Allergic rhinitis manifests as runny or runny nose, sneezing, congestion and nasal itching. The most common allergens are dust mites, pets, pollens or fungi. There are various treatments, which will vary depending on the severity of the case. However, early and appropriate treatment can prevent possible asthma.
Allergic rhinitis: what it is
Allergic rhinitis is an inflammation of the nasal mucosa and manifests itself with symptoms such as nasal mucus, sneezing, nasal congestion or nasal itching. These symptoms usually occur for two or more days in a row and persist for more than one hour.
In allergic rhinitis the reaction is usually immediate when exposed to an allergen that causes allergy in the patient.
Difference between allergic rhinitis and common cold
In allergic rhinitis, nasal mucus is transparent, comes out continuously, like a drip, varies throughout the day and lasts longer. The cold, which is an infection, is accompanied by fever or febrile fever, the symptoms persist throughout the day, usually lasts a week and the mucus is thicker and more colored.
Common causes of allergic rhinitis: allergens
The most common allergens involved in allergic rhinitis and asthma are:
– dust mites and pet mites (indoor allergens)
– pollens and fungi (outdoor allergens)
– occupational allergens. It arises in response to an airborne allergen present in the workplace. The most common causes are laboratory animals, woods, latex, enzymes, flours, dust mites and chemicals.
Other causes of allergic rhinitis
The most common cause of rhinitis is infectious rhinitis, also known as rhinosinusitis, which is an inflammation affecting the nasal mucosa and paranasal sinuses. This rhinitis can be viral or bacterial, and depending on the duration of symptoms, acute or chronic.
Other causes of rhinitis:
– work-related, which may be due to an allergic reaction or an irritant factor.
– drug-induced rhinitis, due to the effect of non-steroidal anti-inflammatory drugs (NSAIDs)
– hormonal rhinitis
– rhinitis induced by food
– rhinitis due to sudden temperature changes
– tobacco smoke
– humidity
– strong odors, known as vasomotor rhinitis.
Drug-induced rhinitis, on the other hand, is the rebound nasal obstruction that occurs in patients who chronically use nasal decongestants. In these cases it is necessary to withdraw the responsible drug and apply other drugs to treat rhinitis.
Influence of pollution on rhinitis
The acute effects of outdoor pollution on allergic rhinitis are an increase in symptoms or consultations for allergic rhinitis on days of increased pollution. Pollution from motor vehicles also favors the development of pollen rhinitis.
Pollution is also an important cause of nasal symptoms in non-allergic individuals.
Diagnosis of allergic rhinitis
The diagnosis of allergic rhinitis by an allergist is based on the concordance between a clinical history of allergic symptoms and diagnostic tests by means of allergic skin tests for inhalants such as mites, pollens, fungi and animals. The finding of positive tests without an associated clinical picture is of no use, since many people without symptoms may have a positive result.
When there is doubt as to whether the skin test result is responsible for allergic rhinitis, a nasal or conjunctival challenge test can be performed, which consists of the application of the suspected allergen to the nose or eye, with the aim of reproducing the symptoms reported by the patient.
Treatment for allergic rhinoconjunctivitis
The pharmacological treatment of allergic rhinoconjunctivitis should be adapted to the patient’s symptoms and their severity.
Antihistamines are a symptomatic treatment (to reduce itching and runny mucus) but are not considered to cure the disease. Therefore, it seems logical to take them on demand depending on the allergic symptoms.
We can also use topical inhaled corticosteroids, which are indicated in allergic rhinitis as well as in sinusitis and nasal polyposis. They are considered to be the most effective drugs for the treatment of rhinitis. They are effective in reducing nasal congestion, but also in reducing nasal itching, sneezing and rhinorrhea (secretions). Although their effects can be detected within a few hours, their optimal effect is achieved after several consecutive days or weeks.
There are other treatments such as nasal decongestants, with which care must be taken because they can cause rhinitis medicamentosa. And other less potent treatments for rhinitis include local spray treatments such as local antihistamines, anticholinergics, cromones or oral anti-leukotrienes.
In addition to medication to control symptoms, allergen vaccines (immunotherapy) are available and are currently the only specific treatment to treat the cause of the allergy and alter the natural course of allergic diseases.
Relationship between allergic rhinitis and asthma
The nose is an organ with several functions. The main one, probably, is the conditioning of inspired air, warming and moistening it, and the alteration of this function is related to the presence or severity of asthma.
In patients with allergic rhinitis, an increase of bronchial inflammation has been proved, when applying the substance that produces allergy in the nose.
Several studies have shown clinical improvement and improvement of the inflammation occurring in the bronchi after treatment of rhinitis with corticosteroids, anti-leukotrienes and antihistamines.
If we leave patients with allergic rhinitis untreated, they are more likely to develop asthma. And, conversely, patients with allergic rhinitis who are treated with vaccines for their allergy usually do not develop asthma.