Allergic rhinitis

Allergic rhinitis or hay fever is an immune response that occurs when you breathe in outdoor or indoor allergens such as dust, animal dander, or pollen. Grass pollen is the most common allergen. If you have symptoms triggered or aggravated at the work-place, then the condition is said to be occupational rhinitis.

In India, more than 30% of the total population was affected adversely due to allergic rhinitis. The prevalence of this condition has increased mostly in the past two decades due to changes in the lifestyle. The condition is commonly seen in young adults. 80% incidence is reported in individuals with age less than 20. However, this condition is a serious concern in older adults.

Signs and symptoms

Rhinitis is the inflammation of the nose. Allergic rhinitis has cold-like symptoms, and they include:

  • sneezing
  • cough
  • stuffy nose
  • runny nose
  • nasal congestion
  • frequent headache
  • itching
  • watery, red eyes
  • fatigue

You may experience one or more symptoms after immediate exposure to the allergen. These symptoms may worsen, or new symptoms may be seen if there is long-term exposure.

Causes

Usually, allergic rhinitis occurs or worsens due to seasonal factors. The triggers include tree pollen in early spring, grass pollen in late spring or summer, or ragweed pollen in the fall season.

Dust mites, cockroaches, or dander are seen all the year. These are called perennial factors. Allergic rhinitis may occur more due to indoor allergens in winter. Smoke and fuel exhaust can also cause allergies in few cases.

Risk factors

The risk of allergic rhinitis increases if you have other allergies, asthma, family history of allergies or asthma, and continuous exposure to allergens such as dander, at the workplace.

Complications

Complications such as worsening asthma, ear infection, and sinusitis are associated with allergic rhinitis. You may also have less sleep due to bothersome symptoms.

Diagnosis

Your doctor performs a physical examination and takes a thorough review of your medical history. Your doctor will ask about the onset of symptoms whether they are seasonal or vary by time of day. The diagnosis also includes:

  • Skin prick or scratch test and intradermal test: for allergen testing
  • Allergy blood tests: IgE RAST tests – to examine levels of allergy-related substances
  • Complete blood count: eosinophil count – to diagnose allergies

Your doctor recommends allergy blood tests when you cannot undergo a skin prick test or intradermal test.

Allergic Rhinitis Treatment

The best therapy for hay fever is to avoid exposure to the allergen. For mild symptoms, you may use over-the-counter medications. However, if the symptoms worsen, your doctor may prescribe medications.

Medications

Nasal corticosteroids: Nasal corticosteroid sprays are the most effective treatment for hay fever. These drugs treat the nasal inflammation, itching, and runny nose.

Antihistamines: They block histamine, which is an inflammatory mediator and treat itching, sneezing, and runny nose. They do not have much effect on congestion.

These drugs cause drowsiness, so avoid taking alcohol while using these medications and do not use more than one medication, unless prescribed by your doctor.

Decongestants: These are available in the form of liquids, tablets, and nasal sprays and also given as over-the-counter medications. Examples include pseudoephedrine and phenylephrine.

Cromolyn sodium: This medication blocks the release of allergy-causing substances. But, it is not effective in all the patients.

Allergen immunotherapy (allergy shots)

In this therapy, allergens are administered either orally, sublingually, or subcutaneously to induce specific long-term tolerance. This helps the body to accept the harmless substances such as pollen and house dust mites.

Self-management

Avoid triggers by implementing some changes to your home

  • Keep windows closed at seasons when pollen is high.
  • Use air-conditioning in your car and home.
  • Clean your hands after petting or playing with an animal.
  • Use mite-proof bedding covers to prevent exposure to dust mites.