NOSE – Allergic Rhinitis

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What are the symptoms of allergic rhinitis?

Allergic Rhinitis is an IgE mediated hypersensitivity disease of the nasal mucous membrane, characterized by sneezing and nasal blockage and nasal discharge.

Types of allergic rhinitis:

●  Seasonal allergic rhinitis: It occurs in certain months

●   Perennial allergic rhinitis: Occurs throughout the year

Causes of allergic rhinitis:

●  Environmental: Cold environment triggers off the allergy.

●  Hereditary: There are higher chances if both parents have allergy to certain allergens.

●  Age: Common in the 2nd and 3rd decade.

●  Psychological stress: Known to precipitate already existing allergy.

Some of the common allergens:

●   Dust, pollen

●  Food: Eggs, prawns, pineapple etc.

●  Fungi: Cladosporium, Aspergillus

●  Irritating fumes, vehicular exhaust

●  Cosmetics, synthetic clothes, shampoo

●  Intestinal helminths

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What are the symptoms of allergic rhinitis?

Some of the common symptoms of allergic rhinitis are:

●  Nasal irritation and obstruction

●  Sneezing episodes

●  Watery discharge

●  Anosmia

Causes of allergic rhinitis:

●  Environmental: Cold environment triggers off the allergy.

●  Hereditary: There are higher chances if both parents have allergy to certain allergens.

●  Age: Common in the 2nd and 3rd decade.

●  Psychological stress: Known to precipitate already existing allergy.

Some of the common allergens:

●   Dust, pollen

●  Food: Eggs, prawns, pineapple etc.

●  Fungi: Cladosporium, Aspergillus

●  Irritating fumes, vehicular exhaust

●  Cosmetics, synthetic clothes, shampoo

●  Intestinal helminths

Signs of examination:

●   On Anterior rhinoscopy, there is turbinate hypertrophy.

●  Ethmoidal polyps may be present in long-standing untreated allergy patients.

●  Patients often complain of ophthalmic symptoms like conjunctivitis and respiratory symptoms like asthma.

Investigations required for diagnosing allergic rhinitis:

●   Detail history

●   Blood count – eosinophil

●  CT Scan PNS

●   Nasal smear

●   Radio-Allergo Sorbent Test (RAST)

Management of allergic rhinitis:

●   Avoidance

●   Desensitization by vaccines

Local treatment of allergic rhinitis:

●   Local steroid sprays

●   Chemical cautery by silver nitrate application

●   Auto-immune therapy

●   Steroid Injections

●   Cryo-cautery

Systemic treatment for allergic rhinitis:

●   Anti-histaminics

●   Corticosteroids

●   Mast cell stabilizers like sodium cromoglycate

●   Oral decongestants, Analgesics

Surgical treatment of allergic rhinitis:

●   Septal correction and polypectomy

●   FESS( Endoscopic surgery helps in the better creation of the sinuses and helps better drug action locally.

●   Vivian Neurectomy

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What is allergy?

The term allergy describes the hypersensitivity of cells to specific substances that result in various physiological reactions.The diseases associated with an allergic response includes seasonal and perennial allergic rhinitis, asthma and allergic skin reactions. Allergic Rhinitis Allergic rhinitis represents the most common allergic diseases with approximately 10% of the worlds commonly suffering from its symptoms.The signs and symptoms of allergic rhinitis include itching, sneezing, running nose and nasal blockage.There are two types of allergic rhinitis-seasonal (generally called “ hay fever”) and perennial rhinitis.Seasonal rhinitis is mainly triggered by pollens which depending on climate and time of the year-are mainly released by trees, grasses, and herbs.The main symptoms, especially in the months of spring, are itching, sneezing, watery nasal discharge, swollen nasal mucosa as well as the blocked nose.The typical hay fever patients suffer additionally from watering eyes, whereas these symptoms are hardly seen in perennial rhinitis.Perennial rhinitis occurs around the year and is more difficult to diagnose.It is triggered by house dust or mite, molds, animal hair or other perennial present allergens.The symptoms resemble seasonal allergic rhinitis, however mostly without eye symptoms.

MANAGEMENT OF ALLERGIC RHINITIS

Your Doctor is the best judge to prescribe the right medication for controlling your symptoms Tips for symptoms prevention inside your home. 1.Regularly vacuum clean the carpets and other furnishings at least once a week.Opt for lightweight curtains, which can be washed at least monthly in hot water.Frequent washing of curtains and bedding. 2.Prefer window shade made of cotton or other natural fibers to Venetian blinds.Avoid keeping pets in the bedroom at night,bathe your pet weekly with a shampoo. 3.Close your windows at night since night air carries more pollens during season of high outdoor pollen.Cover your mattress and box spring in plastic encasings.Wash all beddings weekly in hot water, use natural wool or cotton fibre blankets. 4.Repair any plumbing leaks to reduce mould growth.Check your refrigerator weekly for spoiled foods and throw them out. 5.Make sure that dried grains including flour,rice,cereals and dry pet foods are carefully sealed.Do not keep them unused for a very long time.Keep the storage area cool and dry.Use a damp cloth to dust. 6.Carefully read labels on hair sprays,perfumes,shave lotions and underarm deodoranTs-they may contain allergens.Use air conditioners at home and office. 7.Decrease humidity in house.Avoid fans that draw air from outdoors.Don’t hang laundry clothes outside to dry. 8.Use HEPA air filter in our bedroom.stay away from stuff toys.Cover your pillows and mattress with dust mite cover.Remove carpet and install tile or hardwood floor.Use area rugs and wash them often in very hot water.Use blinds instead of curtains.Use air purifiers.Always check food labels for additives that are known allergens-yellow food dye no.5 and gum Arabic.Avoid jute.When climate changes take 1-2 tablespoons of honey.Put mask/hanky over nose when exposed to dust or smoke.

OUTSIDE YOUR HOUSE

1.Wash your hands after gardening or handling animals to avoid rubbing allergens into eyes or nasal mucosa. 2.Perform low-level exercise daily like walking at normal speed and deep breathing. 3.Wash summer sports equipment made of nylon, plastic or canvas with a mildew retardant to prevent the growth of allergens. 4.Wear a mask over mouth and nose while traveling . 5.Early morning and late night air carry more pollens.Plan outdoor activities at other times.

INSIDE YOUR CAR

1.Use recirculation modes on a heater or air conditioner while traveling by car during heavy pollen occurrence outside air intake vents draw pollen into the car. 2.Avoid parking under trees, tree pollens collect in the intake vents and ducts.

YOUR ALLERGY MEDICATION

.Consult your doctor about starting you allergy medication therapy early in the season or even before the season starts to give your body sometime to build up resistance. 2.Carefully follow your doctor dosing instructions,for example twice a day dosed medications may be best taken just before bedtime to avoid onset of early morning symptoms,your dose should be taken 12 hours later.