Allergic Rhinitis

This a common problem affecting children and adults. It is caused by an allergy to inhalant allergen and not food allergy. This could be house dust mites, grass, weed or tree pollens, cat allergen, dog allergen, cockroach allergen and mould allergen.

The symptoms are

  1. Sneezing
  2. Runny nose
  3. Itchy nose
  4. Nasal congestion

The symptoms may occur seasonally or throughout the year. If the symptoms are seasonal the most likely allergen will be pollen allergy. If the symptoms are throughout the year it may be dog, cat, mould, or house dust mite allergen.

Patients with allergic rhinitis experience significant effects on their quality of life. Allergic rhinitis does not only affect the nose but can have widespread implications such as:

  1. Poor quality of life
  2. Recurrent ear infection
  3. Recurrent sinusitis
  4. Orthodontic problems
  5. Poor concentration in school
  6. Poor asthma control
  7. Constant tiredness

Many of these patients will look pale, have dark rings under the eyes, a nasal crease from frequent rubbing of the nose and congestion of the eyes.

Allergic conjunctivitis frequently affects patients with allergic rhinitis. They will have watery, itchy eyes with discolouration of the white part of the eye.

The diagnosis of allergic rhinitis is made by taking a good history and doing allergy tests. If the allergy test is negative then the patient may have another type of rhinitis, infection or enlarged adenoids.

Once the diagnosis is made we start treatment. This consists of:

  1. Allergen avoidance
  2. Medications

There are many different types of medications used.

  1. Nasal Steroids (Avamys, Flonase, Flomist, Omnair are the common ones used)
  2. Antihistamines (Deselex, Texa, Allercet, Telfast, and many others)
  3. Leukotriene Receptor antagonist (Singulair, Montair, Topraz)
  4. Nasal antihistamine sprays (Sinumax)
  5. Immunotherapy

The most effective treatment is the steroid nasal spray. It is highly effective, safe and easily available.

These sprays must be used daily for life unlike other nasal sprays like Iliadin which should only be used for 5 days.

If the steroid nasal sprays do not work, then the other medicines listed can be added.