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Definition
Allergic rhinitis is the set of symptoms that occurs when you breathe in substances you are allergic to. These substances are called allergens.
- Seasonal (intermittent) allergic rhinitisSometimes called hay fever or rose fever. This condition occurs during times of the year when allergens are in the air. Spring and Fall are the most common times. The most common allergen is pollen.
- Perennial (persistent) allergic rhinitisThis condition is caused by allergens such as chemicals, dust, dust mites, cockroaches, animal dander, mold spores, or, occasionally, foods. It may occur any time of year that you encounter these allergens.
Causes
An allergic reaction occurs when your body's immune system overreacts to an allergen. When you breathe in an allergen, cells in your nasal passages make a chemical called histamine. Histamine causes your nose to feel itchy and also causes swelling and mucus production in the nasal passages.
Site of Histamine Production
This area has swelling and increased mucus production after contact with an allergen.
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Risk Factors
A risk factor is something that increases your chance of getting a disease or condition.Some risk factors include:
Family members with allergic rhinitis, eczema, or asthmaEczemaAsthmaFood allergies Symptoms Allergic rhinitis can cause the following symptoms: SneezingItching in the nose, eyes, throat, earsRed, watery eyesRunny nose, nasal congestionSinus pressure Postnasal drip and coughHeadacheDark circles under your eyes DiagnosisYour doctor will try to find out which allergens you are allergic to. You may be referred you to an allergist, if necessary.Tests may include: Skin Prick TestA tiny bit of an allergen is placed under the skin with a needle. The doctor watches to see if the skin in that area becomes raised or irritated. This can be done for multiple allergens at the same time. RAST TestingA small sample of blood is taken and tested for different allergens. Provocation TestingYou breathe in air containing an allergen. The doctor will watch to see if you have an allergic reaction, such as wheezing or trouble breathing. TreatmentThe most effective way to treat allergies is to avoid the allergen. Since this can sometimes be difficult or impossible, other treatments are available.Treatments may include: MedicationsAntihistaminesstop or reduce the production of histamine, usually taken as pillsDecongestantsdecrease congestion by constricting blood vessels, taken as pills or as a nasal sprayMast cell inhibitorsnasal sprays that interfere with the chemical reactions leading to histamine releaseTopical corticosteroidsnasal sprays that decrease swelling in the nasal passages Immunotherapy (Allergy Shots)Very small amounts of allergens are injected over weeks, months, or even years. The goal is to make your body's immune system less sensitive to those allergens.
It may be possible to perform this therapy by placing allergens under the tongue (sublingual). In a recent study, adult patients allergic to a certain grass pollen modestly reduced their symptoms by taking grass allergen tablets sublingually every day for 18 weeks. * Further study is needed. Prevention The following strategies may help prevent allergic rhinitis: Stay inside during the morning hours when pollen counts are highestAvoid outside activities during the time of year when the trees, flowers, or molds to which you are allergic are bloomingKeep the windows of your house and car closed to keep pollen outUse an air conditioner to reduce indoor humidity during the warmer months to prevent mold and mildew growthClean your air conditioner's filters regularlyConsider running an air purifier in your home, especially in your bedroomUse vacuum cleaners and air conditioners with HEPA filters to trap allergensDecrease or avoid outdoor activities on hot summer days, when ozone levels may exacerbate allergiesCover pillows and mattresses with vinyl covers to reduce your exposure to dust mitesWash bedding weekly in very hot waterUse fewer dust-collecting items such as curtains, bed skirts, carpeting, and stuffed animals, especially in your bedroom If you can't avoid having a furry pet, vacuum frequently, keep your pet out of bedrooms and other rooms with carpets RESOURCES:
American Academy of Allergy, Asthma, and Immunologyhttp://www.aaaai.org/ Asthma and Allergy Foundation of Americahttp://www.aafa.org/ CANADIAN RESOURCES: Allergy Asthma Information Associationhttp://aaia.ca/ Calgary Allergy Networkhttp://www.calgaryallergy.ca/ References: Conn HF, Rakel RE. Conn's Current Therapy 2001. 53rd ed. Philadelphia, PA: WB Saunders Company; 2001. Joint Council of Allergy, Asthma, and Immunology website. Available at: http://www.jcaai.org. Accessed June 15, 2008. Middleton E. Allergy: Principles and Practice. 5th ed. St. Louis, MO: Mosby-Year Book, Inc; 1998. National Institute of Allergy and Infectious Disease website. Available at: http://www3.niaid.nih.gov/. Accessed June 15, 2008. Patients and Consumer. American Academy of Allergy, Asthma, and Immunology website. Available at: http://www.aaaai.org/patients.stm. Accessed June 15, 2008. *Updated section on Treatment on 8/11/06 according to the following study, as cited by DynaMed's Systematic Literature Surveillance: Durham SR, Yang WH, Pedersen MR, et al. Sublingual immunotherapy with once-daily grass allergen tablets: a randomized controlled trial in seasonal allergic rhinoconjunctivitis. J Allergy Clin Immunol. 2006;117:802-809.
Last reviewed November 2007 by Kari Kassir, MDPlease be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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