How to deal with allergic rhinitis

As we turn a calendar page, we come to realization that summer is over and fall has arrived.  As the temperate begins to fall, many people begin to sneeze, have runny nose, itchy eyes, and/or itchy palates. So, what is going on?  You may be suffering from allergic rhinitis.

Sneezing girl

Allergic rhinitis is a common disease those impact on daily life cannot be underestimated. Many adults find themselves debilitated by symptoms and children are not any different. Inability to breathe well at night disturbs their sleep, causing them to feel fatigue and generalized malaise (not feeling well), affecting their concentration in school, causing poor performance grades, and/or Attention Deficit Hyperactivity Disorder-like symptoms.

Allergic rhinitis is typically uncommon before age of 2 as it requires a few years of allergen exposure. When a patient is continually exposed to an allergen, persistent nasal mucosal inflammation develops. Clinically, immune system mistakenly identifies a typically harmless substance as an intruder (allergen).  It responds to allergen by releasing histamine and other chemical mediators that cause symptoms in the nose, throat, eye, ears, roof of the mouth and skin.

Pollen particles under the microscope
Pollen particles under the microscope

In medical world, we like to differentiate between seasonal and perennial allergic rhinitis, since it allows us counsel our patient allergens to avoid. Seasonal allergic rhinitis is usually caused by outdoor allergens, such as pollen.  Perennial allergic rhinitis (occurring year round) is usually caused by indoor allergens such as pet dander, mold, dust mites, cockroach particles.

Diagnoses are usually made on clinical grounds based upon the presence of characteristic symptoms, detailed history, and supportive findings on physical examination.  Rarely additional testing or referral to a specialist is required.

Treatment includes multiple pharmacological remedies as well as complementary and alternative remedy (CAM).  Most people suffering from allergic rhinitis turn to pharmacological remedies, in addition to allergen avoidance, for a better control.   The most effective single therapy with persistent nasal symptoms is a glucocorticoid nasal spray (in layman’s terms – steroidal spray).  Other therapies include oral histamines (Benadryl®, Claritin®, Allegra®, Zyrtec®), nasal spray antihistamine, mast cell stabilizers, leukotriene modifiers, and Ipratropium Bromide (Atrovent®, Apovent®, Ipraxa®, Aerovent® and Rinatec®).

The use of CAM is growing in Western countries because of the reputed effectiveness, low cost, and favorable safety profiles of some therapies.  Unfortunately, not many CAM therapies undergone randomized controlled trials, reporting of adverse effects.  Below are some CAM therapies that I had success with in my practice:

  • Nasal saline washes multiple times a day
  • Steam inhalations
  • Eucalyptus inhalation for 3- 5 min.

There are many more herbal remedies that are currently being evaluated such as Ginkgo Biloba, Milk Thistle, Grape Seed extract to name a few.

If you believe your child might be suffering from allergic rhinitis, you should make an appointment to discuss the right therapy for your child. Visit our site or our page on Facebook for the phone, hours and directions.

Dr. Alla

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