Know your health: Allergic Rhinitis

Definition:

Allergic rhinitis is a medical condition linked to a group of symptoms affecting the nose. These symptoms arise when you breathe in something you are allergic e.g. dust, animal dander, pollen or food that you are allergic to e.g. fish.

Causes:

When you suffer from allergic rhinitis and you breathe in an allergen, the body will release chemicals that give you allergy symptoms.

Immediate symptoms

Itchy nose, mouth, throat, skin and any area that was in contact with the allergen;
Problems smelling anything within your surrounding
Sneezing
Runny nose
Watery eye

Symptoms that may develop later;

Stuffy or blocked nose
Sore throat
Puffiness under the eyes
Headache
Coughing
Dark circles under the eyes
Clogged ears
Decreased sense of smell

Diagnosis

Normally done by physical examination where the healthcare provider will ask you about the symptoms you are experiencing, whether they vary by the time of the day or season, exposure to pets or other suspected allergens.

Skin testing is the most common method of allergy testing though special blood tests may be used to help with diagnosis such as the IgE RAST test to measure levels of allergy related substances, eosinophil count may also help with diagnosing allergies.

Treatment

Non pharmacological treatment

The best is to avoid the allergen as far as possible if known though in most cases it is quite difficult to identify one prior to diagnosis.

For mild allergic rhinitis, a nasal wash helps to remove mucus from the nose. A nasal wash is a saline (salt) solution that you can buy at a local pharmacy or supermarket or you can make one at home using 1 cup (240ml) of warm water, half a tea spoon of salt (3g) and a pinch of baking soda. Use as a nasal wash as you wish. The mixture should be used within 24 hours of preparation.

If symptoms do not improve after 5 days, consult your doctor or pharmacist.

A warm compress can be used to relieve nasal congestion by placing a warm cloth on the fore head. Ensure that is not too hot to burn your skin.

Pharmacologic treatment

Your doctor or pharmacist may prescribe medicine to treat the allergic rhinitis which depends on the symptoms and how severe they are, age, if you have other medical conditions that should be considered for example asthma.

Medicines used include;

Antihistamines: Chlorpheniramine,cetirizine,loratadine e.t.c

These work well for allergy symptoms that do not happen so often or do not last for a long period of time. They can be taken by mouth as tablets or capsules or as a nasal spray.

Care should be taken when using antihistamines as they can cause; dry mouth, sleepiness (if at work , operating machines or driving),

Corticosteroids:prednisone,prednisolone,fluticasone,fexofenadine

Nasal corticosteroids sprays are the most preferable and effective treatment for allergic rhinitis when used for a long period of time though can also be beneficial in short term use for both children and adults.

Oral corticosteroids should be avoided unless when indicated and prescribed by your doctor or pharmacist as they pose a lot of risks with long term use.

Decongestants: Oxymetazoline, phenylephrine

These can be used to reduce nasal stuffiness/ blocked nose but should not be used for more than 4 times a day as they can block the nose or more that 3 days as they can cause nose bleeds.

Some cold and flu medications contain an antihistamine and phenylephrine or pseudoephedrine that can help with the blocked nose.

Other medicines: Leukotriene inhibitors

These are prescription medicines that block leukotrienes, chemicals in the body released in response to an allergen.

Allergy shots: Immunotherapy

In this type of treatment, regular shots of the allergen is injected , with each dose of the allergen slightly higher than the dose before until such a dose when the symptoms are controlled thus allowing the body to adjust to the allergen causing the reaction. Sublingual immunotherapy treatment can be used where the allergen is placed under the tongue instead of an injection

By Johnson Mwebaze Nabyoma

Bachelor of Pharmacy (UL-MEDUNSA), Mmed.clinical pharmacy (UL-MEDUNSA), MBA (NWU)

Department of Health, Northwest Provincial Government.