What is Allergic Rhinitis?
Allergic rhinitis or ‘hay fever’, is a type of reaction caused by the presence of an allergen, resulting in heavy eyes with a hot sensation, runny nose, blocked nasal activity and inflammation of the nasal passage. This article discusses allergic rhinitis in detail.
Allergic rhinitis is a response of the immune system to any particular allergen that in general has no danger associated with it. The defense system overreacts to the allergens present in the air, and in result causes allergies. The rhinitis is caused by the response of the immune system that tends to save the body before any foreign attack.
Causes of Allergic Rhinitis
Allergic rhinitis is commonly caused by allergens such as dust, smoke, and pollen from flora and fauna, dander from animals and saliva of the cats and mites. In most of the cases of allergic rhinitis, pollens are responsible for bringing up allergic reactions. During sometimes in a year, pollens are more common and can harm people with an over reactive immune system. Most of the allergic rhinitis brings along mild symptoms that could be treated easily and quickly. Although most cases lie on the mild side, few of the cases are severe with more trouble. Severe rhinitis may be persistent over time and with its frequent visit, it could easily disturb everyday life. Allergic rhinitis could result in sleeping problems, which in turn can ruin an important day. Severe symptoms result in sleep disturbance and memory loss, an imbalance in rest and work, interference in daily routine, and impairment of mental balance.
In a year, an average of about 35%-40% of people is affected by allergic rhinitis.1 Allergic rhinitis is the major type of allergy problem faced by a majority of people. People aging 20-40 are most prone to this type of allergic reaction. Around 30% of Americans are affected by allergic rhinitis every year.2
Allergic rhinitis is caused by allergens that include pollen from flora and fauna as the major cause, dust, smoke, dirt, and germs. Allergic pollen originates from the trees such as Cedar, Pine, Olive, Birch, and chestnut. They traverse through an air medium and cause rhinitis all over the globe.
Grasses share pollens to the surroundings which are the cause of approximately 90% cases of hay fever. Weed pollens contribute to the remaining few percentages.
Smoking and any sort of addition, dust, and fear from germs tend to trigger the reaction immediately. Allergic rhinitis is also caused by some sort of tacky fragrance. The reaction initiates as soon as the fragrance is found present near.
Types of Allergic Rhinitis
Allergic rhinitis shows up its presence in mostly observed two forms: Seasonal and Perennial allergy.
Seasonal Allergic Rhinitis: It confronts mainly during the first and second quarters of the year or in spring and early summer. During these seasons, pollens are produced by the trees and flowers in a huge figure, as a result, a rapid increase in the number of people affected with allergy problem is observed. Furthermore, the grasses, weeds and small plants also produce pollen during this period contributing even more allergic reactions.
Perennial Allergic Rhinitis: It shows up its symptoms all around throughout the year, from January to December end. Mainly caused by dust or any other impurity in the air, by dander of animals, the sting from pets and pet hair, cockroaches and mites, they show up when an allergen is present to trigger the reaction. An individual infected with this type of experience allergy at any point in time. Hereditary reasons gravitate more of this type of allergic reaction.
However, individuals can experience both types of rhinitis simultaneously. Both seasonal and perennial allergic rhinitis foster symptoms in them and hence they’re more prone to allergic problems. In this presence of seasonal allergic rhinitis, if the perennial allergic rhinitis to gets triggered, it can turn the situation to even worse. During the season of pollen reactions, perennially infected individuals may find several allergic reactions and are vulnerable to more episodes of allergic rhinitis.
Local allergic rhinitis generally demonstrates an allergy in the nose. The symptoms are like the common allergic rhinitis but are mild in this case. One-fourth of the allergic individuals have local allergic rhinitis problem.
Signs and Symptoms of Allergic Rhinitis
Allergic rhinitis presents with some signs and symptoms that help identify the condition too. The symptoms are as experienced during a common cold.
The most observed of them are-
- Runny and inflated nose, redness covers the inner lining of the nasal passage
- The continuous flow of mucus and transparent liquid through the nose
- Nasal blockage, inability to breathe through the nose
- Facial pain due to sinus pressure development
- Headaches, heavy and watery eyes with a hot sensation
- Sneezing very often, continuous in the long streak at times
- Itchiness over nose, mouth, and skin
- Swelling of the eyelids, conjunctivitis swelling
- Excessive fatigue and tiresome state
- Frequent coughing.
All the symptoms may show up together in case of long-time exposure to an allergen causing the rhinitis. Usually, 3-4 symptoms can be observed in infrequent cases of minor reactions, which include runny nose, inflation, and blockage of nasal passage as the main symptoms showing up in almost 95% of the case. Fever is not a symptom, although the name suggests ‘hay fever‘.
If an individual is allergic to any particular allergen, redness, itchiness, and swelling of the interior nose starts developing within 15 minutes of exposure.
Treatment of Allergic Rhinitis
Treatment of allergic rhinitis includes the use of medications and as well as measures for the prevention of allergic rhinitis or its triggers.
Here are some of the important preventive measures for allergic rhinitis. The main step is to reduce exposure to allergens, which can be done in various ways. The reaction of the body to allergens could be reduced by following the following precautions –
- Carrying an air filter mask or dust mask to cover the nose would radically minimize the reaction by exfoliating the pollen that initiates the symptoms. Furthermore wearing a dust mask prevents any sort of unwanted particle from entering the nose and hence allergens are restricted from entering the nasal passage.
- Wearing neat and clean clothes may help to reduce the allergen count. Allergens do reside as dust and dirt, wearing neat garments would keep them apart from you.
- Avoid any sort of addiction such as smoking. They act as the reaction initiator.
- Dwelling indoors as much possible, especially on stormy and windy days. The pollen count in the air is high these days, so staying indoors would be a good option to avoid any sort of reaction.
- Prevention is better than cure, so avoiding the allergen would avoid the symptoms too.
Medications for Allergic Rhinitis:
A preventive measure would reduce the activity of the symptoms for sure but not always. In severe cases when all the symptoms show up simultaneously and the reaction is at the peak, medicines propel the reaction to terminate abruptly thereby reducing the raging effect and suffering retained by the cause. To treat the triggered rhinitis, few of the medicines are available, these are mainly
Cetrizine and Levocetirizine tablets work to cease the triggered activity fast. They erminate the runny nose and nasal blockage symptoms within a few minutes. They fall under the category of Antihistamines. Any formula under this category would do the job to counter the reaction. Antihistamines may show unexpected side-effects like drowsiness and fatigue.
Montelukast containing tablets are often found useful to remove the cold-like symptoms like sneezing and runny nose.
Decongestants are used to relieve the nasal blockage. The decongestants are a mixture of pseudoephedrine, phenylephrine or oxymetazoline. The ingredients work quickly and clear the congestion within 15-20 seconds. In a situation of heavy congestion, it could be a good option, but it must be consumed in limited quantity and not for long periods. They show side-effects otherwise.
Allergen immunotherapy often referred to as desensitization, is a method of studying the allergen and inspecting the amount of dose taken to tackle the reaction to reframe and accustom the body to any specific allergen through long-term allergen tolerance process. It may proceed via an oral method or injection process.
Allergic rhinitis can be treated by first figuring out the type and cause of the rhinitis. The diagnosis process proceeds via finding the allergen responsible for rhinitis. The allergen present behind the rhinitis is determined using a Patch test. RAT Blood tests and reports of leukocyte count can also contribute to finding the cause. Eosinophilia count report can tell about the allergen causing the rhinitis. The skin-prick test is also carried to expose the allergen behind. The intradermal allergy test shows a positive result most of the time, so it is favored in most cases.
Allergic rhinitis is a major disorder all around the globe. Around 25%-30% of the total population is affected by this problem.1, 3
- World Health Organization. White Book on Allergy 2011-2012 Executive Summary. By Prof. Ruby Pawankar, MD, Ph.D., Prof. Giorgio Walkter Canonica, MD, Prof. Stephen T. Holgate, BSc, MD, DSc, FMed Sci and Prof. Richard F. Lockey, MD. https://www.worldallergy.org/UserFiles/file/WAO-White-Book-on-Allergy_web.pdf
- Bloom B, Cohen RA, Freeman G. Summary health statistics for U.S. children: National Health Interview Survey, 2010. National Center for Health Statistics. Vital Health Stat 10(250). 2011, https://www.cdc.gov/nchs/data/series/sr_10/sr10_250.pdf
- Meltzer EO: Allergic Rhinitis: Burden of Illness, Quality of Life, Comorbidities, and Control. Immunol Allergy Clin North Am. 2016;36(2):235–48. https://www.ncbi.nlm.nih.gov/pubmed/27083099
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