Sajid Latif asked:


What is allergic rhinitis?

Allergic rhinitis is inflammation of the nose resulting from an allergy. It affects five to 10 per cent of the population. A very common form is hay fever.

What causes allergic rhinitis and what are the risk factors?

An allergy is a response by the body’s defence system (the immune system) to something that is not a harmful infection. Such ‘harmless’ substances (allergens) include pollen, cat hair, animal dander, the house dust mite and mould spores.

It is not known why people develop allergic rhinitis. It is more common in people from families with eczema and asthma and there is probably an inherited factor that affects the way the immune system reacts to allergens.

What are the symptoms and complications of allergic rhinitis?

Allergic rhinitis results in a runny, itchy and blocked nose. On lying down at night the fluid in the nose drips down on to the back of the throat and causes bouts of coughing, which can be uncomfortable and disturb sleep.

How do doctors recognise allergic rhinitis?

Allergic rhinitis is usually diagnosed on the basis of the symptoms and their seasonal nature if it is hay fever or their association with a particular allergen such as cat hair.

Year-round allergic rhinitis due to mould spores or house dust mite is more difficult to diagnose as there are other similar forms of rhinitis that do not result from allergy. More than one allergen may be involved

What is the treatment for allergic rhinitis?

Self-care action plan

A self-care action plans to avoid the allergen and so minimise the symptoms of allergic rhinitis includes:

Keeping windows closed and using an air ioniser (for pollen)

Regular vacuuming using a vacuum cleaner with a pollen filter (all allergens)

Damp dusting, so preventing dust from being dispersed into the air (for house dust mite)

Use of special bed and pillow coverings and regular laundering of bedclothes

Medicines

A variety of medicines can be bought at the chemist to treat allergic rhinitis. Probably the most effective is a beclomethasone nasal spray. This acts to stop the inflammation in the nose, but takes a few days to produce this effect and so needs to be started before the symptoms become too severe. Once the symptoms are severe it may be sneezed straight out again.

Although allergic rhinitis is common in young women, none of these medications is recommended for use during pregnancy. All should be avoided if possible during pregnancy and increased efforts should be made to minimise exposure to the allergen as outlined in the self-care section of this factsheet. If the symptoms remain a problem, a doctor should be consulted.

Hyposensitisation

This involves giving gradually increasing doses of the substance that causes the allergy and in the process making the immune system less responsive to it. This should only be carried out under close medical supervision as occasionally this treatment causes a life-threatening allergic response that must be treated immediately with an injection of adrenaline.

Complementary therapy

Some complementary therapies (homoeopathy, osteopathy and acupuncture) claim to have beneficial effects on hay fever, but the explanations for their effect are not consistent with the traditional medical understanding of hay fever. Shiatsu, the Alexander technique and aromatherapy may help to improve general well-being and symptoms.

Mark Bevan asked:

What is hay fever?

Hay fever is a common form of allergic reaction. It is also known as allergic rhinitis where rhinitis comes from ‘rhino’ meaning nose and ‘itis’ meaning inflammatory. Hay fever in layman’s terms can be described as inflammation of the nose caused by an allergic reaction. The other parts of the body affected by hay fever include eyes, sinuses, throat and ears. Many times hay fever is mistaken for common cold because it is marked by cold like symptoms such as runny nose, sneezing, congestion and sinus pressure. However, unlike cold which is caused by a virus, hay fever is caused by an allergic response to indoor or outdoor airborne allergens, such as pollen, dust mites or pet dander. In some people hay fever may also be triggered by pollution such as cigarette smoke and car exhaust fumes.

There are two categories of hay fever or allergic rhinitis -

Seasonal hay fever – A large number of people are affected by seasonal hay fever that occurs during spring, summer, and in early fall mainly because of the high levels of pollens present in the atmosphere during these seasons. Perennial hay fever – People who experience hay fever all year round are said to be suffering from perennial hay fever.

Hay fever symptoms

Hay fever symptoms vary from person to person. While some people are fortunate to have only mild symptoms that do not last long, some hay fever victims are severely affected and show symptoms every day during the pollen season. In such cases, people may have difficulty attending school or work.

Common hay fever symptoms include – stuffy or runny nose, itchy nose, throat, or ear canals, sneezing, watery red eyes and ear congestion. Less common hay fever symptoms include – inability to taste or smell food, ‘nasal’ voice, face pain, sweats, and headache. Asthma symptoms – some people may also experience shortness of breath, especially with exercise or exertion, coughing and wheezing. Symptoms can worsen in people who already have asthma.

Medicine used for the treatment of hay fever

Anti-histamine medicines are commonly used for the treatment of hay fever this is because symptoms are caused due the release of a chemical in the body called histamine in response to the allergen. Anti- inflammatory drugs and decongestants may also be given to relieve patients of the symptoms. A doctor may suggest stronger prescription drugs in severe cases of hay fever.

These days, many people who are constantly affected by hay fever are going in for drug-free alternate therapies such as Qu-Chi bands. Based on the Chinese knowledge of acupressure, the Qu-Chi band provides fast relief from hay fever as it works directly on the acupressure points that relieve hay fever symptoms. Since it is natural, Qu-Chi band does not cause any side effects. The band is easy to wear and can be worn when the symptoms start or as a preventive measure when the symptoms are about to start so that fast and effective hay fever treatment becomes possible. The Qu-Chi band can be used round the year; it can be safely used in conjunction with other medications also.

Alisha Dhamani asked:


Allergy shots are given to some people who have persistent and disruptive allergy symptoms. The shots do not treat symptoms, but by altering the immune response they prevent future reactions. (This is referred to as immunotherapy.) Treatment involves a series of shots, each containing a slightly greater amount of the antigen(s) that cause the reaction. Ideally, the person will become “desensitized” to the antigen(s) over time. The effectiveness of shots varies by individual.

Anti-allergy medications are of many types. The choice of medication and how it is given depends on the severity of the reaction.

For relief of long-term allergies such as hay fever or reactions to dust or animal dander, the following medications may be prescribed.

Long-acting prescription antihistamines, such as cetirizine (Zyrtec), fexofenadine (Allegra), and loratadine (Claritin), can relieve symptoms without causing sleepiness. They are meant to be taken for months at a time, even indefinitely. Most have to be taken only once a day and last for 24 hours.

Nasal corticosteroid sprays are widely prescribed for nasal symptoms not relieved by antihistamines. These prescription medications work very well and are safe, without the side effects of taking steroids by mouth or injection. These sprays take a few days to take effect, and must be used every day. Examples are fluticasone (Flonase), mometasone (Nasonex), and triamcinolone (Nasacort).

In some people, cromolyn sodium nasal spray prevents allergic rhinitis, inflammation of the nose that occurs as an allergic reaction. Decongestants can restore sinus drainage, relieving symptoms such as nasal congestion and swelling and runny nose and sinus pain (pain or pressure in the face, especially around the eyes). They are available in oral forms and as nasal sprays. They should be used for only a few days, as they may have side effects such as high blood pressure, rapid heartbeat, and nervousness.

Self-care at home is not enough in severe reactions. A severe reaction is a medical emergency. Do not attempt to treat or “wait out” severe reactions at home. Go immediately to a hospital emergency department. If no one is available to drive you right away, call 911 for emergency medical transport. For more information on what to do in a severe reaction, see Anaphylaxis.

An oral antihistamine, such as diphenhydramine (Benadryl). Caution these may make you too drowsy to drive or operate machinery safely. They can affect concentration and interfere with children’s learning in school. These medications should be taken for only a few days. For rashes, an anti-inflammatory steroid cream such as hydrocortisone