ALLERGIC RHINITIS: Symptoms and Treatment in Adults

Rhinitis, or runny nose, is an inflammation of the nasal mucosa. It can be caused by various reasons: viral or bacterial infection, colds, allergic reactions.

Usually, rhinitis is accompanied by swelling of the inner surface of the nasal passages, sneezing, itching, and an increase in the amount of mucous secretions. Allergic rhinitis is an immune disease.

In this article we will consider all the features, symptoms, causes of this particular form of the disease. Here you will find information on what to do and how to get rid of an allergic rhinitis.

What is allergic rhinitis?

Allergic rhinitis is an immediate type of allergic reaction (type I allergy).

When pollen comes in contact with the mucous membranes of the nose, eyes, or respiratory tract, the body reacts immediately and develops corresponding allergic symptoms (shortness of breath, sneezing and other).

Causes of allergic rhinitis

In the case of allergic rhinitis, or as it is also called hay fever, the reason lies in the inadequate response of the human immune system to the ingress of particles of an external substance (allergen) into the body. Hypersensitivity (increased sensitivity of the body to a substance) can manifest itself to the same substances that do not cause any reaction in other people.

The irritants can be:

• pollen of plants;
• wool and skin particles of some animals (cats, dogs, etc.);
• mold spores;
• waste products of microscopic mites contained in house dust (often causing allergy symptoms).

There is also an increased reaction of the mucous membranes to food allergens, in this case, an allergic rhinitis may also appear, among other painful manifestations.

Factors provoking the onset of allergic rhinitis

A predisposition to allergic rhinitis or hay fever increases if a person has chronic inflammatory diseases in the ear, throat and nose. Those who are prone to lingering colds and frequent viral infections are also at increased risk. Environmental factors:

• severe air pollution;
• tobacco smoke;
• an abundance of dust in the premises;
• constant presence of animals.

The likelihood of allergic rhinitis increases if there is a hereditary predisposition (one of the parents or both are prone to allergic reactions).

Symptoms of allergic rhinitis

The appearance of an allergic rhinitis is characterized by certain symptoms. Some of them can appear almost immediately, within 4 - 8 hours, while others after 2 days or even weeks from the onset of the disease.

According to allergists, when a person first meets an irritating substance, a noticeable allergic reaction may not occur, however, during the next contact with the allergen, it will become more pronounced.

In most cases, the symptoms of allergic rhinitis are as follows:

• repeated sneezing. Usually it immediately occurs when an allergen enters the nasal mucosa;
• itching in the nose, tickling in the nasopharynx. These manifestations are also very pronounced, and precisely at the very beginning of the disease;
• increased secretion of mucus from the nose. At the beginning, it is a very thin, watery discharge. In the future, the mucous discharge becomes thicker;
• watery eyes, itching and redness of the eyes;
• nasal congestion, inability to breathe through the nose, deterioration of smell;
• hypersensitivity to pungent odors: household and construction chemicals, perfumes, tobacco smoke;
• dry cough that joins later;
• weakness, drowsiness, chills and high fatigue (the phenomena are characteristic at the later stages of the disease). This is how the general allergic reaction of the body manifests itself;
• ear congestion, hearing impairment are also characteristic of chronic allergic rhinitis.

Forms and stages of allergic rhinitis

For a disease such as allergic rhinitis, there are two main forms:

• periodic (seasonal);
• permanent (year-round).

The difference between them is that in the seasonal form, the allergen is of plant origin and is released during the flowering of certain types of flowers or trees. In the chronic form, the irritant is present in human life (dust mites, mold, animals) and the disease may not stop all year round.

There is also a mixed form, in which chronic rhinitis is expressed year-round in an erased form and is amenable to drug control, and in the summer season it worsens.

There are the following stages of the disease:

• acute - allergic rhinitis lasts up to 4 weeks;
• chronic - the manifestations of the disease last longer than 4 weeks in a row. They do not stop at all or there is an unstable remission, and then a recurrence.

An annual recurrence of symptoms of allergic rhinitis for more than 4 weeks is also considered a chronic course of the disease.

Diagnosis of allergic rhinitis

At the very beginning, to establish a diagnosis, the doctor conducts a detailed survey of the patient. This is how an anamnesis is collected about the course of the disease and all factors accompanying its development, individual characteristics of the reaction to various substances, as well as to methods of treatment previously taken at home conditions.

The hereditary factor is also being investigated, which is very important in the diagnosis of any allergic diseases.

In the diagnosis of allergic rhinitis, it is of great importance to identify exactly those irritating substances that trigger a negative reaction of the immune system. Thus, a possible range of cross-allergens (similar products and substances that can also negatively affect a person) is established. Allergic rhinitis should be treated only after an accurate diagnosis has been established.

Proven diagnostic methods, the most popular at the moment:

• Skin test (allergy tests). This simple method is often used, but its error is quite large. The bottom line is that with the help of a special tool, a small scratch is made on the human skin, into which a substance is introduced - an allergen. After 15 minutes, you can evaluate the result. In case of a positive reaction, the test site will turn red, there will be slight swelling and itching.
• Immunoblotting. This is an analysis of the reaction of human antibodies to molecules of an irritating substance. Carried out in laboratory conditions. A fairly accurate diagnostic method.
• Microscopic examination of smears. For this analysis, smears of mucous secretions taken from a patient during an exacerbation of allergic rhinitis are stained with special preparations and examined under a microscope.
• Allergen-specific immunoglobulin (IgE) test. A blood test for an increase in the level of immunoglobulins of class E when exposed to various suspected allergenic substances.
• Provocative analysis method (rarely used). The patient is injected with a small amount of a substance that could potentially cause an allergic reaction. If the result is negative, the dose is gradually increased. Such a study is used only in stationary conditions.

Complications

If the disease is left untreated, allergic rhinitis usually goes through a stage of change, over time, the allergy moves from the nose and eyes to the lower respiratory tract, leading to allergic bronchial asthma. As a result, allergic pollen will cause shortness of breath.

In addition, many other complications can occur with hay fever, such as:

• asthma;
• itching of the oral mucosa, throat, ear;
• angina;
• cough;
• allergic skin reactions (eg, redness, swelling);
• trouble concentrating;
• sleep disorders;
• violation of smell, taste and hearing;
• general apathetic state.

The main complication of this disease is asthma (asthma attacks). Suffering pollen allergy significantly higher risk of developing asthma than non-allergic people: in 80% of cases, asthma is preceded by an allergy. However, early treatment of allergic rhinitis reduces the risk of developing asthma.

How is allergic rhinitis treated in adults?

To cure allergic rhinitis, first of all, it is necessary to establish and confirm an accurate diagnosis, as well as to identify a list of obvious and potential irritating substances - allergens. In the future, treatment is carried out aimed at solving three problems:

• removal of allergic inflammation and swelling of the nasal mucosa;
• elimination of the reaction to the influence of allergens (allergen-specific therapy);
• organization of a hypoallergenic life, minimization of contact with an irritant.

Nutrition and lifestyle

If the question of treating allergic rhinitis has already arisen, the first step is to change the usual way of life. Of great importance for any allergic disease is the issue of reducing contact with irritants:

• when detecting signs of a negative reaction to food, it is necessary to strictly follow a diet and completely exclude those products that are allergic;
• in the event of a reaction to plant pollen, it is recommended avoid any contact with the allergen during the flowering season (nature walks, trips out of town). During an exacerbation, coming home from the street, you need to immediately change clothes, take a shower, rinse your nose with isotonic solution. This is done in order to reduce the duration of contact with pollen that could be brought into the house on a person's clothes, body and hair;
• if an allergic reaction to house dust is established, it is necessary to regularly carry out wet cleaning indoors. It is also recommended to organize a hypoallergenic life: the absence of carpets, heavy fabric curtains and down pillows, the removal of all kinds of dust collectors. It is necessary to use special covers for upholstered furniture and bedding, acaricidal (anti-mite) cleaning agents;
• using household air purifiers is useful for both pollen allergies and house dust reactions.

The listed methods are especially relevant in cases where it becomes necessary to treat allergic rhinitis during pregnancy. In this case, you need to take all possible measures to organize a healthy lifestyle, proper nutrition and a hypoallergenic life.

This set of measures will reduce the need for the use of chemical drugs.

Drug therapy

Medicines designed to treat allergic rhinitis are designed primarily to relieve an allergic reaction and remove severe symptoms of the disease. Most often these are antihistamines of general action, produced in tablets or drops.

They are taken as prescribed by a doctor, usually once a day, for a long period (from 1 month). Among such agents, second-generation drugs have proven themselves well:

• Cetirizine;
• Claritin;
• Zodak.
• and the third (Erius, Zyrtec).

They have fewer side effects than drugs for allergies first generation (Suprastin). With a rather mild form of the disease, it happens one drug from this list is enough to completely eliminate symptoms.

When treating allergic rhinitis in patients with a more serious stage of the disease, at the same time with the use of tablets, doctors prescribe local anti-inflammatory drugs.

Usually they are a nasal spray and differ in the composition and principle of action of the active substance. Agents based on sodium derivatives cromoglycate are widely known. These are drugs such as:

• Cromohexal
• Kromosol.

Such medicines are used only as directed by a doctor. They are usually prescribed for mild to moderate severity of the disease.

Allergic rhinitis in adults is sometimes preferable to treat with local agents of this particular group, so that systemic effects from a general antihistamine drug do not develop.

For severe symptoms of allergic rhinitis, more serious hormonal medications are used to suppressing the inflammatory response: nasal corticosteroids, which are also available in the form sprays. These include drugs such as:

• Nazonex;
• Tafen;
• Benarin.

Although topical corticosteroids are generally well tolerated and have few side effects, they should never be taken without a doctor's prescription. Only treatment in adults is permissible; in young children, these drugs are rarely prescribed.

Preparations based on isotonic solution or seawater:

• Salin;
• Aquamaris.

They are completely harmless and are designed to gently rinse and cleanse the nasal passages from allergens and mucus accumulations that have got there.

Attention!!! It is strongly not recommended to use popular vasoconstrictor drugs for a long time in the treatment of allergic rhinitis - Naphtizin, Xymelin. They do not solve the problem, but instead dry out the inflamed nasal mucosa and, with regular use, cause the development of rhinitis medicamentosa.

Before treating an allergic rhinitis, it is worth trying prophylaxis, for example, Nazaval and Prevalin. These are protective sprays based on cellulose or oils and clay, which have an enveloping effect. They help isolate the nasal mucosa from the irritant, that is, prevent the allergen from entering it.

The use of such funds is advisable only in a state without exacerbation - it makes no sense to apply them to the irritated mucous membrane during an allergy attack.

Allergen specific immunotherapy (ASIT)

A separate group of medicines is designed to prevent the development of a negative reaction to an allergen.

Allergen-specific immunotherapy (ASIT) is a relatively new treatment. The method is based on a gradual decrease in the body's sensitivity to an allergen by gradual "habituation". This long and complex therapy, carried out during the period of remission, allows you to prepare for the season of exacerbation of hay fever and achieve a decrease or complete absence of response to stimuli.

To achieve a stable remission, 3-4 courses of therapy may be required.

Treatment of allergic rhinitis with folk remedies

Trying to treat an allergic rhinitis with alternative medicine is permissible only if the disease is mild and has not turned into a chronic stage.

Care should be taken to remember that many plants themselves can be quite strong allergens.

To find out how the body reacts to a particular herbal remedy, you must try to apply it for several days in a minimal amount.

If the body's reaction is normal, treatment with folk remedies can be carried out in long courses. Here are some popular recipes:

• A decoction of raspberry roots. Pour 100 grams of dry raw materials with 1 liter of water, boil for half an hour, cool and strain. Take such a broth in a quarter of a glass three times a day, before meals. The course of treatment is 14 days.
• Elecampane broth. 2 teaspoons of dry, crushed roots of elecampane pour 200 ml of water, boil for 10 minutes. Strain, take half a glass 2 times a day. The course of taking a decoction is 14 days.
• Aloe juice nose drops. Squeeze juice from a fresh aloe leaf, instill 2 drops in each nostril 2 times a day. The juice can be stored in a tightly sealed container in the refrigerator for 1 week.
• A mixture of lemon and horseradish. Mix the crushed components in equal parts. If desired, you can add a little honey (if you are sure there is no allergic reaction). Take 1 teaspoon twice a day, half an hour before meals.

Prevention and recommendations

The symptoms of an allergic rhinitis are very unpleasant, and it can be quite difficult to completely cure this disease. Doctors recommend people at risk to adhere to the following rules to prevent manifestations of allergies:

• use filters and indoor air purifiers;
• regularly carry out wet cleaning, get rid of house dust accumulators (carpets, large soft toys, down and feather pillows);
• avoid long-term exposure to aggressive air (tobacco smoke, strong chemical odors, dust and soot);
• during the flowering season of allergenic plants, stay indoors as much as possible or move to another climatic zone;
• follow the principles of proper nutrition and a hypoallergenic diet;
• at the slightest tendency to allergies, it is worth refusing to keep any animals in the house.

The topic of prevention of such a disease as allergic rhinitis during pregnancy is becoming especially relevant. After all, there is a risk of developing the disease not only for the mother, but also for the unborn child. The use of drugs such as Prevalin or Nazaval - a safe way to prevent the development of the disease.

Forecast

The long-term prognosis of allergic rhinitis is positive because in many cases hay fever successfully managed by minimizing exposure to allergens and treatment with one or more drugs.

However, when people with allergic rhinitis have other coexisting disorders, such as asthma, the disease is far more serious, as it has rarely been fatal.

Although the condition is not considered serious (if there is no asthma), it causes a lot of discomfort and interferes with the patient's normal daily life.

Conclusion

There is no simple and quick way to treat allergic rhinitis in allergy-prone people. Only a qualified doctor will tell you what to do in each specific case.

To completely get rid of the disease, you will have to undergo complex diagnostics and a long course of treatment. In the future, it will be necessary to avoid contact with allergens and adhere to a whole set of rules.

Sometimes moving to another climatic zone helps to solve this problem.