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GaramChai features Medical articles by Dr.Kumaresh Krishnamoorthy
Allergic
Rhinitis
What
is rhinitis?
The
nose is separated into two passages by a wall of cartilage
called the septum and is lined with a membrane that produces
mucus. The mucus, a thin clear liquid, traps small particles
and bacteria that are drawn into the nose as a person breathes.
The trapped bacteria usually remain harmless in healthy individuals.
Normally, a cycle of congestion and decongestion occurs continuously
throughout the day. When one side of the nose is congested,
air passes through the open, or decongested, side. The sides
alternate between being wide open and being narrowed.
What is allergic rhinitis?
Allergic
rhinitis is an soreness or irritation of the mucous membranes
that line the nose. Common symptoms include sneezing; a stuffy
or runny nose; itchy eyes, nose and throat; and watery eyes.
You may also have a nasal voice; breathe noisily; snore; feel
chronically tired; have a poor appetite; feel nauseated; have
frequent headaches; and, have some difficulty hearing and
smelling.
Causes
Allergic
rhinitis happens when an allergen (an allergy-producing substance,
such as pollen) causes your body to defend itself by producing
antibodies. When an allergen and an antibody combine, your
body releases histamine and other chemical substances into
your bloodstream, which causes an allergic response. Pollen,
dust, mold or other substances that can be inhaled, are common
allergens that cause symptoms.
Seasonal
allergic rhinitis usually results from tree, grass, weeds
or pollen and is experienced during summer. Perennial allergic
rhinitis can cause year-round symptoms. This allergic reaction
is the result of indoor irritants such as feathers; mold spores,
animal dander’s (hair and skin shed by pets), or mould spores,
which are carried in the air.
What
are the signs and symptoms of allergic rhinitis?
Signs
of allergic rhinitis are similar to signs of a common cold.
But, unlike common cold symptoms, allergic rhinitis can last
for more than 8-10 days and may include:
- A stuffy
nose or a runny nose.
- Sneezing.
- Itchy
nose, itchy eyes or watery eyes.
- Children
who have allergic rhinitis might have dark circles under
their eyes, or use the palm of their hand to push their
nose up as they try to stop the itching (called the “allergic
salute”).
- Coughing
caused by clear mucus running down the back of your throat.
Treatment
The
best treatment for your allergy is to avoid the allergen.
When this is not possible, medication can usually control
the symptoms of a reaction. These medications are used to
treat allergic rhinitis:
Antihistamines block the action of the histamine (the substance
which triggers the reaction). They are considered the "mainstay
of treatment." They are more effective when taken around
the clock. They can cause you to become drowsy, especially
if you combine them with alcohol. Other side effects include
dizziness, blurred vision, insomnia, tremors, nausea and
dry mouth. If any of the side effects are a problem, discuss
them with your practitioner.
Decongestants
can give short-term relief from nasal stuffiness. However,
many decongestants promote histamine release. This can cause
a "rebound" effect that ultimately makes you even
more congested than before. Use them only on a short-term,
special occasion basis (i.e., unable to sleep for several
nights, a test, a date, etc.).
Corticosteroids
may lessen your allergic reaction by preventing body cells
from responding to histamine. For allergic rhinitis, these
compounds are administered via a nasal spray. Minimal side
effects have been found even with chronic use at customary
dosage. For profound allergy symptoms, a one-time very short
course of systemic cortisteroid may be considered as a last
resort.
Cromolyn
sodium inhibits the body's release of histamine after exposure
to an antigen, which can lessen or stop the allergic response.
If you are allergic to a substance that you are exposed
to occasionally, you would only take this medication prior
to exposure. Side effects are minimal. Unfortunately, not
everyone is helped by this medication.
Immunotherapy
or (allergy shots) are also used in cases of allergic rhinitis.
It is effective only when a specific allergen can be identified.
Since you are allergic to the substance injected, you may
experience severe allergic responses. Therefore, if you
undergo immunotherapy, you should work closely with your
physician and report any symptoms of reaction to the injection.
Immunotherapy is not a "quick fix" and may take
six months before effectiveness is noted. It is very helpful
for many people.
Prevention
You
cannot prevent an allergy, but you can prevent a reaction.
The most effective method you can use to prevent a reaction
is to avoid the allergen that triggers your allergic response.
Try these steps:
- Although
it’s best not to have pets when you have allergic rhinitis,
washing your pet once a week and keeping it out of the bedroom
and off the furniture will help.
- Put
pillows and mattresses in sealed plastic covers that keep
out dust mites
- Wash
sheets in hot water every week.
- Feathers,
foam rubber, or pillows more than five years old are often
allergens.
- Keep
windows closed, so that there will not be so many pollens
and molds in the house.
- Wearing
a mask when cleaning the house
- Rid
your home of indoor plants
- Use
synthetic materials for your bedding, pillow and blankets
- Sleep
with the head of bed elevated to relieve nasal congestion
- Observe
good health by exercising daily, eating balanced food and
avoiding pollutants
- Stop
smoking
- Move
out decorative pillows, books, and stuffed animals
- Store
clothing so dust will not settle on it
Author:
Dr.Kumaresh Krishnamoorthy, M.S (ENT)
Head and Neck Surgery Fellowship (Buffalo, USA)
Neurotology & Skull Base Surgery Fellowship (Cincinnati,
USA)
Senior Consultant in ENT - Head and Neck Surgeon and Skull
Base Surgeon
Apollo Hospitals, 154/11, Bannerghatta Road, BANGALORE 560
076, INDIA
Phone: 91-(0) - 99002 36819
Email: drkumaresh@drkumaresh.com
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