About the diagnosis, diagnosis and treatment of allergic rhinitis (allergic rhinitis)

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Do you have a long-standing runny nose, nasal congestion? These symptoms may be one of the signs of rhinitis.

The word “rhinitis” means inflammation of the nasal passages. This inflammation can cause a variety of annoying symptoms, including sneezing, itching, stuffy nose, runny nose, and post-nasal drip (the feeling of mucus running down the back of the throat from the sinuses). Rhinitis is usually caused by allergies, but it can also be caused by overuse of certain medications, certain medical conditions, and other unknown factors. This article is about allergic rhinitis (allergic rhinitis). I will cover non-allergic rhinitis in another article.

Who gets allergic rhinitis?

Allergic rhinitis is seen in 22% of adult males, 24% of adult females, and approximately 7% in childhood in Turkey.

The risk of developing allergic rhinitis is much higher in people with asthma or eczema, and in people with a family history of asthma or allergic rhinitis. In addition, there are studies showing that allergic rhinitis is more common in children whose parents smoke, live in an apartment and have pets.3

At what age does allergic rhinitis occur?

It can occur at any age, but most people develop symptoms in childhood or young adulthood, and the symptoms are more severe than at other ages. However, the severity of symptoms tends to vary throughout a person’s life.

How does allergic rhinitis occur?

Allergic rhinitis is caused by the nose’s reaction to small particles in the air called allergens (substances that cause an allergic reaction). In some people, these particles also cause reactions in the lungs (asthma) and eyes (allergic conjunctivitis).

As a result of the reaction caused by allergens, cells called mast cells and basophils are activated in the body, and the natural chemicals released from these cells cause symptoms such as nasal congestion, itching, sneezing and runny nose.

What are the causes of allergic rhinitis?

You must have an allergy that causes allergic rhinitis. Allergens are different for each allergic rhinitis patient. The most common allergens that cause allergic rhinitis are:

Trees

herbs

pollen

house dust (mites)

Animal dander (Cat-dog, cockroach, bird…)

Mold fungus

What are the symptoms of allergic rhinitis?

Symptoms of allergic rhinitis vary from person to person. Although the term “rhinitis” refers only to nasal symptoms, many people also have symptoms that affect the eyes, throat, and ears. It negatively affects sleep and quality of life.

Nose ;

watery runny nose

Sneeze

itchy nose

allergic salute

nasal congestion

eyes ;

itchy red eyes

Sensation of delicacy in the eyes

Swelling and dark discoloration of the skin under the eyes (called “allergic brighteners”)

Throat and ears

Itching of the throat and palate

Itching, congestion in the ears

Sleep

mouth breathing

Frequent waking

daytime fatigue

Problems doing normal activities (eg, decrease in work and school performance, decrease in sports performance..)

How often do allergic rhinitis symptoms occur?

Symptoms occur with exposure to allergens. For this reason, the time and duration of the appearance of symptoms varies from person to person, depending on what the allergy is against. Allergic rhinitis is divided into two groups according to the period of occurrence 4;

1-Intermittent (Seasonal) allergic rhinitis;

Less than four days a week or less than four consecutive weeks

Caused by allergens such as tree, pollen, grass

2- Persistent (Year-Round) allergic rhinitis;

More than four days a week or more than four consecutive weeks

Caused by allergens such as house dust, mold, pet dander

How is allergic rhinitis diagnosed?

Your doctor can diagnose allergic rhinitis by performing a physical examination after reviewing your symptoms. Medical tests can confirm the diagnosis and identify what you are allergic to.

How do we identify allergens and other triggers?

It is often possible to identify allergens and other triggers that provoke allergic rhinitis. Here you will give the most important information to your doctor:

Remembering where you were and what you were doing before your symptoms started (for example, being in a carpeted indoor environment, spending time with animals, walking in the countryside, mowing the lawn…)

Note the time of year when you noticed the symptoms

Taking a close look at home, work and school environments for potential allergens

If your symptoms are not well controlled with medications or it is not clear what is causing your symptoms, one of the most frequently and effectively used tests Skin Prick Test It is an economical test that is easy to apply, gives fast results. It is made by dripping small amounts of different allergens onto your skin. Skin reactions that occur are evaluated.

In cases where no results can be obtained with the skin prick test, if necessary, in the blood Serum Specific IgE Antibody Test can be done. Although this test is an easy-to-apply test, its cost is a bit high.

How is allergic rhinitis treated?

Treatment of allergic rhinitis involves reducing exposure to allergens and other triggers, along with medication. This combined approach can effectively control symptoms in most people. The best treatment(s) will depend on your symptoms and personal preferences.

What is the drug treatment of allergic rhinitis?

The main purpose of drug therapy is to reduce the symptoms of an allergic reaction. In this, drugs are used that suppress the effects of chemicals that cause symptoms. They can be used in the form of oral (systemic) tablets or directly into the nose (local) sprays. The most commonly and effectively used drugs are;

antihistamine tablets

nasal sprays containing cortisone

Antihistamine nasal sprays

Leukotriene antagonist tablets

Combination drugs of antihistamine and leukotriene antagonists

What is vaccine treatment?

Vaccine treatment applied in allergic rhinitis is called “Immunotherapy”. Immunotherapy involves trying to change the way a person’s immune system responds to allergens. The most common form of immunotherapy is regular injections. Whether or not you are a candidate for immunotherapy depends on both your history and what your allergies are.

1- Cingi C, Topuz B, Songu M, Kara CO, Ural A, Yaz A, et al. Prevalence of allergic rhinitis among the adult population in Turkey. Acta Oto-Laryngologica 2010; 130: 600-6 (10.3109/00016480903311880).

2- Duksal F, Akcay A, Şıkir T, Ergin A, Şıkir C, Guler N. Rising trend of allergic rhinitis prevalence among Turkish schoolchildren. Int J Pediatr Otorhinolaryngol 2013; 77: 1434-9 (10.1016/j.ijporl.2013.05.038).

3- Çobanoğlu HB, Işık AU, Topbaş M, Ural A. Prevalence of Allergic Rhinitis in Children in the Trabzon Province of the Black Sea Region of Turkey. Turk Arch Otorhinolaryngol 2016; 54:21-8. (10.5152/tao.2016.1089).

4- Bousquet J, Schünemann HJ, Samolinski B, et al. World Health Organization Collaborating Center for Asthma and Rhinitis. Allergic Rhinitis and its Impact on Asthma (ARIA): achievements in 10 years and future needs. J Allergy Clin Immunol. 2012 Nov;130(5):1049-62. doi: 10.1016/j.jaci.2012.07.053.

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