By Dr. Andreas Schapowal
Allergic rhinitis, whether seasonal or constant, are characterized by sneezing, runny nose, blocked nasal passages, itchy eyes and throat, and runny eyes.
Although the term hay fever is commonly used for seasonal allergic rhinitis, it is inappropriate because the symptoms are neither produced by hay nor associated with fever. Allergic rhinitis is caused by pollen allergens falling on the mucous membranes of the nose, resulting in a hypersensitivity reaction.
Butterbur (Petasites hybridus; butter dock, bog rhubarb, exwort) is an Asteraceae herbaceous plant native to Europe, northern Africa, and south western Asia.
Extracts of butterbur have been used in bronchial asthma, smooth muscle spasms, and headache, and studies have shown that they inhibit the biosynthesis of leukotrienes, which may be associated with antispasmodic activity and anti-inflammatory hypersensitivity.
The usual treatment for seasonal allergic rhinitis is antihistamines. These reduce the runny nose and sneezing but are less effective for nasal congestion and may cause sedation and drowsiness.
The availability of steroid nasal sprays without prescription has increased their use by patients with allergic rhinitis. Similarly, antihistamines can be obtained over the counter for treatment of hay fever, and all may interact with alcohol and decrease driving ability.
Value of Butterbur
The study found that the butterbur was comparable in effectiveness to antihistamines when judged separately and blindly by patients and their doctors.
With regard to safety, butterbur was well tolerated and did not have the sedative effects associated with antihistamines. Fatigue and drowsiness accounted for two thirds of the side effects reported in the antihistamine group.
Butterbur can be found growing along rivers, ditches, and marshy areas in northern Asia, Europe, and parts of North America. It sends up stalks of reddish flowers very early in spring, before producing very large heart-shaped leaves with a furry gray underside.
Once the leaves appear, butterbur somewhat resembles rhubarb-one of its common names is bog rhubarb. It is also sometimes referred to as "umbrella leaves" due to the size of its foliage. Other more or less descriptive common names abound, including blatterdock, bogshorns, butter-dock, butterly dock, capdockin, flapperdock, and langwort.
Butterbur is often described as possessing an unpleasant smell, but being malodorous has not affected its popularity. The plant has a long medicinal history, including use for stomach cramps, whooping cough, and asthma.
Source: British Medical Journal January 19, 2002; 324:144