Allergic Rhinitis : Causes, Symptoms and Treatment
Allergic rhinitis or hay fever is a disease in which a person rapidly develops cold-like symptoms after coming in contact with certain substances (allergens). The symptoms occur because the body’s immune system reacts against an allergic substance(s). Allergic rhinitis affects 10-30% of the population globally [AAAAI]. Allergic rhinitis is mainly of two types, seasonal and perennial. Seasonal type causes symptoms in specific seasons (spring, summer or fall) and perennial type causes persistent symptoms throughout the year. Sometimes people may experience both types of allergic rhinitis with harsher symptoms during the seasons.
Signs and Symptoms of Allergic Rhinitis
Allergic rhinitis is associated with a wide range of cold-like symptoms, which are:
- Sneezing and coughing
- Runny nose
- Blocked nose
- Itchy nose
- Throat irritation
- Itchiness in the eyes
- Watery eyes
- Dark circles under the eyes
- Frequent headaches
- Patches of itchy and flaky skin
- Feeling exhausted
- Decreased concentration
- Limited activity
- Sleep disorders
- Problems remembering things
Most symptoms present themselves as soon as the person comes in contact with an allergen. Other symptoms occur depending on the extent of exposure to the allergens.
Causes of Allergic Rhinitis
Allergic rhinitis occurs when the body reacts strongly to various allergens. Some known allergens include grass and tree pollens, dust mites, dust, mold, animal hair and dander, etc. When an allergen enters the body, a chemical, histamine, is released to defend the body. As a result of this reaction, symptoms of allergic rhinitis appear. There may be other causes for rhinitis that may include a family history of allergic rhinitis and having allergic diseases such as asthma and atopic dermatitis. Also, some known irritants such as cigarette smoke, chemical fumes, humidity, air pollution, perfumes, wood smoke, etc, can cause and worsen this condition.
Diagnosis and Management of Allergic Rhinitis
The doctor diagnoses allergic rhinitis by linking the symptoms to an allergen. Complete patient history is taken to diagnose the disease. Allergy testing is also done to identify possible allergen causing the problem or triggering the symptoms. A small amount of allergen is exposed to the body by prick, scratch, intradermic, scraping, or patch test on the back or forearm. The exposed area is noticed for the allergic reaction. The allergen(s) that causes hives, rash, or anaphylaxis is considered the cause of the allergy. Management includes avoiding the allergens by:
- Using special air filters known as high-efficiency particulate air (HEPA) filters at homes to trap the allergens
- Using air dehumidifiers
- Washing bed sheets and blankets in hot water
- Limiting the number of carpets
- Minimizing contact with hairy animals
- Using special masks during allergy seasons
- Staying indoors during allergy seasons
Medical Treatment of Allergic Rhinitis
Some medications and therapies can help to control the symptoms and provide relief. These are:
- Intranasal corticosteroids: Corticosteroids administered as a spray in the nose help to ease the nasal symptoms such as sneezing, itching etc.
- Antihistamines: These drugs block the activity of histamine, thereby preventing allergic reactions. These drugs may be administered in the form of sprays, drops or tablets.
- Decongestants: These medications help to relieve the blockage of the nose. Oral tablets, in combination with an antihistaminic drug, are available over-the-counter (OTC).
- Nasal sprays: These sprays help to ease the nasal symptoms. They may contain a saline solution, ipratropium bromide or cromolyn and are available OTC.
- Leukotriene pathway inhibitors: Leukotriene is a substance in the body responsible for various allergic reactions. By using inhibitors of this substance, various allergic symptoms can be controlled.
- Eye drops: These are sterilized solutions to relieve eye allergies.
- Immunotherapy: Immunotherapy may also provide significant long-term benefits. It is performed by introducing the allergen through shots or sublingual tablets to develop a resistance to the allergen that helps in achieving long-lasting relief.