Allergic Rhinitis

Allergic Rhinitis

Allergic Rhinitis is defined as inflammation of the lining of the nasal cavity as a result of an allergic response. The common allergens include house dust mite, pollens, grasses, cockroach and animal dander like dogs and cats.

The Common symptoms are

  1. Nasal blockage – from swelling of turbinates, build-up of secretions
  2. Discharge – runny nose, usually clear
  3. Sneezing
  4. Itchy

Associated symptoms

  1. Postnasal drip causing cough, sorethroat, hoarseness
  2. Itchy eyes
  3. Itchy throat
  4. Snoring, poor sleep
  5. Blocked ears

Diagnosis

  1. Skin Prick Test – involves a simple scratch test on the skin (usually forearm)
  2. RAST (Radioallergosorbent Test) – a blood test that measures antibody levels to different allergens
  3. Intradermal Provocation Food Test (IPFT) – a skin test for food allergy

Treatment

  1. Allergen Avoidance – Ideal but practically difficult with inhalant allergens. For house dust mites, proof covers for pillows, mattresses, blankets can be useful
  2. Pharmacological – Medications such as nasal steroid sprays, decongestant sprays/drops, oral anthistamines, oral steroids offer good symptom control but does not cure allergy.
  3. Sublingual Immunotherapy (SLIT) – the closest to a cure for allergy. Effective for nasal allergy and asthma, the principle is to desensitise patients to the offending allergens.
  4. Surgery – aims mainly at relieving nasal blockage through turbinate reduction. There are a few ways to reduce the size of turbinates including heat (radiofrequency), cutting, debulking.