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Home About Allergy Manifestation Allergic Rhinitis

  • Allergic Rhinitis
  • Signs and Symptoms
  • Diagnosis
  • Prevention
  • Treatment

What is allergic rhinitis(1,2)?

Allergic rhinitis is defined as allergic symptoms in the nasal passage. Allergic rhinitis can be seasonal (occurring during specific seasons) or perennial (occurring year round).

The allergens that most commonly cause seasonal allergic rhinitis include pollens from trees, grasses, and weeds, as well as spores from fungi and moulds. The allergens that most commonly cause perennial allergic rhinitis are house dust mites, cockroaches, animal dander, and fungi or moulds. Perennial allergic rhinitis tends to be more difficult to treat.

How does allergic rhinitis occur(1)?

This condition occurs when allergens (allergy-causing substances) come into contact with the nose, and usually also the ears, sinuses, and the throat.

When allergens come in contact with the lining of the nose and sinuses, they trigger the cells to release the chemical histamine, which causes the allergy.

Allergy Rhinitis

References:

  1. UMHS clinical care guidelines
  2. http://www.uptodate.com/contents/allergic-rhinitis-seasonal-allergiesbeyond-the-basics

What are the symptoms(1)?

  • Nasal congestion
  • Sneezing
  • Watery “runny nose”
  • Itchy eyes, nose, or throat
  • Puffy eyes or “allergic shiners”
  • Post nasal drip
  • Tears

These symptoms may occur during a certain season or year-long. They can occur at any age.

How does allergic rhinitis differ from a cold or flu(2)?

Allergic rhinitis lasts longer than a cold or flu, up to several weeks, and does not cause fever. The nasal discharge from allergic rhinitis is thin, watery and clear, while nasal discharge from a cold or flu tends to be thicker. Itching (mostly eyes, nose, mouth, throat and skin) is common with allergic rhinitis but not with a cold or flu. Sneezing is more prominent with allergic rhinitis and can occur in rather severe form.

What are the most common allergens(2)?

  • House Dust Mite
  • Pollen from trees, grass and weeds
  • Mould
  • Animal dander

References:

  1. UMHS clinical care guidelines
  2. http://www.uptodate.com/contents/allergic-rhinitis-seasonal-allergiesbeyond-the-basics

How will I know what I am allergic to(1)?

Your doctor will do a physical exam and will ask you about your symptoms and when they occur. Your doctor may also want to perform an allergy skin test to help determine exactly what is causing your allergy. An allergy skin test puts tiny amounts of allergens onto your skin to see which ones you react to.

Skin prick test

The skin prick test involves:

  • Placing a small amount of substances that may be causing your symptoms on the skin, most often on the forearm, only in exceptional cases, the skin of the prostrate back can be used as an alternative.
  • The skin is then pricked so the allergen goes under the skin’s surface.
  • The health care provider closely watches the skin for swelling and redness or other signs of a reaction. Results are usually seen within 15 to 20 minutes.
Diagnosis

Once you know which allergens you are allergic to, your doctor can decide what is the optimal treatment for you. Your doctor may also decide to do a blood test.

References:

  1. http://familydoctor.org/familydoctor/en/diseases-conditions/allergic-rhinitis.html

What preventive measures can you take(1)?

The best way to treat seasonal allergic rhinitis is to prevent attacks by reducing exposure to allergens.

There are several ways to reduce exposure:

  • Keep windows and doors closed and air conditioning on at home and in the car during allergy season. Avoid using fans that draw in outside air.
  • Run a dehumidifier to keep humidity low.
  • Stay indoors when possible and minimize outdoor activity during peak pollen periods.
  • Avoid contact with freshly cut grass.
  • Shower or bathe and change clothing after outdoor activities.
  • Dry clothes in a dryer; do not hang clothes outside to dry, if possible in a separate room.

Do

  • Eliminate mite reservoirs: Plastic encase pillows and mattresses Wash bedding weekly (140° F or 60° C)
  • Remove carpets, feather/down bedding and pillows, stuffed animals
  • Reduce upholstered furniture to a minimum
  • Keep humidity 25-45%
  • Use air conditioner and dehumidifier
    Use air filtration measures:
    - Portable HEPA filters - Vacuum cleaning - Exposure to heat or cold
  • Do not hang clothes in damp cupboards or pack clothes too tightly in wardrobes. Leave wardrobe doors ajar to ventilate the clothes.
  • Keep houseplants to a minimum and change the soil regularly.
  • Remove piles of old newspaper.

Avoid

  • Too-tight houses (use outdoor ventilation in spring and fall)

Do

  • Close windows and doors
  • Wear loose, light clothing outdoors; shower, change, and wash clothes in hot water after each use
  • Vacation away during peak pollen season
  • Keep humidity 25-45%
  • Use air conditioning

Avoid

  • Using fans
  • Using fansFlowers indoors, direct contact with plants (e.g., weeding)
  • Going outdoors on hot, dry days

Do

  • Keep humidity at 25-45% Clean surface with mould inhibitors/ chlorine bleach
  • Let window/car air conditioner run at full blast 3-5 minutes with window open when first turned on
  • Vent clothes dryers, stoves, and bathrooms to outdoors
  • Ventilate closets (use incandescent light bulbs)
  • Empty and clean garbage cans frequently

Avoid

  • Leaks, old wallpaper
  • Basements
  • Old books, poorly ventilated- and
  • Poor air-conditioned libraries

Do

  • Allergy bedding covers
  • Filter facemasks
  • Open windows and close internal kitchen and bathroom doors when cooking, showering or bathing
  • Keep houseplants to a minimum
  • Remove piles of old newspaper

Avoid

  • Do not spend time in buildings where hay or grain is stored
  • Do not go into damp and musty buildings
  • Do not walk in mild damp conditions or among rotting leaves Outdoor activities at sunset
  • Sleeping/camping out

Do

  • Clean fanatically as dog dander can get everywhere
  • Remove carpets, too much furniture
  • Filter air
  • Keep animal out of bedroom

Avoid

  • Keep distance from the animal
  • Be wary of visitors who own animals
  • Keeping a pet

References:

  1. www.jama.com; JAMA, December 19, 2001—Vol 286,No. 23

What is the treatment for allergic rhinitis(1)?

A number of medications, including antihistamines, intranasal corticosteroids, and decongestants are available to control symptoms. Allergen immunotherapy consists of a series of allergy shots that help prevent or decrease allergic reactions.

Allergen immunotherapy could provide long lasting benefit. You can “train” your immune system not to react exaggerated to an allergen anymore. This is done through a series of allergy shots called immunotherapy. One to two weekly shots expose you to very small doses of the allergen, that causes an allergic reaction. The dose is gradually increased, usually during a three-to six-months period. Maintenance shots are needed every four weeks for three to five years. Immunotherapy is usually used when other treatments like antisymptomatic medication are not satisfactory.

References:

  1. www.jama.com; JAMA, December 19, 2001—Vol 286,No. 23
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