Allergic rhinitis
Rhinitis is a term used to describe the irritation and inflammation of the lining of the nose often resulting in persistent cold-like symptoms in affected individuals.
Symptoms
Common atopic eczema symptoms include:
- sneezing
- itchy, blocked or runny nose
- red, itchy or watery eyes
- itchy throat, inner ear or mouth
- headaches
- a loss of concentration and generally feeling unwell
Rhinitis can be categorised into:
Infective rhinitis–symptoms are caused by viral infection resulting in the “common cold”.
Non allergic rhinitis- rhinitis symptoms such as itchy throat etc are induced by drugs such as aspirin and non-steroidal anti-inflammatory drugs (NSAID) in susceptible individuals. Hormonal changes as observed during pregnancy and menstrual cycle can also trigger non-allergic rhinitis symptoms.
Allergic rhinitis- an allergic reaction often triggered by exposure to pollen, mold, and pet dander etc. results in symptoms typically associated with rhinitis.
There are two main forms of allergic rhinitis :
- Intermittent allergic rhinitis (IAR) a prime example of this is hay fever which lasts for a period of weeks due to high pollen count during the spring/summer season.
- Persistent allergic rhinitis (PAR) which occurs throughout the year due to constant exposure to the allergen.
ALLERGIC RHINITIS: Classification of allergic rhinitis |
| (IAR) |
Symptoms are present less than 4 days a week or for less than 4 consecutive weeks |
(PAR) |
Symptoms are present for more than 4 days a week and for more than 4 consecutive weeks |
| Disease Severity |
| Mild |
- None of the following items are present:
- Sleep disturbance
- Impairment of daily activities, leisure and/or sport
- Impairment of school or work
- Symptoms present but not troublesome
|
Moderate/Severe |
- One or more of the following items are present:
- Sleep disturbance
- Impairment of daily activities, leisure and/or sport
- Impairment of school or work
- Troublesome symptoms
|
Cause
Allergic rhinitis is caused by the sustained overproduction of antibodies by the body’s immune system in response to allergens such as pet dander, pollen etc. The production of specific antibodies called IgE induces the release of chemicals including histamine, which results in allergic rhinitis symptoms.
Allergic rhinitis is similar to asthma in that is caused by a combination of genetic and environmental factors. It is common for patients with a family history of eczema (a form of allergic reaction) and rhinitis to be diagnosed with asthma. Over 80% of asthma patients have rhinitis, effective management and treatment of both conditions result in a better outcome for the patient.
Allergens can be found indoors and outdoors, these include:
- Pollen (e.g. from grass, birch trees, nettles)
- Dust mites
- Mould spores
- Pet dander – dead skin, hair, urine, saliva (e.g. from cat, dog, horse)
- Food (e.g. shellfish, peanuts, milk, egg)
- Insect stings (e.g. from wasps and bees)
- Medicines (e.g. some antibiotics)
Diagnosis
Rhinitis is often diagnosed by the physical examination of the lining of the nose. Your GP will also ask for detailed symptoms and also try to establish whether symptoms occur due to contact with known triggers. This will help to build a complete medical history.
Allergic responses to triggers are confirmed with the aid of a "skin prick test" and/or "IgE blood test". Identifying allergens makes it easier for patients to avoid or minimise contact with known triggers.
Treatment and prevention measures
Antihistamines oral tablets and nasal spray- provide immediate relief to symptom such as itchy throat, sneezing etc.
Decongestant sprays- may be used to relieve congested nose.
Steroid nasal sprays and drops(Preventer treatment)- These can be taken in anticipation of exposure to known allergen such as pollen in hay fever sufferers.
If you suffer from asthma in addition to allergic rhinitis, please do not hesitate speak to your GP/practice nurse to provide tailored medication to suit your needs.
If you are experiencing any symptoms associated with allergic rhinitis please contact your GP/Practice nurse for further advice and based on their diagnosis you will be placed on suitable medication.
Please visit the Asthma UK website for tips on minimising contact with indoor and outdoor allergens.