Allergic rhinitis: symptoms, causes and treatment

Allergic rhinitis is a disease with a chronic course, characterized by the development of the underlying inflammatory IgE-mediated reaction due to the penetration of allergens into the nasal mucosa and manifested by nasal congestion, sneezing, itching and rhinorrhea.

This is one of the most difficult and widely spread pathologies to which many studies have been devoted. To date, a common allergic rhinitis is the subject of attention in connection with the dynamics of morbidity, frequent complications and a sharp decline in ability to work.

Causes of

The development of an allergic rhinitis is caused by exposure to allergens, of which the following are particularly relevant:

• pollen of plants( see how to treat allergy to flowering);
  
• spores of mold fungi;
  
• home and book( library) dust;
  
• pliers;
  
• medication;
  
• feed for aquarium fish and fish;
  
• saliva and pet hair;
  
• down from pillows;
  
• allergens of insects( cockroaches, ants, fleas);
  
• food products( rare).

Symptoms of the disease can be provoked by wearing fur and clothing made from wool, aggravated by household chemicals, infections, tobacco smoke, sudden temperature changes, and also due to physical exertion.

An important role in the development of an allergic rhinitis is burdened with heredity, anatomical features of the nasal cavity, increased permeability of the mucous membrane.

Rhinitis often begins after a previous acute respiratory viral infection. It can be triggered by the introduction of nasal drugs on turunda, as well as infusion of drops.

Classification

Earlier in the classification, the exposure time of allergens was taken into account, in connection with which a seasonal, year-round runny nose was distinguished, and also a professional cold.

But in 2001 experts in this area proposed alternative systematization, where the main emphasis is placed on the duration of the maintenance of symptoms and the severity of the clinical course.

Thus, intermittent( periodic) and persistent allergic rhinitis are distinguished, each of which in its turn can have a light, moderate and severe course.

Read also, the symptoms of vasomotor rhinitis.

Symptoms of allergic rhinitis

The clinic of intermittent allergic rhinitis shows such characteristic symptoms:

• with a blocked nose;
  
• paroxysmal sneezing;
  
• by constant release of watery secretion in large quantities;
  
• is the attenuation attenuation;
  
• headache;
  
• dark areas around the eyes as a result of stagnation in periorbital veins;
  
• hearing loss;
  
• with a crash in the ears( often with swallowing);
  
• by lacrimation;
  
• redness of the skin near the eyes;
  
• dermatitis in the region of the wings of the nose;
  
• is a photophobia;
  
• itching in the throat or in the palate;

Also in adults, there may be systemic manifestations in the form of general weakness, irritability, loss of appetite, nausea( due to swallowing large amounts of mucus), drowsiness.

Persistent allergic rhinitis is characterized by a less pronounced clinical picture, which is explained by a lower concentration of allergens. The only complaint can be nasal congestion.

Symptoms of rhinitis of allergic origin in adults can manifest only after direct contact with the allergen in a particular season, or under the influence of various triggers will persist throughout the year with periodic regress or improvement.

Seasonality of the disease is due to activation of sporulation of fungi or is associated with the flowering of plants, reproduction of ticks.

Treatment of allergic rhinitis

In adults, modern methods of treating allergic rhinitis include actions to exclude contact with a provoking factor, pharmacotherapy and allergen-specific immunotherapy. Eliminate the effect of allergens is not always obtained, but if this can be achieved, a good result is guaranteed.

For allergic rhinitis, the following actions are recommended:

• moist cleaning of the room( frequent);
  
• moving to another geographic area;
  
• change of pillow;
  
• discontinuing contact with a pet;
  
• application of air cleaners;
  
• observance of personal hygiene( showing frequent showering);
  
• use of insect control products;
  
• elimination diet;
  
• avoiding places with high humidity if there is sensitization by fungi;
  
• quitting.

Of the drugs today, six major groups have quite a wide popularity:

• antiallergic drugs, including intranasal H1-blockers;
  
• mast cell membrane stabilizers( cromoglycate);
  
• decongestants( oxymetazoline, naphazoline);
  
• antagonists of leukotriene receptors;
  
• anticholinergic drugs( ipratropium bromide);
  
• intranasal glucocorticosteroids.

If a causally-relevant allergen is diagnosed and the patient needs a long daily intake of symptomatic remedies, then allergen-specific immunotherapy is recommended, which reduces the need for drugs, reduces symptoms and risks the transformation of an allergic rhinitis into bronchial asthma.

This is the only therapeutic method that achieves a stable effect, since it acts on all pathogenically important elements of immunity.

Immunotherapy is performed by an allergist-immunologist taking into account indications and contraindications. In the patient's body allergen is administered in gradually increasing doses. The treatment is designed for 3-5 years and is focused on changing the nature of the response and reducing sensitivity to the allergen.

Alternatively, there is also an operative treatment for allergic rhinitis, but this method can be applied only on strict indications with:

• a poor effect from conservative treatment, when nasal breathing can not be restored;
  
• irrecoverable changes in nasal concha;
  
• for impaired intranasal cavity;
  
• cysts or suppurative processes of the paranasal sinuses.

Thus, the amount of treatment depends on the severity of the disease.


Diagnosis of an allergic rhinitis contains a collection of information that allows you to find out the causative factor, conduct all kinds of tests and physical examination of a person.

The main and additional diagnostic actions and methods include:

• examination of an allergist, an otolaryngologist;
  
• trial therapy with nasal antihistamines or glucocorticosteroids;
  
• skin tests with mixed allergens;
  
• cytological and bacteriological analysis of the discharge from the nose;
  
• anterior rhinoscopy;
  
• X-ray of the nose and paranasal sinuses;
  
• provocative nasal test with allergens;
  
• endoscopic examination of the nasal cavity;
  
• computed tomography;
  
• rhinomanometry;
  
• definition of allergen-specific IgE in blood serum;
  
• study of the function of external respiration by spirography.

Diagnostics performed on time and adequate treatment are important tasks of practicing doctors, since timely actions significantly increase the quality of life.

Forecast

The prognosis is favorable, but if the disease is not treated, then it can progress and intensify the symptoms. Chronic inflammation of the nasal mucosa can cause the development of otitis, sinusitis, attachment of a secondary bacterial infection.

There is a relationship between rhinitis and bronchial asthma. According to statistics in the future, asthma develops in almost half of patients with an allergic rhinitis. This explains the close attention to this disease of practical public health and doctors of many specialties.

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