Allergic rhinitis, also known as allergic cold, is a discomfort that arises after allergens (substances causing allergies) come into contact with the nasal mucosa, leading to symptoms such as runny nose, itching in the nose and eyes, sneezing, and throat itching. It is an abnormal reaction developed against particles present in the air that enter the nose through respiration. Terms synonymous with allergic rhinitis include hay fever, summer flu, and allergic rhinitis (nasal inflammation).

The severity of allergic reactions in this condition varies from person to person; while some patients experience very mild allergic reactions, others may suffer from symptoms so severe that they hinder their daily activities and degrade their quality of life.

Allergic rhinitis is categorized into two subgroups based on the duration of symptoms: Intermittent (sporadic) and Persistent (continuous), and into three groups based on severity: mild, moderate, and severe.

CAUSES OF ALLERGY

Allergy is defined as an exaggerated reaction developed by the immune system. The immune system responds to all foreign substances entering the body. Under normal conditions, this is a natural defense mechanism. However, some individuals develop a different immune response to certain substances, resulting in unexpected severe reactions upon subsequent exposures to these substances.

These substances are called allergens, and individuals reacting to them are referred to as allergic. Allergy is a genetically inheritable trait, with approximately a 50% chance of a child developing allergies if both parents are allergic. Allergens stimulate the body to produce antibodies. These antibodies then bind to allergens, causing the release of certain chemicals in the body that lead to unwanted effects.

Histamine is the most well-known chemical among these. This substance causes swelling of the nasal membranes, itching, irritation, and excessive nasal discharge.

WHICH ALLERGENS CAUSE RHINITIS?

Animal and plant proteins that are small and light enough to be carried by the air accumulate on the membranes of our eyes, nose, and throat. Pollens, mold spores, animal dander, and house dust are among the most frequently encountered particles. In the early spring, pollens from commonly found trees or those prevalent in the environment cause allergic reactions. In the late spring, pollens from grasses are the culprits. Colorful ornamental plants rarely cause allergies because their pollens are too heavy to be carried by the wind. These plants’ pollens are transported from one place to another by insects. Some plants begin to release pollens at the end of August, continuing throughout September, and sometimes until October or the first frosts.

Molds are fungi that cause bread to mold, fruits to spoil, and are also found on dry leaves, meadows, reeds, seeds, other plants, and soil. They are resistant to cold, making allergy issues persistent, and their spores are airborne all year round except during periods when the ground is covered by snow. Inside homes, molds live on plants and in their potting soil. They are also found in damp areas such as basements and laundry rooms, as well as in cheese and fermented beverages.

CHANGES IN ALLERGIC RHINITIS THROUGHOUT THE YEAR

Allergens, including animal dander, cosmetic products, molds, foods, and house dust, are present in the environment all year round. House dust is a complex mixture consisting of cellulose shed from furniture, molds, weeds, residues shed by pets, and insect parts. Allergy symptoms increase during winter when heating systems are turned on, exposing individuals to house dust allergens.

HARMFUL EFFECTS OF ALLERGY

Individuals with allergies have increased sensitivity to colds, sinus infections, and ear infections. These conditions can cause more discomfort in allergic individuals compared to those without allergies. In some cases, allergies can even lead to asthma.

APPROACH TO ALLERGIC PATIENTS

All patients should undergo a complete examination of the ears, nose, throat, head, and neck. It should be determined whether any infections or structural abnormalities are causing the symptoms. If such a problem is identified, appropriate treatment should be administered.

After taking the patient’s history and conducting a physical examination, skin tests or blood tests may be requested to identify the specific allergen causing the allergic reaction. These tests not only determine which substances the patient is allergic to but also the severity of the allergies.

There are different groups of medications available for treating patients diagnosed with allergies. Various treatment protocols can be applied based on the patient’s characteristics, examination findings, and the severity of their symptoms.

The main groups of medications used include antihistamines (which suppress allergic reactions), decongestants (which reduce swelling in the nasal passages), cromolyn (which prevents the release of substances that cause reactions from cells), corticosteroids (which reduce reactions and can be administered as injections, pills, or sprays), and immunotherapy (which blocks allergens in the body without causing allergies, thereby reducing sensitivity to allergens).

When an allergen causing symptoms is identified through tests or history, in addition to medical treatment, environmental control counseling should be provided to protect against these allergenic substances.

The approach followed in treating allergic rhinitis is as follows:

  • Eliminating contact with allergenic triggers,
  • Medication therapy,
  • Immunotherapy,
  • Surgery: Particularly for nasal turbinate hypertrophy, nasal polyps, and chronic sinusitis cases that do not respond to treatment. It helps reduce the patient’s symptoms.

METHODS OF PREVENTING ALLERGY

Ideally, avoiding the environment where the allergy occurs is preferable, but this is rarely feasible. However, certain preventive measures can be beneficial:

  • Wearing a pollen mask while mowing the lawn or cleaning the house.
  • Changing filters in heating and ventilation systems monthly or starting to use an air purifier.
  • Keeping doors and windows closed during periods when pollen levels are very high.
  • Avoiding having plants and animals at home.
  • Replacing feather pillows, wool blankets, and wool covers with those made from cotton or synthetic materials.
  • Using sufficient antihistamines and decongestants when necessary.
  • Sleeping with the head of the bed elevated.
  • Maintaining general health rules, exercising daily, quitting smoking, avoiding other causes of air pollution, eating a balanced diet, reducing carbohydrates, adding vitamins to the diet (vitamin C). Since dry indoor air can worsen conditions for many allergic individuals, especially during winter, using a humidifier can be beneficial. However, the possibility of mold growth in humidifiers should be considered.