What is Allergic Rhinitis?

Allergic Rhinitis refers to a condition triggered when allergens come into contact with the nasal mucosa, resulting in symptoms such as nasal discharge, itching in the nose and eyes, sneezing, and throat irritation.

The cause is an abnormal reaction to particles in the air that enter the nose during breathing. Terms like hay fever, summer flu, and allergic rhinitis are often used synonymously with allergic rhinitis.

The severity of allergic reactions varies from person to person; some experience mild reactions, while others may endure symptoms severe enough to disrupt their daily lives and affect their quality of life.

Allergic rhinitis is classified into two subgroups based on the duration of symptoms: Intermittent (occasional) and Persistent (continuous). It is further divided into mild, moderate, and severe categories based on its intensity.

Causes of Allergy

An allergy is defined as an excessive reaction developed by the immune system. The immune system normally responds to all foreign substances entering the body as a natural defense mechanism. However, some individuals develop a unique immune response to certain substances, leading to unexpected reactions upon subsequent exposure.

These substances are called allergens, and the affected individuals are referred to as allergic. Allergy is a genetically transmitted trait, with approximately 50% of children developing allergies if both parents are allergic. Allergens stimulate the body to produce antibodies. These antibodies later combine with allergens, causing the release of certain chemicals in the body that lead to unwanted effects.

Histamine is the most well-known of these chemicals. It causes swelling in the nasal membranes, itching, irritation, and excessive nasal discharge.

Which Allergens Cause Rhinitis?

Proteins from animals and plants, light enough to be airborne, accumulate on the membranes of our eyes, nose, and throat. Common allergens include pollen, mold spores, animal dander, and house dust. During early spring, pollens from frequently found trees trigger allergic reactions.

In late spring, pollens mainly originate from grasses. Colorful ornamental plants rarely cause allergies since their pollens are too heavy to be airborne and are instead carried by insects. Certain plants begin releasing pollen in late August, continuing through September and sometimes October, until the first frost.

Molds, which spoil bread and fruits, also grow on dry leaves, grass, hay, seeds, other plants, and soil. They are resistant to cold, prolonging allergy issues except when snow covers the soil.

Indoors, molds thrive on plants and their potting soil, as well as in damp areas like basements and laundry rooms, and even on cheese and fermented drinks.

Year-Round Changes in Allergic Rhinitis

Allergens, including animal dander, cosmetics, molds, food, and house dust, are present year-round. House dust comprises a mix of cellulose from furniture, molds, mites, pet dander, and insect fragments. Allergies tend to worsen in winter when heating systems activate, stirring up house dust.

Effects of Allergies

Allergic individuals are more sensitive to colds, sinus infections, and ear infections. These conditions affect them more severely than those without allergies. In some cases, they may also develop asthma.

Approach to Allergic Patients

A thorough examination of the ears, nose, throat, head, and neck should be conducted for all patients. It is essential to determine whether symptoms are caused by an infection or structural abnormality, in which case appropriate treatment is provided.

After taking a medical history and conducting an examination, skin or blood tests may be performed to identify the specific allergen causing the reaction. These tests reveal both the allergen and the level of the allergic reaction.

Various drug groups are available for treating patients diagnosed with allergies. Different treatment protocols are applied based on the patient’s condition, examination findings, and severity of symptoms.

Main Drug Groups Used:

  • Antihistamines (suppress allergic reactions)
  • Decongestants (reduce nasal swelling)
  • Cromolyn (prevents the release of reactive substances from cells)
  • Corticosteroids (reduce reactions, available as injections, tablets, or sprays)
  • Immunotherapy (vaccines to block allergen effects and reduce sensitivity)

When an allergen is identified through testing or medical history, medical treatment is complemented by environmental control counseling to minimize exposure to allergens.

Steps in Allergic Rhinitis Treatment:

  • Avoiding contact with allergenic triggers
  • Drug therapy
  • Immunotherapy
  • Surgery: Considered for conditions like nasal polyps, enlarged nasal turbinates causing obstruction, or chronic sinusitis unresponsive to treatment. This helps alleviate symptoms.

Methods to Prevent Allergies

Ideally, living away from allergen sources is the best solution, but this is rarely practical. However, certain measures can help:

  • Wearing a pollen mask while mowing the lawn or cleaning.
  • Replacing heating and ventilation filters monthly or using an air purifier.
  • Keeping doors and windows closed during high-pollen periods.
  • Avoiding indoor plants and pets.
  • Replacing feather pillows, wool blankets, and wool covers with cotton or synthetic alternatives.
  • Using antihistamines and decongestants when necessary.
  • Sleeping with the head of the bed elevated.
  • Following general health guidelines, exercising daily, quitting smoking, avoiding air pollutants, maintaining a balanced diet, reducing carbohydrate intake, and adding vitamins like vitamin C. Using a humidifier during winter can be beneficial but beware of mold growth in humidifiers.