Allergic Rhinitis

What is "allergic rhinitis"?

Allergic rhinitis is the medical term for hay or rose fever. It refers to that illness characterized by sneezing fits, runny nose, nasal congestion, and itchy nose. Hay fever and Rose fever are two great examples in medicine of misnomers in that the condition is not due to hay or roses and it does not cause a fever. Rose fever traditionally refers to symptoms in the month of June when roses come into bloom. The rose pollen is too large to be the responsible allergen. The pollen of grass triggers those of us who suffer nasal symptoms during this time. The "haying" season starts in August. Those who suffer symptoms during this time of the year should not blame the hay but consider ragweed a the culprit for their illness. The term allergic rhinitis is more appropriate. This is simply an inflammation of the nose that has allergy as the cause.

Allergic rhinitis can be occur in two variations- year round or perennial rhinitis or seasonal rhinitis.

Perennial allergic rhinitis is due to allergens that are present to some degree all year round. These allergens include the house dust mite, molds, animal dander, and cockroach.

Seasonal allergic rhinitis is due to tree polle in the early spring to the beginning of summer, grass pollen in late May through early July, and weed pollen in July through the second frost. There is also an outdoor mold season- in the dampness of April and also from August until that second frost. These time frames may be different depending on where yo live. These time frames are characteristic of Indiana.

Allergic rhinitis may also involve the eyes causing them to be red, watery, and itchy.

There are a number of other things that those with allergic noses do. We find them clearing the throat, making funny clicking noises when the palate itches, they may mouth breathe, they may grimace and make funny faces as they try to scratch the nose by not using their hands, and they may complain of frequent bloody nose.

What are the complications of allergic rhinitis?

There are a number of issues with allergic rhinitis. One of the most intriguing and recent concerns is that of quality of life. I was surprised to see a recent report that claimed those with allergic rhinitis have poorer quality of life than those who suffer from asthma! Allergic rhinitis may be involved with poor sleep especially when nasal congestion is extreme and unrelenting.

Sinus disease may have allergic rhinitis as an underlying factor. There is also evidence that perhaps one of three children, who suffer from chronic serous otitis media, may have allergy as a potential contributing factor. Dental malocclusion may have allergic rhinitis as a factor as well.

Interesting facts about allergic rhinitis:

Allergic rhinitis is one of the most common allergic conditions. The age of onset can be in childhood, adolescence, and early adulthood. The average age for perennial allergic rhinitis is 9 years and for seasonal allergic rhinitis it is 10 years of age. It is very rare to see allergic rhinitis in a child less than three years of age.

The treatment of allergic rhinitis:

Once again, as it is for all allergic diseases, avoidance is the most effective form of therapy. This recommendation is so powerful that without avoidance, there is often very little hope that any other form of therapy will work. It is imperative that especially in the case of indoor allergens, that avoidance measures be optimized prior to embarking on a course of allergen immunotherapy.

The next treatment approach is that of medications. Those used to treat the allergic nose include:

Antihistamines - such as:

• Allegra
  
• Claritin
  
• Zyrtec
  
• Benadryl
  
• Atarax
  
• Tavist
  
• Astelin
  

Decongestants - such as:

• Sudafed
  
• topical corticosteroids
  
• Beconase
  
• Vancenase
  
• Nasacort
  
• Rhinocort
  
• Nasarel
  
• Flonase
  
• mast cell stabilizers
  
• Nasalcrom
  
• anticholinergic agents
  
• Atrovent

The antihistamines work against symptoms that are triggered by the allergic mediator, histamine. Histamine causes runny nose, an itchy nose, and sneezing fits. An antihistamine would help with these symptoms. Antihistamines do very little for congestion. If congestion is an issue, then a decongestant is needed.

Allergy shots or allergen immunotherapy is also a form of treatment frequently utilized. Allergy shot have been shown to be effective in a number of types of allergic rhinitis. The clinical models that have been well studied and show a positive effect from the program include grass, ragweed, tree, house dust mite, and alternaria (a mold) induced allergic rhinitis. These studies that looked at these allergens did show decreases in medication use, symptoms and complications of allergic rhinitis.