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Allergic rhinitis is the inflammation of the nasal airways. It refers to the collection of symptoms occurring mostly in the nose and eyes. If it is due to outdoor triggers, such as pollen, it is called hay fever.
Substances which trigger an allergic reaction in the body are called allergens. The body’s immune system overreacts to the inhaled allergen causing symptoms such as sneezing and a runny nose. When exposed for the first time, the body’s immune system recognizes the allergen as a foreign substance and reacts by making antibodies against it. Subsequent exposure causes the antibodies to attack it and release chemicals like histamine that causes the allergy symptoms.
Based on how often a person has it and how severe it is, allergic rhinitis can be classified as:
- Moderate to severe
Based on the kind of allergens a person reacted to and when the reactions occurred, the disease can also be classified as:
- Seasonal – occurs at the same time each year and is often called hay fever
- Perennial – occurs any time during the year
- Occupational – caused by an allergic reaction to a substance present in the workplace
Allergic rhinitis occurs when someone breathes in something he/she is allergic to such as dust, pollen, insect venom, etc.
- Most common allergens are dust mites, indoor fungi, animal dandruff, cockroaches, and mold.
- Allergens at workplace such as cereal grain, wood dust, chemicals or lab animals can also be the causative factors.
- Pollens are the common causes for seasonal allergic rhinitis. Tree pollens are the common causes for symptoms in winter and spring, grass and weed pollens for symptoms in summer and ragweed for symptoms in late summer and autumn.
Some of the factors that increase your chances of getting allergic rhinitis are
- Genes – A child is more likely to have an allergy if both parents have an allergy.
- Environment – Exposure to indoor allergens and pollens or molds.
- Suffering from eczema or asthma increases the chances of having allergic rhinitis.
Symptoms of allergic rhinitis may develop at certain times of the year or often during the year. The symptoms may show up for many years whenever one is exposed to the allergen. But over time, the allergens may affect less with decreased severity in symptoms.
Immediate symptoms that occur on coming into contact with the allergen are:
- Itchy nose, mouth, throat, etc.
- Itchy and watery eyes
- Runny nose – drainage from a runny nose caused by allergies is usually clear and thin.
- Repeated sneezing
Some symptoms develop later, such as:
- Stuffy nose (nasal congestion)
- Clogged ears
- Sore throat
- Decreased smell sensation
- Puffiness and dark circles under the eyes
Diagnosis is usually based on the physical examination and history of symptoms. A family history can usually be elicited. Skin tests and blood tests help in diagnosing the condition and detecting the allergen.
- Skin test – The test is safe, specific and rapid. Skin is pricked with a small amount of suspected allergens and watched for signs of reaction (swelling, redness). The test may reveal the substances that trigger the symptoms.
- Blood test – IgE immunoassays measure the levels of allergy-related substances, immunoglobulin E (IgE) in the blood. A complete blood count (CBC) test shows an increased Eosinophil count.
Most symptoms of allergic rhinitis can be treated. Allergens usually continue to affect a person over the long term. But some people, especially children, may outgrow an allergy. Over time, the allergens may affect them less. The symptoms may not be as severe as they used to be.
Allergic rhinitis can affect the quality of one’s life. If not treated, it can affect the body health too. The allergy could trigger a number of health problems like:
- Sinusitis (sinus infections)
- Otitis media
- Upper respiratory infections
- Dental implications like high, narrow roof of the mouth (palate), pinched-looking face and malocclusion.
A nasal wash with a saline solution can help remove mucus from the nose. Over-the-counter medicines can help treat the symptoms.
- Antihistamines work well for treating allergy symptoms that are infrequent or do not last very long.
- Nasal corticosteroid sprays are the most effective treatment for allergic rhinitis.
- Nasal congestion may be reduced with decongestants.
- Leukotriene modifiers help block the actions of leukotriene that causes inflammation in allergic rhinitis. They are highly efficient in treating allergic rhinitis.
- The anti-inflammatory activities of mast cell stabilizers can prevent the release of histamine and related mediators of inflammation.
- Allergy shots may be recommended if the allergen cannot be avoided and the symptoms are hard to control. Small doses of allergens, each dose slightly larger than the previous dose, help your body get used to it, which can result in fewer or less severe symptoms.
- Anti–immunoglobulin E antibodies have been used in the treatment of seasonal allergic rhinitis. They reduce the risk of anaphylaxis in patients who are receiving immunotherapy.
- Sublingually administered allergen immunotherapy (SLIT) can significantly reduce the symptoms of allergic rhinitis.
- Ayurveda believes that an imbalance in the three doshas – vata, pitta and kapha – results in a disease. According to the ancient Indian system of medicine, allergy or Sheetpitta is a condition of pitta caused due to toxins present in the body (ama) and low immunity. Allergic rhinitis is a Kapha-Pitta Ama increases the levels of pitta and kapha in the body, thus giving rise to various allergy symptoms. Some of the therapeutic approaches are adding a slice of ginger, pepper and cardamom while preparing tea, consuming tea made of camphor, cloves and basil, inducing therapeutic vomiting to help balance Kapha, etc.
- Homeopathic treatment targets your body’s immune system and reduces the hypersensitivity to the allergens. With time, the body reacts less aggressively to the allergens and the hypersensitivity is cured. Medications help reduce symptoms and improve quality of life. Nux vomica, Euphrasia, and Histaminum hydrochloride are some of the medicines.
- Herbs help strengthening the body and treating disease. Butterbur is used traditionally to reduce mucus. It is thought to reduce the activity of leukotriene. A study has suggested that it may be an effective herbal treatment for seasonal (intermittent) allergic rhinitis.1 Stinging nettle extract helps block the production of many of the immune system compounds involved in the allergic response. A nettle (Urtica dioica) extract has been shown to reduce allergic and other inflammatory responses that cause the symptoms of seasonal allergies.2 Biminne and Shi-Bi-Lin (SBL), Chinese herbal formulae, have been shown to be effective in treatment of perennial AR. Biminne reduces symptoms of allergic rhinitis including runny nose, sneezing and itching by improving vascular permeability of nasal mucosa, inhibiting the proliferation of splenic lymphocyte and reducing serum level of IgE.3,4 SBL modulates the mast cell-mediated hypersensitivity reaction and relieves symptoms of nose blockage.5
- In Acupuncture, very thin needles are placed into the skin at specific points on the body. It is based on the belief that chi (prana, in India), the bio-energy or life force, moves and sustains life. Illness, according to this holistic approach, is caused whenever the chi of the external environment is disturbed, or if one’s internal chi, the body-mind complex, is not in harmony. Healing is therefore achieved by correcting the outer environment and by stimulating the acupoints. To eliminate pain and disease the flow of energy is restored by inserting thin needles at specific points. The therapy has been shown to be effective in the treatment of perennial AR.6
- Detoxification is a regimen of diet, exercise, pills, forced sweating, colonics, etc. It removes toxins from the body and help decrease the sensitivity of body’s immune system.
- Biologically based therapies use natural substances like foods, vitamins and both herbal and non-herbal dietary supplements to treat illness or promote wellness.
- In enzyme potentiated therapy, a low dose of an allergen mixed with a very small quantity of a natural body enzyme is injected into the skin. It activates the T lymphocytes to favor desensitization.
1. Käufeler R, Polasek W, Brattström A, Koetter U. Efficacy and safety of butterbur herbal extract Ze 339 in seasonal allergic rhinitis: postmarketing surveillance study. Adv Ther. 2006 Mar-Apr;23(2):373-84. PubMed PMID: 16751170.
2. Roschek B Jr, Fink RC, McMichael M, Alberte RS. Nettle extract (Urtica dioica) affects key receptors and enzymes associated with allergic rhinitis. Phytother Res. 2009 Jul;23(7):920-6. doi: 10.1002/ptr.2763. PubMed PMID: 19140159.
3. Gu YF, Zhang XM, Hu GR. [Effect of biminne on vascular permeability of nasal mucosa in allergic rhinitis rats]. Zhongguo Zhong Xi Yi Jie He Za Zhi. 2006 Oct;26(10):918-21. Chinese. PubMed PMID: 17121045.
4. Liu RH, Zhang XM, Zhang SQ. [Study on mechanism of biminne in treating allergic rhinitis]. Zhongguo Zhong Xi Yi Jie He Za Zhi. 2007 Jul;27(7):623-5. Chinese. PubMed PMID: 17717923.
5. Zhao Y, Woo KS, Ma KH, van Hansselt CA, Wong KC, Cheng KF, Lam CW, Leung PC. Treatment of perennial allergic rhinitis using Shi-Bi-Lin, a Chinese herbal formula. J Ethnopharmacol. 2009 Feb 25;122(1):100-5. doi: 10.1016/j.jep.2008.12.005. Epub 2008 Dec 11. PubMed PMID: 19118617.
6. Lee MS, Pittler MH, Shin BC, Kim JI, Ernst E. Acupuncture for allergic rhinitis: a systematic review. Ann Allergy Asthma Immunol. 2009 Apr;102(4):269-79; quiz 279-81, 307. doi: 10.1016/S1081-1206(10)60330-4. Review. PubMed PMID: 19441597.