Allergic rhinitis is one such condition created by the harmful effect of altered immunity. The word allergy means as altered reactivity of the body immune system to certain environment substances, namely-allergens. However the same protective mechanisms may at times become harmful when the body tries eliminate allergens from the system.
In allergic rhinitis, there is inflation of the mucous membranes of the nose due to exposure to an inhaled allergenic trigger. It is becoming more common with increasing urbanization and industrialization. It is being considered as serious global health issue, affecting human productivity and quality of life.20-25 per cent of Indian population suffers from allergic rhinitis. The problem is more prevalent in the productive age group of 18-40 years.
People continue to suffer from the ailment with self medication and no relief. It is very important for the patients to understand about allergic rhinitis, its cause, prevention and treatment. Untreated rhinitis has a very strong association with sinusitis, asthma, nasal polyps and ear infection. It is essential to differentiate allergic rhinitis from other causes of rhinitis and cold.
Allergic rhinitis may be seasonal or remain throughout the year. Patients suffer from bouts of sneezing, which may also get triggered by an exposure to sudden change of temperature, dusty humid environment or strong smell. Patient have stuffiness, irritation or blockage of nose. Post nasal drip is common symptom and is the commonest cause of cough associated with this condition. Allergy makes these patients more susceptible to respiratory tract infections and sinusitis leading to green mucous discharge from the throat and nose, headache, facial discomfort and persistent nasal blockage.
Various allergens implicated in allergic rhinitis are pollen, fungi, moulds, house dust mite, animal dander, insect and animal. Apart from environmental factors, heredity also plays a key role in the development of this ailment. This is the reason why everyone exposed to a similar environment does not suffer from allergy.
At present, the management of allergic rhinitis includes allergen avoidance measures and medical therapy. Immunotherapy is given to patients who fail to respond to standard medical therapy. Each of these therapies complement each other.Preventive measures
Avoiding the allergen that triggers the response can prevent the allergic reaction. Most of the patients are prone to not one but multiple allergens. Few of the allergens and their respective preventive measures are mentioned below:
1.House dust mite.
House dust mite is one of the most important allergens worldwide that cause allergic rhinitis. These are found in carpets, heavy curtains, mattress, pillows, bed covers and soft furnishings in the home. Following methods help in reducing the exposure to these antigens:
– Remove carpets;
– Cover mattresses and pillows in a mite impermeable encasing;
– Wash linen in hot water(60 degree Celsius)
– Minimize soft furnishings in the bedroom;
– Use vacuum cleaner with powerful suction and a HEPA filter.
2. Allergy due to pollen is seasonal. Wind currents carry pollen to considerable heights and to several hundred kilometers. So the symptoms can be caused several kilometers away from the source. Avoidance of pollens is very difficult. Certain measures which can be taken are:
– Keep the windows shut in cars and building and stay indoors during mid-day and afternoon, when the pollen count is high;
– Avoid walking in open grassy areas;
– Wear eyeglasses to avoid eye problems and infections;
– Use air conditioning, if possible.
3. Fungi and Moulds
Fungi and Moulds can cause diseases both due to their allergic effect and otherwise. To keep away from these microbes, one must:
– Avoid sources of moulds like wet leaves, garden debris, houseplants ,hot , humid and damp areas;
– Keep areas around the sink, garbage cans and refrigerator clean. Moulds frequent grow in these areas.
4. Major animal allergen is in the saliva that may settle on fur or feather, becomes flakes when it dries up and suspend in air as very minute particles, Animal allergens may remain in home for several months even after the removal of pets. Patients are advised:
– Not to visit home where animals are present;
– Not to keep pets;
– If they have a pet, then wash the pet weekly and keep it out of the bedroom;
-Avoid pillows, quilts and other items made of feather.
– Get the house sprayed by insecticide by someone who is not allergic to spray;
– Stay out of the house for few hours after the spray and enter only after opening all doors and windows;
– Use cockroach traps and keep bathrooms and kitchen clean and well ventilated.
The second major mode of treatment of allergic rhinitis is the us of medicines. These are needed when avoiding allergens becomes impossible or symptoms persist despite allergen avoidance. The medicines are prescribed by an ENT specialist, depending on the severity and duration of the symptoms. Anti-allergic medicines and decongestants help when the symptoms are mild. There are newer types of medicines available which cause no or very little sedation. Nasal sprays, when given under medical supervision, are found to be very help in allergic rhinitis. The sprays are given for few weeks and then reduced to a minimum dose as maintenance therapy for some more weeks in order to control the symptoms.
It is recommended for persons who do not respond well to other modes of therapy. It consist of injecting diluted allergen in increasing doses. It develops the tolerance in the body to a certain allergen and thus reduces the symptoms. It is a long treatment and may have to be given for multiple allergens. Immunotherapy should be taken only from trained specialist.
Surgery has no role in managing allergic rhinitis. However, certain patient may need surgery for nasal polyps, hypertrophied turbinates or deviated nasal septum. Surgery provides better airway but symptoms of allergy may need medical treatment even after surgery. There are certain guidelines for the treatment of allergic rhinitis but treatment is individualize keeping duration, severity and frequency of the disease and other coexistent conditions in mind.