Symptoms And Treatment Of Allergic Rhinitis

What are the symptoms and treatment of allergic rhinitis? First of all, it is important to know that allergic rhinitis is a chronic disease that results from reactions of the nasal mucosa to exposure to certain external agents. In this situation, there is a nasal hyperactivity that affects the eyes and nose.

The above reactions are the body’s main defense mechanism against IgE antibodies. Also known as immunoglobulin E, antibodies stimulate the release of chemical mediators in cells, which are predisposed to certain antigens to balance infections.

At the same time, antigens or immunoglobulins are toxic substances that produce antibodies. This explains the defense mechanism against them. Due to this chemical process, the body enters a state of immediate hypersensitivity which is manifested by slow inflammatory reactions.

Symptoms of allergic rhinitis

The symptoms of allergic rhinitis differ from person to person. However, it is not necessary for all of them to be present for the patient to be diagnosed with allergic rhinitis. The most common symptoms are:

• Fatigue during the day
• Headache
• Runny nose
• Pharyngitis
• Sleeping disorders
• Nasal and pharyngeal itching
• Nose flow
• Irregularities in the alignment of the nose
• Constant sneezing
• Signs on the face (bags under the eyes, Morgan-Dennie lines, notches)
• Symptoms of conjunctivitis (red, watery eyes, itchy eyes)
• Disinterested facial expression, absent gaze, half-open mouth, mouth breathing
• Light or glossy nasal mucus (transparent and watery).

Factors underlying allergic rhinitis

There are certain factors that can lead to the development of allergic rhinitis. These include:

• Genetic predisposition
• The fact that you were born in danger zones
• Early exposure to allergens
• Excessive use of antibiotics in childhood
• History of atopy (allergic disorders) in the family history
• Exposure to harmful elements (tobacco, dust mites, animal fur)

Types of allergic rhinitis

There are two types of allergic rhinitis: seasonal and perennial.

Seasonal allergic rhinitis

Also called pollen, seasonal allergic rhinitis is present in about 75% of cases. It usually occurs between winter and spring (in the northern hemisphere) due to plant pollination.

Seasonal allergic rhinitis causes acute itching in the ears, eyes and oropharynx. This symptom may become more intense with prolonged exposure to fresh air, especially during pollination hours (5:00 – 10:00 and 19:00 – 22:00) and may improve on wet and rainy days.

Perennial allergic rhinitis

Perennial allergic rhinitis is triggered by factors such as dust, spores (Alternia and Cladosporium) and particles of the skin of cats, dogs or rodents.

The symptoms of perennial allergic rhinitis are similar to those of seasonal rhinitis, but the itching in the ear is milder and the nasal obstruction is more watery. Therefore, the patient has to breathe through his mouth, has a nasal voice, loses his taste and smell and faces other easily identifiable symptoms.

Frequent allergens

There are many allergens, but the most common are:

• Pollen
• enzyme
• Food
• Drugs
• Materials (latex, gloves, probes)
• Animal epithelial tissue (hair, urine, saliva)
• Spores (penicillium, cladosporium, alternaria and aspergillus)
• Mites (dermatophagoides pteronysinus, dermatophagoides farinae, dermatophagoides microceras)

Treatment of allergic rhinitis

In general, a combination of pharmaceutical and environmental treatment is needed to control allergic reactions and eliminate allergens.

Environmental treatment

Before starting a drug treatment, it is necessary to take certain measures. By creating a healthy environment, you can speed healing. Here are the steps to follow:

• Avoid sudden changes in temperature.
• Keep the windows closed at night.
• Wash your nasal passages with sterile saline.
• Adopt a balanced diet, free of allergies and drink water.
• Spend as little time outside as possible (during periods of pollination, when the wind blows, during peak periods of allergens).
• Use a filter air conditioner, both in the house and in the car).
• Avoid contact with chemical irritants, from tobacco to chlorine.

Pharmaceutical treatment

Currently, there are many drugs that can be used in the treatment of allergic rhinitis, such as decongestants, antihistamines, inhibitors of mast cell degranulation and nasal decongestants with topical application).

Antihistamines

Antihistamines are recommended for relieving itching, sneezing and runny nose. But their ability to combat nasal congestion and the symptoms of allergic rhinitis is limited. The most useful oral medications are cetirizine and loratadine. 

It is important to note that first-generation antihistamines can have side effects such as drowsiness and low abilities. At the same time, second-generation antihistamines have no side effects and provide immediate relief, but the effect is not lasting.

Decongestants for the treatment of allergic rhinitis

Decongestant drugs have a long-lasting effect, do not cause local irritation, congestion or drug rhinitis. But they have certain side effects, such as drowsiness, dizziness, anxiety, urinary retention or high blood pressure.

Used for more than 2-3 days, local nasal decongestants lose their effectiveness, cause the recurrence of symptoms and aggravate chronic rhinitis. Therefore, it is advisable to use oral decongestants.

Intranasal corticosteroids

Intranasal corticosteroids are effective in relieving the symptoms of rhinitis: nasal congestion, runny nose, itching and sneezing. These drugs are metabolized quickly and have a lasting effect. However, consumed over a long period of time, intranasal corticosteroids can have severe side effects: stunted growth, behavioral disorders, suppression of the hypothalamus axis, etc.

The most recommended intranasal corticosteroids are:

• Flunisolid
• Mometasone furoate
• Fluticasone propionate
• Beclomethasone dipropionate

Immunotherapy

Immunotherapy consists of the progressive administration of gradual concentrations of certain allergen extracts depending on the patient’s condition. In this way, a tolerance to the respective allergen is created.

Immunotherapy is the mainstay in the treatment of allergic rhinitis because it is very effective. However, in some countries, it can only be applied subcutaneously. For this reason, patients need to consider several factors, such as the frequency of injections, the duration of treatment, the risks and their willingness to continue treatment.