Allergic rhinitis (known as hay fever) is the inflammatory process in the nose which occurs when the immune system overreacts to allergens getting into your nose.  Mast cells involved in this inflammatory process degranulates and release excess histamine and other inflammatory chemical which make you feel itchy, sneeze, have runny nose and eyes. 

Risk Factors

• Allergies to dust, pollen or chemical smell or other organic compounds
• History of asthma or eczema
• Family history of allergy

Click FreeMedEducation video on Rhinitis

Symptoms

• Nasal congestion and blocked ears
• Watery eyes and runny nose
• Itchy nose and throat
• Postnasal drip to back of your throat
• Repetitive sneezing
• Difficulty breathing through your nose.

Definition of Allergic Rhinitis

• Intermittent (occurs less than 4 days per week or for less than 4 weeks)
• Persistent (occurs more than 4 days per week or for more than 4 weeks)

Diagnosis

• History and Symptoms (these is usually sufficient to make a diagnosis)
• Skin or Blood Allergy Tests
• Blood test

Complications

• Middle ear infection
• Sinusitis

Treatment

The strategy to treat allergic rhinitis is:

• Avoid exposure to allergens.
• Medication to treat the symptoms.
• Medication to prevent allergic flare-up.

1. Saline nasal spray

These spray helps to provide some relief to the feeling of discomfort or dryness in the nasal passage and wash out allergens on the inside lining of your nose.

2. Anti-inflammatory nasal spray medication

These medications help to reduce the inflammation in your nasal passage.  Examples include Mometasone (NASONEX), Budesonide (RHINOCORT), Cicleonide (OMNARIS), Flunisoide, Fluticasone (AVAMYS)

3. Oral Decongestants

These medications help to reduce the swelling in your nasal passage. Examples include medicine or syrups which contain Pseudoephredine.

4. Antihistamine nasal spray

These medications block H1-receptors on the mast cells in the nose.  Examples include Azelastine(ASTELIN) and Olopatadine (PATANASE).

5. Antihistamine medication

These medications block H1-receptors on the mast cells and helps reduce the severity and frequency of allergic responses to allergens.  Examples include Cetrizine (ZYRTEC), Desloratidine (AERIUS), Fexofenadine (ALLEGRA), Loratadine (CLARITIN)

6. Leukotriene receptor antagonist

Montelukast (SINGULAR) inhibit leukotriene release which helps reduce inflammation and nasal congestion.   They are useful only to reduce your sensitivity to allergens and have not much effect on helping your symptoms during a flare-up.  

Prevention Do’s and Don’t’s

DO change your clothes when you come in from outdoors.

DO use an air purifier in your room.

DO NOT smoke

DO NOT go to places with high pollen count or with animal fur.

See your Doctor or an ENT Specialist if you have recurrent symptoms.

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