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What is rhinitis?
The nose is separated into two passages by a wall of cartilage called the septum and is lined with a membrane that produces mucus. The mucus, a thin clear liquid, traps small particles and bacteria that are drawn into the nose as a person breathes. The trapped bacteria usually remain harmless in healthy individuals. Normally, a cycle of congestion and decongestion occurs continuously throughout the day. When one side of the nose is congested, air passes through the open, or decongested, side. The sides alternate between being wide open and being narrowed.
What is allergic rhinitis?
Allergic rhinitis is an soreness or irritation of the mucous membranes that line the nose. Common symptoms include sneezing; a stuffy or runny nose; itchy eyes, nose and throat; and watery eyes. You may also have a nasal voice; breathe noisily; snore; feel chronically tired; have a poor appetite; feel nauseated; have frequent headaches; and, have some difficulty hearing and smelling
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Causes
Allergic rhinitis happens when an allergen (an allergy-producing substance, such as pollen) causes your body to defend itself by producing antibodies. When an allergen and an antibody combine, your body releases histamine and other chemical substances into your bloodstream, which causes an allergic response. Pollen, dust, mold or other substances that can be inhaled, are common allergens that cause symptoms.
Seasonal allergic rhinitis usually results from tree, grass, weeds or pollen and is experienced during summer. Perennial allergic rhinitis can cause year-round symptoms. This allergic reaction is the result of indoor irritants such as feathers; mold spores, animal danders (hair and skin shed by pets), or mould spores, which are carried in the air.
What are the signs and symptoms of allergic rhinitis?
Signs of allergic rhinitis are similar to signs of a common cold. But, unlike common cold symptoms, allergic rhinitis can last for more than 8-10 days and may include:
- A stuffy nose or a runny nose.
- Sneezing.
- Itchy nose, itchy eyes or watery eyes.
- Children who have allergic rhinitis might have dark circles under their eyes, or use the palm of their hand to push their nose up as they try to stop the itching (called the "allergic salute").
- Coughing caused by clear mucus running down the back of your throat
Treatment
The best treatment for your allergy is to avoid the allergen. When this is not possible, medication can usually control the symptoms of a reaction. These medications are used to treat allergic rhinitis:
Antihistamines block the action of the histamine (the substance which triggers the reaction). They are considered the "mainstay of treatment." They are more effective when taken around the clock. They can cause you to become drowsy, especially if you combine them with alcohol. Other side effects include dizziness, blurred vision, insomnia, tremors, nausea and dry mouth. If any of the side effects are a problem, discuss them with your practitioner
Decongestants can give short-term relief from nasal stuffiness. However, many decongestants promote histamine release. This can cause a "rebound" effect that ultimately makes you even more congested than before. Use them only on a short-term, special occasion basis (i.e., unable to sleep for several nights, a test, a date, etc.).
Corticosteroids may lessen your allergic reaction by preventing body cells from responding to histamine. For allergic rhinitis, these compounds are administered via a nasal spray. Minimal side effects have been found even with chronic use at customary dosage. For profound allergy symptoms, a one-time very short course of systemic cortisteroid may be considered as a last resort.
Cromolyn sodium inhibits the body's release of histamine after exposure to an antigen, which can lessen or stop the allergic response. If you are allergic to a substance that you are exposed to occasionally, you would only take this medication prior to exposure. Side effects are minimal. Unfortunately, not everyone is helped by this medication.
Immunotherapy or (allergy shots) are also used in cases of allergic rhinitis. It is effective only when a specific allergen can be identified. Since you are allergic to the substance injected, you may experience severe allergic responses. Therefore, if you undergo immunotherapy, you should work closely with your physician and report any symptoms of reaction to the injection. Immunotherapy is not a "quick fix" and may take six months before effectiveness is noted. It is very helpful for many people.
Prevention
You cannot prevent an allergy, but you can prevent a reaction. The most effective method you can use to prevent a reaction is to avoid the allergen that triggers your allergic response. Try these steps:
- Although its best not to have pets when you have allergic rhinitis, washing your pet once a week and keeping it out of the bedroom and off the furniture will help.
- Put pillows and mattresses in sealed plastic covers that keep out dust mites
- Wash sheets in hot water every week.
- Feathers, foam rubber, or pillows more than five years old are often allergens.
- Keep windows closed, so that there will not be so many pollens and molds in the house
- Wearing a mask when cleaning the house
- Rid your home of indoor plants
- Use synthetic materials for your bedding, pillow and blankets
- Sleep with the head of bed elevated to relieve nasal congestion
- Observe good health by exercising daily, eating balanced food and avoiding pollutants
- Stop smoking
- Move out decorative pillows, books, and stuffed animals
- Store clothing so dust will not settle on it
CONTACT:
Dr.Kumaresh Krishnamoorthy, M.S (ENT)
Head and Neck Surgery Fellowship (Buffalo, USA)
Neurotology & Skull Base Surgery Fellowship (Cincinnati, USA)
Senior Consultant in ENT - Head and Neck Surgeon and Skull Base Surgeon
Apollo Hospitals, 154/11, Bannerghatta Road, BANGALORE 560 076, INDIA
Phone: 91-(0) - 99002 36819
Email: drkumaresh@drkumaresh.com.
For the columns authored by Dr.Kumaresh Krishnamoorthy in "Dr.Kumaresh Krishnamoorthy Column", please click here.
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