Chapter 2 : Allergic Rhinitis
Topics covered in this snack-sized chapter:
Allergic rhinitis, more commonly referred to as hay fever, is an inflammation of the nasal passages caused by allergic reaction to airborne substances.
Allergic rhinitis is a type of immune reaction.
It occurs when you breathe in something you are allergic to, such as dust, dander, insect venom, or pollen.
The pollens that cause hay fever vary from person to person and from area to area. Tiny, hard-to-see pollens often cause hay fever. Examples of plants that cause hay fever include:
Allergic rhinitis occurs only during periods of intense airborne pollen or spores.
Aging Process:
The elderly are at risk for chronic rhinitis as the mucus membranes become dry with age. In addition, the cartilage supporting the nasal passages weakens, causing changes in airflow.
Irritative Rhinitis:
Irritative rhinitis is caused by an overreaction to irritants, such as cigarette smoke, dozens of other air pollutants, strong odors, alcoholic beverages, and exposure to cold.
The nasal passages become red and engorged.
House dust and mites.
Molds growing on wallpaper, house plants, carpeting, and upholstery
Symptoms that occur shortly after you come into contact with the substance you are allergic to may include:
- Itchy nose, mouth, eyes, throat, skin, or any area
Symptoms that may develop later include:
- Stuffy nose (nasal congestion)
- Clogged ears and decreased sense of smell
- Dark circles under the eyes
- People with allergic rhinitis often have allergy symptoms that also involve the eyes.
The doctor will examine the inside of the nose with an instrument called a speculum.
This is a painless examination allowing the doctor to check for redness and other signs of inflammation.
The doctor will also usually check the eyes, ears, and chest.
A skin test is a simple method for detecting common allergens.
Patients are usually tested for a panel of common allergens.
Nasal Smear: The doctor may take a nasal smear.
The nasal secretion is examined microscopically for factors that might indicate a cause, such as increased number of white blood cells, indicating infection, or high counts of eosinophils.
Blood tests for IgE immunoglobulin production may also be performed. One test is called the radioallergosorbent Test (RAST), used to detect increased levels of allergen-specific IgE in response to particular allergens.
Imaging tests may be useful if other tests are ambiguous. CT scans may be useful for some cases of suspected sinusitis or sinus polyps.
Avoidance of the allergens is the best treatment, but this is often not possible.
When it is not possible to avoid one or more allergens, there are two major forms of medical treatment, drugs and immunotherapy.
Antihistamines work well for treating allergy symptoms.
Many antihistamines taken by mouth can be bought over the counter, without a prescription.
Older antihistamines can cause sleepiness.
Newer antihistamines cause little or no sleepiness.
Antihistamine nasal sprays work well for treating allergic rhinitis.
Immunotherapy, also known as desensitization or allergy shots, alters the balance of antibody types in the body, thereby reducing the ability of IgE to cause allergic reactions
Immunotherapy is preceded by allergy testing to determine the precise allergens responsible.
Stay indoors with windows closed during the morning hours, when pollen levels are highest.
Keep car windows up while driving.
Clean air conditioner filters in the home regularly.
House dust.
Clean floors and walls with a damp mop.
Vacuum frequently, and change the bag regularly.
Install electrostatic filters in heating and cooling ducts, and change all filters regularly.
Excessive exposure to allergens, such as outdoor molds, can be prevented by avoiding lawn mowing and other activities likely to stir these up.
Animal dander.
Avoid contact if possible.
Wash hands after contact.
Vacuum frequently.
Keep pets out of the bedroom, and off furniture, rugs, and other dander-catching surfaces.
Have your pets bathed and groomed frequently.
