Allergic Rhinitis

It is an exaggerated reaction of the nasal lining to the allergens in the air, which are usually harmless but can cause problems in sensitive people. Although it is not a life threatening condition, it can significantly impair quality of life and work and school performance.

 

Common Causes:

 

When it is caused by outdoor allergens such as pollens from grass, weeds or trees, it is called seasonal allergic rhinitis (hay fever). When it is caused by indoor allergens like house dust mites, moulds or cockroach droppings, it is called perennial allergic rhinitis. One can have either seasonal or perennial allergic rhinitis, or a combination of both.

 

 

Medical Symptoms:

 

Common symptoms are sneezing, runny nose, itchy eyes, blocked nose, postnasal drip and decreased sense of smell. Allergic Rhinitis can contribute to other problems such as bronchial asthma, sinus disease, ear disease and sleep disturbances.

 

Familial Tendency:

 

Allergic rhinitis may coexist with other allergic disorders such as food allergies, bronchial asthma and eczema. You are more likely to develop these diseases if there is a strong family history of allergic disorders

 

 

Medical Treatment:

 

There is no cure for Allergic rhinitis but different options are available to control the symptoms.

 

1 – Allergens avoidance

2 – Medications

3 – Immunotherapy

4 – Sublingual Immunotherapy

 

1 – Allergen avoidance

 

Allergen avoidance is the most effective way to control the symptoms but it is not always possible. Because of the widespread presence in the outdoor air, pollens can be difficult to avoid. Reduction of outdoor exposure during the season can be somewhat helpful.

Indoor allergens can be controlled by appropriate measures. For dust mites, covering the mattresses and pillows with impermeable covers helps reduce exposure. It is very difficult to clear carpets and rugs from dust mites so they should be removed from house. Dust mites thrive when indoor humidity is more than 50%, dehumidification or air conditioning is helpful. For animal allergy, complete avoidance is the best option. Cockroach extermination may be helpful for cases of cockroach sensitivity.

Nonspecific triggers like smoke, strong perfumes and rapid changes in temperature should be avoided as much as possible

 

2 – Medication

 

Most cases of allergic rhinitis respond to medication. Patients with intermittent symptoms can be treated adequately with non-sedating antihistamine and decongestant. Regular use of intranasal steroid spray may be more appropriate for patients with chronic symptoms. In some cases short course of oral corticosteroid may be very helpful.

 

3 – Immunotherapy (Desensitization)

 

In some patients it is an effective and sustainable mode of treatment. It is a long term process, improvement is often not observed for 6-12 months. Immunotherapy is not without risk because severe systemic allergic reactions can sometimes occur. Therefore, careful consideration of risks and benefits of immunotherapy is required in every patient.

 

4 – Sublingual immunotherapy

 

Sublingual immunotherapy (SLIT) is an alternative way to treat patients affected by allergies without injections.

Sublingual immunotherapy decreases the use of allergy medications, such as nasal steroids and antihistamines. Sublingual immunotherapy is more time-efficient for patients than subcutaneous immunotherapy. Treatments are kept and taken at home at the patient’s convenience.

After the patient has had an allergy test to confirm the patients sensitive’s, an allergen extract is prepared in drop or tablet form and the patient is directed to keep it under the tongue for one to two minutes and then swallow it. The process is repeated from three days a week to as often as daily with recommendations that therapy is continued for three to five years to develop a lasting immunity.

 

Surgery:

 

Surgery is reserved for patients who wish to have a clear nose. It is designed  to shrink the inferior turbinate and allow for more airflow through the nose. It is a simple day procedure which can allow you to return to work after 7 days.