Do you fear season change as it causes frequent sneezing, sore throat and cold?

Are you allergic to dust, pollen or similar?

If the answer is yes, then you are mostly suffering from Allergic rhinitis

According to the American Academy of Allergy, Asthma and Immunology, approximately 10-30% of people suffer from allergic rhinitis worldwide. Tree pollen, ragweed, animal dander, dust and mold are some of the common allergens that cause allergic rhinitis and are most common in the age group of 20-40.

Allergic symptoms are miserable and usually affect the quality of life, but they can be managed effectively with the help of medication and lifestyle modifications.

What is Allergic Rhinitis

What is Allergic Rhinitis?

Allergic Rhinitis is a type of inflammation in the nose, caused by the overreaction of the immune system to the allergens.

Some people suffer from allergic symptoms, when the season changes (like at the beginning of spring or fall season), while others suffer from allergic symptoms all year round.

Signs and symptoms of Allergic Rhinitis

Signs and symptoms of allergic rhinitis can differ from person to person. They can range from mild to moderate and may cause complications of allergic rhinitis at a later stage.

Signs and symptoms of allergic rhinitis

Some of the common symptoms of allergic symptoms are:

  • Increased nasal discharge (rhinorrhea)
  • Blocked nose
  • Frequent sneezing
  • Itching in nose, eyes, ear, throat and skin
  • Increased congestion in nose and throat
  • Increased mucus secretion in nose and throat
  • Eye symptoms like redness and swelling of eyes; watery discharge from eyes
  • Ear symptoms like blocked ear or ear popping.
  • Sore throat (in some cases)
  • General symptoms like headache, fatigue, irritability, general feeling of discomfort, dark circles around the eyes, reduced concentration, poor sleep quality (due to nasal obstruction) etc.
Types of allergic rhinitis

Types of Allergic Rhinitis

Seasonal Allergic Rhinitis:

As the name suggests, seasonal allergic rhinitis occurs during the change of season, usually in the spring, summer and early fall seasons. Environmental factors like tree, grass and ragweed pollen are common allergens that cause seasonal allergic rhinitis.

Perennial allergic rhinitis:

This type of allergic rhinitis occurs all year-round. Indoor allergens like pet dander, dust, mold, etc. can be a primary cause of perennial allergic rhinitis and the symptoms persist irrespective of the season.

Occupational allergic rhinitis:

This is another common type of allergic rhinitis caused by work-related exposure to certain chemicals or irritants.

Causes of Allergic Rhinitis

Genetic factor:

Although allergies can affect anyone, having a family history of allergies increases the chance of developing allergic rhinitis, making you more susceptible to it. A family or personal history of other allergic disorders like asthma, atopic dermatitis also increases the risk of developing allergic rhinitis symptoms.

Causes of allergic rhinitis

Environmental factor:

These are some common environmental factors (external allergens) that increase the risk of developing allergic rhinitis.

  • Cigarette and tobacco smoke
  • Irritating fumes
  • Increased air pollution
  • Wood smoke
  • Perfumes and aerosol spray
  • Cold temperature
  • Wind
  • Humidity
Pathology of allergic rhinitis

Pathology of allergic rhinitis. (How do allergic rhinitis symptoms develop?)

These allergens (like animal dander, tree pollen) remain harmless and do not cause any symptoms in most people. However, in sensitive individuals, these allergens cause overreaction in the immune system, leading to allergic rhinitis symptoms.

When sensitive individuals inhale these irritants or allergens through the nose or mouth, their body defends and releases the inflammatory chemical histamine from mast cells as a defensive mechanism. Releasing histamine from mast cells causes the development of common allergic rhinitis symptoms.

Diagnosis of Allergic Rhinitis

Most often, the diagnosis is made by your healthcare provider based on a full health history and physical examination. Besides the above signs, the healthcare provider may find:

  • Dark circles under the eyes (more common in children)
  • Creases under the eyes
  • Swollen tissues inside the nose
  • Mouth breathing
diagnosis of allergic rhinitis

Your doctor may also perform a skin allergy test and a blood test to determine your allergy triggers.

Types of Tests

Skin prick allergy test:

In this test, few different allergens are inserted into the skin. Doctor records, analyzes and reviews the individual allergic reaction caused by different allergens.

Blood Test

A blood test to check the immunoglobulin E (IgE) antibody is another useful diagnostic test that helps in confirming allergic rhinitis diagnosis. This test measures the level of IgE antibodies in the blood and helps in the detection of allergies to a particular substance.

A complete blood count test (CBC) helps diagnose allergic rhinitis. People with allergies usually have an elevated eosinophil count.

treatment and management

Treatment and Management

The treatment of allergic rhinitis involves the use of various medications that include pills, nasal spray and allergy shots.

Here are some common effective medications for allergic rhinitis:

Antihistamines:

Antihistamines are the most commonly used medication for treating allergic rhinitis symptoms. They work by blocking the action of histamines and help in controlling allergic symptoms. Although antihistamine medication is available as over-the-counter medication, some of these may cause side effects like sleepiness and drowsiness. It could also interfere with other medications or existing health conditions, hence talk to your doctor before starting any medications. Cetirizine, levocetirizine and fexofenadine are some of the commonly used antihistamine medications.

Decongestants:

Decongestants help reduce the symptoms of nasal congestion. Decongestants are available as tablets, syrups, drops and sprays, however long-term use may cause other side effects. Some decongestants may increase blood pressure. It is best to take professional advice before using them. Pseudoephedrine and phenylephrine are some commonly used decongestants.

Corticosteroids Nasal sprays:

Corticosteroids nasal sprays are effective medication for allergic rhinitis. They help in reducing nasal congestion and relieve allergic symptoms. They are recommended to be used for the long term; for better control of allergy symptoms.

Leukotriene inhibitors:

Leukotriene is a type of chemical that the body releases as a defensive mechanism when exposed to allergens. Leukotriene inhibitors help to block the leukotriene secretion and control allergic symptoms.

Immunotherapy (allergy shots):

Immunotherapy is used for severe cases of allergic rhinitis. In this therapy, allergy shots are used to decrease your immune response to a particular allergen. This is a long-term treatment plan. In each setting, the doctor increases the dose of allergens and helps you in developing immunity against particular allergens. This is a long-term treatment plan and requires commitment from patients.

Lifestyle Modification

  • Know your allergy triggers and limit exposure: This is one of the important aspects of controlling allergic symptoms. If you are well aware of your allergy triggers (like tree pollen or ragweed pollen), then try to avoid them and limit exposure. Use protective measures, such as wearing a mask or sunglasses, to protect yourself if you have to go outside. Take a quick shower after outdoor activity, to avoid taking pollen to your bed.
  • Salt-water irrigations and rinses for the nose: Salt water or saline rinses and irrigations are an effective method for removing irritants, such as pollens, from the nose. Warm saline rinses can be done once or twice a day to help reduce symptoms. Saline solutions can be purchased or made at home by diluting non-iodized salt in boiled, distilled, or sterile water (to prevent infection, never use regular tap water). You can use saline irrigations and rinses with a bulb syringe, neti pot, or spray bottle. You should also clean your irrigation bottle, bulb syringe, or neti pot after each use with distilled, sterile, or boiled water.
Lifestyle modification
  • Keep your indoor atmosphere and other household items clean by taking appropriate measures: This is an important aspect for reducing dust mite exposure. Try to keep surfaces dust free and clean your carpet by using a vacuum with a HEPA filter. Keep your air conditioner filter clean. Once a week, wash your pillow covers, bed sheets in hot water. Use “Dust mite proof” mattresses, pillow covers and box springs to minimize dust mite exposure.
  • Pet dander: Ideally, try to limit or avoid exposure to any animal you are allergic to. If this is not possible, then keep your furry friend clean and avoid them near the bed. Wash your hands properly, after touching and handling them.
  • Use a dehumidifier and keep your bathroom, kitchen and other surfaces clean and mold-free.
  • Adopt healthy lifestyle practices: Following healthy lifestyle practices like eating nutritious food, regular exercise and managing stress levels helps a lot in managing allergic symptoms.
  • Take your prescribed medication regularly and follow your doctor’s advice.

Complications of Allergic Rhinitis

When left untreated, allergic rhinitis can cause complications.

  • Chronic allergic rhinitis often causes blocked airways and results in disturbed sleep and other sleep disorders like sleep apnea. Poor sleep causes drowsiness and reduced concentration during day time. In the long run, it creates a negative impact on productivity and decreases quality of life.
  • Allergic rhinitis increases the chances of developing asthma symptoms. If you are already suffering from asthma, it may make your asthma worse.
  • When left untreated, allergic rhinitis also causes other nasal and respiratory diseases like chronic nasal obstruction, sinusitis, ear infection and upper respiratory infections.

The prognosis (outlook) of Allergic Rhinitis

Allergic rhinitis is not a life-threatening condition. Though allergic symptoms are miserable and affect the quality of life negatively, medication and lifestyle modification can help manage them effectively.