Allergic rhinitis is caused by inflammation of the lining of the nose due to exposure to allergens. Symptoms include sneezing, itching, clear nasal discharge, post-nasal drip and congestion. Many patients with allergic rhinitis also suffer from allergy symptoms in their eyes. Allergic rhinitis is most commonly caused by allergy to house dust mites, animal dander, cockroaches, mold spores and pollens. Environmental and industrial chemicals can also cause allergic rhinitis.
Allergic rhinitis can cause significant morbidity, especially in children. Nasal congestion often leads to poor quality sleep or even sleep apnea, and results in chronic tiredness, hyperactivity and learning difficulty. Chronic mouth breathing can affect the normal development of the teeth and facial structures. Chronic post-nasal drip can lead to cough and hoarsness, and chronic congestion can cause sinus and middle ear infections. Allergic rhinitis is an important risk factor for the development of asthma in young children.
Not all cases of rhinitis are caused by allergies. Other common causes include vasomotor rhinitis, infection and medications. In order to diagnose allergic rhinitis, patients should undergo allergy testing, preferably with skin tests. The test should include all potential allergens in the patient’s outdoor, home and work environment.
Treatment of allergic rhinitis should first and foremost include avoidance of the relevant allergens. This will involve modifying the environment at home and at work. Nasal steroid spray is the most effective medication for the prevention of rhinitis symptoms, whereas acute symptoms should be treated with oral antihistamines. Long-term use of over-the-counter decongestant sprays should be avoided. For long-term management of moderate to severe allergic rhinitis, especially if the patient fails to adequately respond to allergen avoidance and medications, patients should consider undergoing desensitization treatment to induce tolerance to the relevant allergens.