Allergic rhinitis is a chronic disease that occurs from the set of reactions that the nasal mucosa has when exposed to certain external agents which causes nasal hyperactivity that affects both the eyes and the nose.
These reactions are the body’s defense mechanism mainly against IgE antibodies which stimulate the release of chemical mediators from cells predisposed to a certain antigen to balance infections.
In turn, antigens or immunoglobulins (Ig) are toxic substances that produce antibodies, which gives rise to a defensive response against them. Due to these chemical processes, the body goes into a state of immediate hypersensitivity which has delayed inflammatory responses.
Symptoms of allergic rhinitis
Symptoms can vary for each person.. TO Here are some of the most common:
- daytime fatigue
- Heachache.
- Nasal obstruction.
- Granular oropharynx.
- Sleep disorders.
- Nasal and pharyngeal itching.
- Rhinorrhoea (profuse runny nose).
- Irregularity in nasal alignment.
- Continuous sneezing.
- Allergic stigmata (dark circles, Dennie’s lines, nasal sulcus).
- Conjunctival symptoms (eye redness, itching, tearing).
- Adenoid facies (expression of disinterest, blank gaze, mouth ajar, mouth breathing).
- Pale or congestive nasal lining with hyaline (clear and watery) mucus.
Related factors
There are several factors related to the development of allergic rhinitis, including:
- genetic predisposition.
- Birth in risk areas.
- Early exposure to allergens.
- Indiscriminate use of antibiotics in childhood.
- Family history of atopy (allergic disorders).
- Exposure to adverse environments (smoke, dust mites, animal epithelia).
Types of allergic rhinitis
Seasonal allergic rhinitis
It is also known as pollinosis. It makes up about 75% of cases of allergic rhinitis.. It usually appears between winter and spring (in the northern hemisphere) due to pollination of plants.
The characteristic symptoms of this type of allergic rhinitis include: severe itching of the ears, eyes and oropharynx. These can intensify with prolonged outdoor exposure, especially during pollination hours (5 to 10 hours and 19 to 22 hours) and decrease on humid and rainy days.
Perennial allergic rhinitis
This type of rhinitis is mainly triggered by factors such as dust, fungal spores (Alternaria and Cladosporium) and skin flakes from animals such as dogs, cats and rodents.
Symptoms are similar to those of seasonal rhinitis; however, eye itching is mild and nasal obstruction is more severe. As a result, the patient experiences mouth breathing, nasal voice, loss of smell and taste, among other easy-to-notice symptoms.
common allergens
There are a wide variety of allergens, although the most common are usually the following:
- pollen.
- enzymes.
- Food.
- Medicines.
- Materials (mater, latex, gloves, probes)
- Animal epithelium (fur, urine, saliva)
- Mold spores (penicillium, cladosporium, alternaria and aspergillus).
- Mites (dermatophagoides pteronysinus, dermatophagoides farinae, dermatophagoides microceras)
Treatment
environmental treatment
Environmental treatment consists of a series of measures that are usually taken before starting drug treatment.In this way the patient can create an environment in which to heal more easily.
The measures included in the environmental treatment are as follows:
- Avoid sudden changes in temperature.
- Keep the windows closed at night.
- Perform nasal washes with sterile physiological solution.
- Maintain a balanced diet by avoiding food allergens and drinking water.
- Minimize outdoor travel (during peak pollination periods, windy weather, as well as peak periods)
- Use air conditioning with a filter inside the house and in the car.
- Avoid contact with chemical irritants ranging from tobacco smoke to chlorine.
- Exercise as it promotes the narrowing of blood vessels by contracting muscle fibers (vasoconstriction).
- Tools such as masks to limit contact with allergens and nose strips to reduce nasal congestion can be used.
Pharmacotherapy
There is currently a wide range of medications that help manage allergic rhinitis.. Among them are the following.
antihistamines
Its use is recommended for the effective reduction of itching, sneezing and rhinorrhea. However, its ability to improve nasal congestion is limited. The most recommended oral drugs of this type are: cetirizine and loratadine.
It should be noted that, among first generation antihistamines, side effects such as sedation and decreased capacity may occur. In the case of second generation antihistamines, there are no side effects, they provide almost instantaneous relief but it is short lived.
Decongestants
They are long-acting drugs, they do not produce local irritations, nor rebound congestion or drug rhinitis.. However, they produce side effects such as drowsiness, dizziness, anxiety, urinary retention. Also, they raise blood pressure.
In case of regular use of topical nasal decongestants for more than two or three days, the effectiveness decreases, produces rebound and aggravates chronic rhinitis. Therefore, it is preferable to use oral decongestants.
Intranasal corticosteroids
These drugs are effective for symptomatic relief of rhinitis: nasal congestion, runny nose, itching and sneezing, especially in both types of allergic rhinitis and non-allergic rhinitis.
THE intranasal corticosteroids they are metabolized very quickly and last a long time. However, they must be handled with caution. as they present important side effects due to prolonged use such as: growth retardation, behavioral disturbances, suppression of the hypothalamic axis, etc.
Among the most recommended intranasal corticosteroids are:
- Flunisolide.
- Mometasone furoate.
- fluticasone propionate.
- Beclomethasone dipriopionate.
Immunotherapy
Immunotherapy consists of the progressive administration of gradual concentrations of certain allergenic extracts according to the patient’s condition to produce immunological tolerance.
This is the mainstay of the treatment of allergic rhinitis due to its great efficacy, however, the only route of application in many countries is subcutaneous. For this reason, patients should consider factors such as the frequency of injections, duration of treatment, risks and the patient’s willingness to continue therapy.
Have you been diagnosed with allergic rhinitis? What treatment did your doctor recommend?
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