What is Allergic Rhinitis
Allergic rhinitis (AR) is a very common problem common affecting adults and children alike. AR is one of the most common conditions that affect our Quality of life over the long term. AR can be defined as swelling of the inside lining of the nose that occurs when a person inhales something he/she is allergic to. Patients can have allergies at different times of year or when exposed to different allergens. AR can also affect a person’s quality of life, by interfering with everyday activities. In children, allergic rhinitis can be linked to disorders of learning, behavior, and attention
How does allergic rhinitis occur?
In allergic reaction the inflammatory response causes release of certain chemicals which result in collection of fluid in the lining of the nose (congestion), itch nose, running nose and sneezing.
The symptoms can range from mild to severe. Symptoms are mild when they do not interfere with quality of life. Symptoms are more severe when they are bad enough to interfere with quality of life.
Allergic rhinitis can happen during a particular season or all the year round. Pollen,weeds, grass, fungus are common allergens if your AR is seasonal.
If you have sneezing and running nose almost all the year round, you may have perennial allergic rhinitis.Dust mites, animal hair, and fungus may commonly contribute to this.
Allergic Rhinitis Symptoms
Different people have varying degrees of symptoms. The nasal complaints are referred to as “rhinitis” but often people have other issues as well, as mentioned below. We consider all symptoms when treating anyone with Allergic disease.
- Nose – Nasal discharge is often watery, nasal passages may be blocked, sneezing, itchy nose, postnasal drip (the sensation that mucus is draining from the sinuses down the back of the throat), loss of smell andfacial pressure.
- Eyes – Itching in the eyes, redness, with watering.
- Throat and ears – Itchy throat, hoarseness, congestion or popping of the ears, itching of the ears.
- Sleep – Mouth breathing, snoring, sleep disturbance resulting in , daytime tiredness that could affect performance at work.
Asthma is a related condition, which may occur with allergic rhinitis. In Asthma there is swelling and narrowing of the lower airway that causes difficulty breathing. Asthma may or may not be allergy related and a chest physician can help treat this.
How is Allergic Rhinitis diagnosed
Our team has an Allergy Specialist doctor as well and we work jointly to advise you the best way forward in the diagnosis and management of your Allergic Rhinitis.
The doctors understand the history and your symptoms as well as carry out a detailed examination. We may advise a nasal endoscopy and/or imaging like X –ray or CT scan to rule out other conditions that can mimic or aggravate your symptoms.
The allergy specialist advise that we carry out an allergy test when diagnosis is uncertain, or to confirm what all you might be allergic to.This testing can include skin or blood allergy testing.Our Allergy Specialist may use the results to target therapy for a specific allergy (immunotherapy) if relevant.
If you experience any symptoms you can book an appointment at Adventis for Allergy testing
How do we treat Allergic Rhinitis
Treatment for Allergic Rhintis is a multi-pronged approach.
Reducing or avoiding exposure to potential triggers is key in the treatment of Allergic Rhinitis.
For more details, please see the leaflet on Allergen Avoidance Advice.
Nasal irrigation and saline sprays
Nasal irrigation ordouchingis a very simple method to clean the inised of the nose. It is performed by rinsing the nose with a salt water (saline) solution. Nasal irrigation is particularly useful for treating post nasal drip and other symptoms like sneezing, nasal dryness, and congestion. The treatment helps by rinsing out allergens and irritants from the nose. It is also advised to do this before the use of any medicated sprays to get a better effect from the medication itself.
Steroidal Nasal Spray
Steroidal nasal spray are the most effective medications to reduce and prevent nasal allergy symptoms. Steroid nasal sprays are used frequently with a low chance of side effects: Sometimes they may cause nasal dryness or nosebleeds, but this can generally be avoided by correct spray technique and by using saline sprays.
Because steroid sprays take several days to work, they must be used daily as directed. Relief from symptoms cannot be expected for five to ten days, even with correct use. These sprays should be used one to two weeks before a seasonal allergy period. For patients with only seasonal allergy symptoms, these sprays can be stopped when the allergy season is over. Patients with year round allergy symptoms (perennial allergic rhinitis) will also benefit from steroid nasal sprays. In all cases, correct use of the sprays is essential to ensure the maximal benefit.
Decongestants cause shrinkage of swollen tissues in the nasal cavity and widen passages for breathing. Decongestant are NOT recommended for allergic rhinitis since they can cause an increase in congestion if used for longer than five days at a time. Oral decongestants (pills) are preferred for a short duration; however, patients with high blood pressure, those taking tricyclic antidepressants and men with prostate enlargement should avoid oral decongestants.
Anti histamines block the effect of histamine on cells and can prevent the classic allergic reaction. Antihistamines are most effective when taken before allergen exposure. They relieve the “wet” symptoms such as sneezing, itching, and runny nose and eyes but are less effective on congestion, for which a decongestant may be added. Anti-histamine tablets provide relief, though most of them may also cause drowsiness.Given at the beginning of an attack, they are effective in lessening itching, sneezing and running of the nose. Newer anti-histamines are longer-acting and cause less drowsiness.
Immunotherapy, or “allergy shots,” is the only measure that offers a “cure” for allergies. Shots would be a good fit for patients whose symptoms are hard to control with other medications, those who have a hard time avoiding certain allergens, and those with year-long symptoms or severe symptoms. Patients must be able to follow the program plan to receive allergy shots. You can discuss this with our Allergy Specialist to see if this is an option for you.
See here for more details on Immunotherapy.
Surgery is advisable only when there is nasal airway blockage that does not respond to medication. This treatment is called Inferior Turbinate Reduction, a simple procedure, which can be done when someone has nasal blockage and has not responded to medical treatment.
See here for more details on Turbinate Redution.