How do you know if you have allergic rhinitis?

A allergic rhinitis Allergic rhinitis is a disease that manifests itself as an inflammation of the nasal mucosa. It is estimated that this pathology affects about 22% to 26% of the Portuguese population and about 43% of children aged 3 to 5 years.

This disease, often under-diagnosed and under-treated, can be associated with other uncontrolled pathologies, such as sinusitis, nasal polyposis, otitis or bronchial asthma (link insert asthma).

The allergens most frequently involved in allergic rhinitis are: dust mites, fungi, pollens (insert link to pollens) and animal droppings, among others. Learn more about this disease.


What are the symptoms of allergic rhinitis?

The symptomatology associated with allergic rhinitis consists of a response or reaction of the immune system to the inflammatory process triggered by the disease. Some of its most common symptoms are:

  • Sneezing attacks;
  • Nasal congestion and obstruction;
  • Aqueous rhinorrhea (anterior or posterior);
  • Pruritus in the nose, throat, ears and eyes.

These symptoms may also be accompanied by coughing, decreased sense of smell, headaches, fatigue and/or dark circles under the eyes.

The duration of associated symptomatology can vary widely, ranging from intermittent (less than 4 days per week or less than 4 weeks) to persistent (more than 4 days per week or more than 4 weeks).

In general, when allergic rhinitis is caused by pollens and certain fungi, it is seasonal, meaning that it occurs at specific times of the year.

Therefore, in these cases, the duration and intensity of symptoms will be related to pollination cycles. In addition, these allergic rhinitises may also manifest as conjunctivitis, i.e. a red eye, watery eyes, itching and a foreign body sensation.

Levels of disease severity can also vary, depending on whether the symptomatology interferes with the patient’s daily life.

Allergic rhinitis, especially in children and adolescents, can take on more severe symptomatology that not only alters the patient’s quality of life, causing frequent nighttime awakenings due to intense nasal obstruction and dryness of the oropharynx, but can also progress more easily to asthma, otitis, or sinusitis.

They are therefore considered:

Patients with mild allergic rhinitis

  • Patients with normal sleep;
  • Patients who can carry out normal daily (work or school), sports and/or leisure activities;
  • Patients with tolerable and minimally troublesome symptoms.

Patients with moderate to severe allergic rhinitis

  • Patients with impaired sleep;
  • Patients with difficulties in normal daily (work or school), sports and/or leisure activities;
  • Patients whose symptoms are bothersome and affect their well-being;
  • Patients manifest fatigue, irritability, memory impairment, daytime sleepiness, anxiety, depression, and changes in learning, behavior, attention, productivity, and work/school performance.

Risk Factors

Certain conditions may favor the development of allergic rhinitis.

Some of these are:

  • Other allergic diseases;
  • Asthma;
  • Atopic dermatitis;
  • Family history of allergic rhinitis;
  • Frequenting environments with high exposure to allergens such as pet dander, dust mites, or tobacco smoke.

Diagnosis

Usually, the diagnosis of allergic rhinitis is made on the basis of:

  • Characterization of the patient’s presenting nasal symptoms;
  • The identification of other associated symptoms;
  • Personal and family history of atopy;
  • Concurrent allergic diseases;
  • Pathologic history;
  • Regular medications.

In addition, allergy skin tests and/or the determination of specific IgE in the blood (allergy tests) are prescribed, which not only diagnose the disease, but also identify the allergens responsible.

Sometimes the above tests and analyses can be negative for allergic rhinitis, but the person still suffers from the disease.

In these cases, it is called local allergic rhinitis. Its symptoms and treatment are identical to those of allergic rhinitis.

Treatment

The treatment of allergic rhinitis consists essentially of controlling its symptomatology. Thus, two of the main steps are to regularly clean the nasal passages with saline or intranasal saline and to avoid or reduce as much as possible exposure to the allergen(s) causing the attacks.

In addition, allergic rhinitis can also be controlled with medication, namely:

  • Anti-inflammatory drugs: intranasal corticosteroids and antileukotrienes help control inflammation;
  • Antihistamines: oral or topical, ideally non-sedating;
  • Allergen-specific immunotherapy with allergy vaccines;
  • Decongestants (even sporadically).

Other special precautions should also be taken, taking into account the type of allergen that triggers the attack. Examples include:

Dust mite allergy

  • Air the house well and daily;
  • Avoid carpets, rugs, stuffed animals, books and all objects that easily collect dust;
  • Vacuum floors and mattresses regularly and thoroughly;
  • Wash bed linens weekly at a temperature above 60°C.

Pollen allergy

  • Consult the pollen bulletins ;
  • Avoid outdoor activities on days with high pollen levels;
  • Wear sunglasses, when outdoors.

Allergic rhinitis and asthma

Allergic rhinitis is a risk factor for the development of another disease: asthma.

The figures prove it, since 40% of patients suffering from allergic rhinitis develop asthma and 80% of asthmatic patients develop allergic rhinitis.

Moderate to severe allergic rhinitis not only increases the likelihood of developing asthma, but also the risk of developing a severe asthmatic condition that does not respond to pharmacological therapy.

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