Several factors have been associated with an increased risk of bed-wetting, including:

Being male. Bed-wetting can affect anyone, but it’s twice as common in boys as girls.
Family history. If one or both of a child’s parents wet the bed as children, their child has a significant chance of wetting the bed, too.
Attention-deficit/hyperactivity disorder (ADHD). Bed-wetting is more common in children who have ADHD.

Complications

Although frustrating, bed-wetting without a physical cause doesn’t pose any health risks. However, bed-wetting can create some issues for your child, including:

Guilt and embarrassment, which can lead to low self-esteem
Loss of opportunities for social activities, such as sleepovers and camp
Rashes on the child’s bottom and genital area — especially if your child sleeps in wet underwear

Tests and Diagnosis

Your child will need a physical exam. Depending on the circumstances, your doctor may recommend:

Urine tests to check for signs of an infection or diabetes
X-rays or other imaging tests of the kidneys or bladder, if the doctor suspects a structural problem with your child’s urinary tract or another health concern
Other types of tests or assessments, if other health issues are suspected

Treatment and Management

Most children outgrow bed-wetting on their own. If there’s a family history of bed-wetting, your child will probably stop bed-wetting around the age the parent stopped bed-wetting.

If your child isn’t especially bothered or embarrassed by an occasional wet night, traditional home remedies may work well. However, if your grade schooler is terrified about wetting the bed during a sleepover, he or she may be more motivated to try additional treatments. The child’s and parents’ motivation can impact the selection of treatment and its success.

If found, underlying causes of bed-wetting, such as constipation or sleep apnea, should be addressed before other treatment.

Moisture alarms: These small, battery-operated devices — available without a prescription at most pharmacies — connect to a moisture-sensitive pad on your child’s pajamas or bedding. When the pad senses wetness, the alarm goes off.

Ideally, the moisture alarm sounds just as your child begins to urinate — in time to help your child wake, stop the urine stream and get to the toilet. If your child is a heavy sleeper, another person may need to listen for the alarm and wake the child.

If you try a moisture alarm, give it plenty of time. It often takes at least two weeks to see any type of response and up to 16 weeks to enjoy dry nights. Moisture alarms are effective for many children, carry a low risk of relapse or side effects, and may provide a better long-term solution than medication does. These devices are not typically covered by insurance.

Medication
As a last resort, your child’s doctor may prescribe medication to stop bed-wetting. Certain types of medication can:

Slow nighttime urine production. The drug desmopressin (DDAVP, others) boosts levels of a natural hormone (anti-diuretic hormone, or ADH) that forces the body to make less urine at night. But drinking too much liquid with the medication can cause problems with low sodium levels in the blood and the potential for seizures. So drinking only 8 ounces (237 milliliters) of fluids with and after the medication is recommended. Don’t give your child this medication if he or she has a headache, has vomited or feels nauseated. Desmopressin also may be used in short-term situations, such as going to camp.

According to the Food and Drug Administration, nasal spray formulations of desmopressin (DDAVP Nasal Spray, DDAVP Rhinal Tube, others) are no longer recommended for treatment of bed-wetting due to the risk of serious side effects.

Calm the bladder. If your child has a small bladder, an anticholinergic drug such as oxybutynin (Ditropan XL) may help reduce bladder contractions and increase bladder capacity. This medication is usually used in combination with other medications and is generally recommended only when other treatments have failed.

Sometimes a combination of medications is most effective. There are no guarantees, however, and medication doesn’t cure the problem. Bed-wetting typically resumes when medication is stopped.