What is allergic rhinitis (hay fever)? Symptoms and treatment
Allergic rhinitis is called allergic inflammation of the mucosa covering the nose and is more common, especially in people with allergic susceptibility. It usually lasts a lifetime, but may be less severe in older ages. The most common cause is airborne pollen, but can be triggered by any allergen. The possibility of spontaneous transmission is very low. But avoiding the allergens that cause the problem provides important benefits. The prevalence of the disease is quite high and according to scientific studies, approximately one fifth of the population has been reported to have allergic rhinitis. Social and psychological problems are more common in people with allergic rhinitis.
What is hay fever?
The word rhinitis means nasal inflammation. Allergic rhinitis means nasal inflammation. It occurs when allergens adhere to the nasal airway mucosa and initiate inflammatory reactions. Species that occur in certain seasons (in the spring when the pollen flies) are called seasonal rhinitis. Seasonal allergic rhinitis is also known as hay fever.
Allergic rhinitis also has an all-year type and is called perenial rhinitis. Perenial rhinitis is caused by allergen factors, such as animal hair, various chemicals, or house dust, which are usually present throughout the year. If necessary precautions are taken and appropriate treatment is given, it is possible to reduce the number of attacks of the disease3.
Causes of allergic rhinitis?
The most important cause of allergic rhinitis is airborne pollens and trees.
May develop against allergens such as mold, animal hair, house dust and mites
In dry and windy weather, the amount of pollen is high and the incidence of allergic rhinitis increases,
Seasonal allergic rhinitis is caused by tree pollen, especially in spring
It causes cockroaches and house dust mites while allergic rhinitis persists all year
Feeding animals such as dogs, cats, birds at home can increase the severity of allergic rhinitis
What are the symptoms of allergic rhinitis?
Runny nose and nasal obstruction
Itching and watery eyes
Sneezing, coughing and sore throat
Itching of the throat, nose or upper palate
Sinus pressure and facial pain
Swelling of the custody and a bluish color
Decreased sense of smell and taste
Movement of children frequently rubbing and scratching hands
Fatigue, difficulty in perception, sleep disturbance
Sometimes these symptoms may be accompanied by wheezing, coughing and headache
Age of allergic rhinitis and other allergic problems
Allergic rhinitis usually occurs in people called atopic, with a predisposition to allergies,
The incidence of other allergic diseases (eczema, urticaria, asthma) increases in these people,
The incidence of allergic rhinitis increases in people with a family history of allergic diseases,
The disease is usually seen before the age of 40, complaints decrease with age,
Spontaneous resolution of the disease is a very rare condition,
How is allergic rhinitis diagnosed?
For the diagnosis of allergic rhinitis, physicians first examine the symptoms seen in the patient,
It is important for the diagnosis in which season and how the symptoms occur.
Even if the results of the tests are negative, the patient can also be diagnosed with symptoms.
Examination of the patient's nose mucosa and other points are examined,
There are many diagnostic tests such as antibody IgE test for the diagnosis of allergic rhinitis,
Allergy tests applied to the skin are among the most commonly used methods,
Nasal discharge can be seen directly in the examination of patients,
Nasal pale color, increase in clear secretion, edema - swelling and flesh growth can be seen,
Nasal discharge and pharyngitis may be seen through the mouth
When should I go to an allergy specialist?
If your symptoms are extremely severe
If it bothers you all year round
Allergy medications don't help reduce your symptoms
If your allergy medication causes side effects
If you want to learn about allergy vaccines
How to treat allergic rhinitis
The treatment of allergic rhinitis is aimed at alleviating the complaints, and the disease cannot be eliminated with this treatment. In the treatment of allergic rhinitis, medicines called antihistamines are used which prevent the release of substances that cause the event when the allergen is encountered. They are often very useful. The effects are better when used before exposure to the allergen.
They are particularly effective in relieving symptoms such as itching, discharge and sneezing. In addition, drugs that reduce swelling on the inner surface of the nose are used in the treatment. Another commonly used option is nasal sprays containing cortisone. However, all these drugs must be given by the physician by evaluating the severity of the disease and the patient's condition. Medical treatment of the disease should also include consultation on environmental control.
Recommendations for treatment
Stop contact with allergen stimuli,
Medication,
Hyposensabilization (vaccine treatment),
Surgical treatment
Phototherapy (Rhinolight)
Differences between allergic rhinitis and flu
Allergic rhinitis and flu symptoms may be similar. A few ways to distinguish:
If you don't have a fever and have a thin, fluid runny nose, you've got allergic rhinitis. But if the runny nose is more yellow, you have pain in your body and you have a fever, albeit low, this is a symptom of a cold.
Allergic rhinitis begins immediately after contact with the allergen. In fact, it appears a few days after catching the virus.
Allergic rhinitis persists as long as you are exposed to the allergen. It only takes three or five days.
What should people with allergic rhinitis pay attention to?
Persons with allergic rhinitis should not be present in dusty and polluted environments, if they have to be present, they should wear a mask,
Doors and windows should be kept closed during the seasons when the pollen is flying,
Air humidifiers should be used at home as dry air can cause worsening of allergic rhinitis, especially in heating houses.
Attention should be paid to the cleanliness of the room air,
Feeding animals and plants at home should be avoided,
Fluffy and woolen blankets instead of cotton and synthetic ones should be preferred,
Do not use household items such as rugs and carpets that can contain dust.
Take care to use your medicines as recommended by your doctor,
Follow general health rules,
Exercise every day, stop smoking, eat a balanced diet,
Comprehensive information about the treatment of allergic rhinitis
Careful elimination of allergens (animals, dust in the house) is only necessary if it causes symptoms. According to today's view, there is no need to avoid allergens in the natural environment for prevention purposes only.
Drug treatment should include a combination of drugs administered separately according to symptoms from different drug groups.
In allergic rhinitis, antihistamines are the most effective drugs to control sneezing and mucous formation. New antihistamines with less side effects should be utilized.
Antihistamines are also available as nasal spray.
Combination products (antihistamine + sympathomimetic) have very positive effects on nasal obstruction. It should not be used continuously for more than 10 days.
Nasal corticosteroids are effective against all symptoms of allergic rhinitis and are also the only drugs that have a significant effect on the growth of nasal polyps. Newer medications should be prescribed, especially for children, as they have lower systemic bioavailability.
Chromoglycate has some effect on all symptoms of rhinitis, but its efficacy is clearly less than corticosteroids.
Leukotriene receptor antagonists relieve the symptoms of allergic rhinitis.
Desensitization treatment (hyposensitization, allergen immunotherapy,) is considered primarily in the case of pollen-induced rhinitis. Desensitization treatment is prescribed by a specialist doctor, but in adults treatment is usually performed by a general practitioner in contact with the specialist unit.
Management of other symptoms associated with allergic rhinitis:
eye drops for conjunctival symptoms (mast cell stabilizers, antihistamines)
if antihistamine use or nasal corticosteroids have caused dryness or irritation, nasal sprays and solutions (water or oil based) to moisturize and heal mucous membranes
If a relief of nasal obstruction is required before treatment with nasal corticosteroids is used, sprays containing sympathomimetic drugs may be used for a short time (not more than 7-10 days).
Pharmacotherapy in different rhinitis types
Symptoms of seasonal rhinitis
Antihistamines alone may be sufficient as long as the pollen count is low. In pollen allergy, antihistamines can be used as an adjunct to topical treatment (nasal corticosteroids) if needed. Instead of oral antihistamines, antihistamines administered directly to the nose or conjunctiva may be used.
Nasal corticosteroids are the most effective against nasal obstruction if treatment is initiated before the onset of symptoms. Regular treatment should continue throughout the season. The patient may adjust the dose himself depending on exposure (pollen count) and symptoms.
Kormoglycate is also initiated before the pollen season and symptoms begin. Mast cell stabilizing eye drops (chromoglycate, lodoxamide) are also available. Treatment should continue throughout the season.
The effect of leukotriene receptor antagonists is similar to that of antihistamine2. They are used as an adjunct for asthma and are therefore useful for asthma patients with allergic rhinitis.
Perenial rhinitis (continuous symptoms)
Nasal corticosteroids are generally preferred drugs and can be used both intermittently and continuously (eg patients with nasal polyps). The initial dose is usually two sprays per nostril daily (at night). In general, it is possible to reduce the dose, so that in an optimal case the maintenance dose is spray every two days into each nostril. In addition, periodic treatment may be administered after a few weeks of treatment, with an interruption of equal duration.
Antihistamines can be used to control sneezing and excessive mucous secretion. Antihistamines can also be used in combination with sympathomimetic drugs in cases of mild nasal obstruction.
In order to prevent the onset of allergy symptoms in perennial rhinitis, chromoglit may be used for a short time, eg before an expected contact with animals.
Leukotriene receptor antagonists are also suitable in cases of asthma-associated perenial rhinitis.
NARES (non-allergic rhinitis with eosinophilia syndrome)
Pharmacotherapy consists of antihistines and topical corticosteroids (in practice the drug treatment is the same as that used in allergic rhinitis).
Vasomotor rhinitis
In vasomotor rhinitis, excessive mucous secretion is best treated with ipratropium nasal spray. Contraindications to the anticholinergic drug should be remembered when treating elderly patients. Combination drugs containing antihistamine and sympathomimetic drugs may also be useful.
In which situations does allergic rhinitis cause complications?
Allergic rhinitis may cause complications in some cases. These include: nasal polyps - abnormal and extra-nasal (benign) nasal transitions and fluid vesicles growing in the sinuses, sinusitis - an infection caused by nasal inflammation and swelling that prevents mucus from flowing into the sinuses - middle ear infections - infection of a portion of the ear just behind the eardrum . Although surgery is sometimes necessary in severe or long-term cases, these problems can often be treated with medication.
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