• Allergic Rhinitis

    What is Allergic Rhinitis?

    Allergic rhinitis is a condition where an allergen makes the inside of your nose swell or become inflamed. This can cause cold-like symptoms, such as sneezing, itchiness and a blocked or runny nose.

    Allergic rhinitis is one of the most common conditions in the gulf area. Hay fever is a type of allergic rhinitis that is caused by pollen. Other forms of allergic rhinitis may be caused by allergens, such as house dust mites or animal fur.


    What are the different forms of allergic rhinitis?

    Allergic rhinitis symptoms can occur seasonally or all year round:

    •  Seasonal allergic rhinitis – when you experience symptoms only during spring and summer, it is usually due to allergy to various types of pollen carried by the wind and easily breathed into the nose.


    •  Perennial allergic rhinitis – when you experience symptoms all year around, it is usually caused by allergens such as the house dust mite, particles from family pets known as animal dander, or moulds which are carried in the air.


    How does allergic rhinitis affect your body?

    Whatever allergen is responsible for causing your allergic rhinitis, the allergic response in the nose is similar. The allergen comes into contact with the sensitive, moist lining in your nose and sinuses setting off the allergic response. The release of histamine causes the lining to become inflamed and irritated and production of mucus is greatly increased.



    What are the symptoms of allergic rhinitis?

    Patient with allergic rhinitis will suffer from one or more one of the following symptoms:

    •  A runny nose
    •  A maddening sensation of tickling in the nose, throat, ears and roof of the mouth
    •  Uncontrollable bouts of sneezing
    •  blocked nostrils; this may be on one side only, or on both
    •  Inability to taste or smell food
    •  Reddened, puffy, watering, itchy eyes
    •  Irritating cough
    •  Discomfort from swallowing large amounts of mucus which may lead to nausea at times


    What are the common allergens that cause allergic rhinitis?

    The most common types of airborne allergens are listed below:

    • House dust mites – are tiny insects that feed on the dead flakes of human skin. They can be found in mattresses, carpets, soft furniture, pillows and beds. It is not actually the dust mites themselves that cause rhinitis, but a chemical that is found in their excrement. They are present all year round, though their numbers tend to peak during spring and autumn.
    • Tree and grass pollen – the tiny particles of pollen that are produced by trees and grasses can cause allergic rhinitis. Most trees usually pollinate between early to mid spring. Grasses pollinate at the end of spring and beginning of summer.
    • Animals – it is not actually animal fur that causes allergic rhinitis; it is a reaction to flakes of dead animal skin, and their urine and saliva. Dogs and cats are the most common culprits, although some people can be affected by horses, cattle, rabbits and rodents, such as guinea pigs and hamsters.
    • Work-related allergens – some people are affected by allergens that are present in their work environment, such as wood dust, flour dust, or latex



    How do we diagnose allergic rhinitis?

    To know the exact cause of your allergic rhinitis, you should be referred for allergy testing. Two tests that may be carried out include:

    (1)     Skin prick test – this is usually the first test to be carried out when trying to determine which allergen is causing your allergic rhinitis. The allergens are placed onto your arm and introduced into the skin by pricking it with a short pin. If there is a positive reaction, your skin will become itchy, red and swollen.

    (2)     Blood test – this is used to measure the amount of Immunoglobulin E (IgE) antibody in your blood which has been produced by your immune system in response to a suspected allergen.



    When to seek medical advice?

    You should see an allergist if your allergic rhinitis is:

    • causing disruption to your sleep,
    • impairing your ability to carry out everyday daily activities,
    • adversely affecting your performance at work , and
    • not responding to over-the-counter medications


    What is the treatment of allergic rhinitis?

    Avoidance is the best treatment for any allergy whenever possible. Keeping doors and windows closed in the home and in your car and avoiding vigorous outside activity will help to lessen your exposure during times when the pollen count is high.

    Antihistamines may relieve many hay fever symptoms by inhibiting the action of histamine on nasal and eye tissues. Be careful not to drive or operate dangerous machinery until you know how you are affected by an antihistamine.

    Nasal decongestants act to decrease the swelling of the nasal tissue and the resulting feeling of stuffiness. Oral decongestants may cause sleeplessness and jitteriness. Topical nasal decongestants cause “rebound” congestion and irritation of the nasal passages if used more than 2-3 days.

    Nasal corticosteroids are effective in treating allergic symptoms and are best used locally to minimize side effects. It often takes several days to become effective. Nose bleeding has been reported with nasal steroid use.

    Oral corticosteroids (e.g. prednisone) are different in that when taken internally the risk of side effects is much greater than when used in small amounts locally, such as in the nose. Similarly, long acting injections of steroids may have an increased incidence of side effects.

    Eye drops: Antihistamine decongestant eye drops act similarly to oral preparations and given quick relief of allergic symptoms of red, itchy, watery eyes.

    Saline (salt water) nose drops are often helpful in relieving nasal symptoms. You may purchase these already mixed or you may make your own by mixing 1 cup of water, 1/2 teaspoon salt, and a pinch of baking soda. Inhale a handful of this solution at a time. Discard the home-made solution after twenty-four hours because it contains no preservative.

    Hyposensitisation (immunotherapy)

    Hyposensitisation is a method of treating allergies that involves gradually increasing a person’s exposure to more and more of the allergen in order to make them less sensitive them to it.


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