Allergic Rhinitis
Allergic rhinitis is an inflammation of the nasal passages, usually associated with watery nasal discharge and itching of the nose and eyes.
Allergic rhinitis affects about 20 percent of the American population and ranks as one of the most common illnesses in the U.S. The symptoms occur in the nose and eyes and usually occur after exposure to dust, danders, or certain seasonal pollens in people that are allergic to these substances. Two-thirds of all patients have symptoms of allergic rhinitis before the age of 30, but onset can occur at any age.
Allergic rhinitis has no sexual predilection, although boys up to the age of 10 are twice as likely to have symptoms as girls. There is strong genetic predisposition to allergic rhinitis. One parent with a history of allergic rhinitis has about a 30 percent chance of producing offspring with the disorder; the risk increases to 50 percent if both parents have a history of allergies.
Patients can be severely restricted in their daily activities, resulting in excessive time away from school or work. Millions of dollars are spent each year on physician services and medication for treatment of this chronic illness.
Characteristic symptoms include repetitive sneezing; rhinorrhea (runny nose); post-nasal drip; nasal congestion; pruritic (itchy) eyes, ears, nose or throat; and generalized fatigue. Symptoms can also include wheezing, eye tearing, sore throat, and impaired smell. A chronic cough may be secondary to postnasal drip, but should not be mistaken for asthma. Sinus headaches and ear plugging are also common.
The goal of treatment is to reduce the allergy symptoms. Avoidance of the allergen or minimization of contact with it is the best treatment, but some relief may be found with the following medications. Antihistamines and Decongestants Oral decongestants alone may be helpful, including pseudoephedrine. Antihistamines are available as tablets, capsules and liquids, and may or may not be combined with decongestants.
Common antihistamines include brompheniramine or chlorpheniramine, and clemastine. Non-sedating (less likely to cause drowsiness) long-acting antihistamines include loratidine and fexofenadine.
Nasal sprays For rhinorrhea, a nasal spray of cromolyn sodium (Nasalcrom) or a steroid nasal spray, such as flunisolide (Nasalide), beclomethasone dipropionate (Beconase, Vancenase), triamcinolone acetonide (Nasacort), and fluticasone (Flonase), may work so well that additional antihistamines or decongestants are unnecessary.
It is important to remember that improvement may not occur for one to two weeks after starting therapy with steroid nasal sprays. Short courses of oral corticosteroids may usually be indicated when severe nasal symptoms prevent the adequate delivery of topical agents.
Allergic rhinitis affects about 20 percent of the American population and ranks as one of the most common illnesses in the U.S. The symptoms occur in the nose and eyes and usually occur after exposure to dust, danders, or certain seasonal pollens in people that are allergic to these substances. Two-thirds of all patients have symptoms of allergic rhinitis before the age of 30, but onset can occur at any age.
Allergic rhinitis has no sexual predilection, although boys up to the age of 10 are twice as likely to have symptoms as girls. There is strong genetic predisposition to allergic rhinitis. One parent with a history of allergic rhinitis has about a 30 percent chance of producing offspring with the disorder; the risk increases to 50 percent if both parents have a history of allergies.
Patients can be severely restricted in their daily activities, resulting in excessive time away from school or work. Millions of dollars are spent each year on physician services and medication for treatment of this chronic illness.
Characteristic symptoms include repetitive sneezing; rhinorrhea (runny nose); post-nasal drip; nasal congestion; pruritic (itchy) eyes, ears, nose or throat; and generalized fatigue. Symptoms can also include wheezing, eye tearing, sore throat, and impaired smell. A chronic cough may be secondary to postnasal drip, but should not be mistaken for asthma. Sinus headaches and ear plugging are also common.
The goal of treatment is to reduce the allergy symptoms. Avoidance of the allergen or minimization of contact with it is the best treatment, but some relief may be found with the following medications. Antihistamines and Decongestants Oral decongestants alone may be helpful, including pseudoephedrine. Antihistamines are available as tablets, capsules and liquids, and may or may not be combined with decongestants.
Common antihistamines include brompheniramine or chlorpheniramine, and clemastine. Non-sedating (less likely to cause drowsiness) long-acting antihistamines include loratidine and fexofenadine.
Nasal sprays For rhinorrhea, a nasal spray of cromolyn sodium (Nasalcrom) or a steroid nasal spray, such as flunisolide (Nasalide), beclomethasone dipropionate (Beconase, Vancenase), triamcinolone acetonide (Nasacort), and fluticasone (Flonase), may work so well that additional antihistamines or decongestants are unnecessary.
It is important to remember that improvement may not occur for one to two weeks after starting therapy with steroid nasal sprays. Short courses of oral corticosteroids may usually be indicated when severe nasal symptoms prevent the adequate delivery of topical agents.
