Allergic rhinitis is an inflammation of the nasal mucosa that overreacts to allergens, or simply put, it overreacts to substances in the surrounding environment such as dust smoke, flower pollen, cockroaches, changing weather, etc.
Causes of Allergic Rhinitis and Triggers to Avoid
3 Common Allergen Groups Found in Allergic Rhinitis Patients
- Inhaled substances floating in the air such as PM 2.5 dust, smoke, pollution particles, flower pollen, mold, cockroaches, dog dandruff, cat dandruff, grass, etc.
- Food such as cow’s milk, eggs, seafood, nuts
- Temperature such as extreme heat, extreme cold, humidity
Common Symptoms of Allergic Rhinitis
Symptoms similar to a cold include nasal congestion, sneezing, clear nasal discharge, and nasal itching. Patients usually experience symptoms immediately after exposure to allergens, and the symptoms disappear. The symptoms last at most less than half a day and will resolve on their own. However, if it is a cold caused by infection, these symptoms will last more than a day or persist continuously. Some patients may have additional symptoms beyond the nose such as itchy skin rash, eye inflammation with swollen red conjunctiva, swelling of the middle ear pressure adjustment tube causing ear fullness or hearing loss, and asthma.
Diagnosis of Allergic Rhinitis
The diagnosis of allergic rhinitis relies on history taking combined with physical examination, which is considered the most important step.
Common symptoms include:
- Nasal congestion
- Frequent sneezing
- Clear nasal discharge
- Nasal itching
Patients may have symptoms in one nostril or alternating nostrils. Symptoms are usually worse when exposed to many allergens or cold air, especially at night or in air-conditioned rooms.
Associated Symptoms
In some patients, especially children and adults, specific features may be found including:
- Dark and swollen lower eyelids (Allergic shiner)
caused by swelling of the nasal mucosa and tear duct area, resulting in reduced blood circulation around the eyes. - Nasal bridge wrinkles (Allergic salute)
caused by nasal itching and frequent rubbing or pushing of the nose, leading to skin folds.
When the doctor examines the nose, swollen nasal mucosa causing nasal congestion and clear nasal discharge will be found. In cases with allergic eye symptoms, the doctor will find swollen red conjunctiva. In severe cases, this can cause inflammation and blockage of the tear duct, resulting in tearing. Besides the eyes, it also affects the middle ear pressure adjustment tube or Eustachian tube located behind the nasal cavity. If this tube is swollen and inflamed, it can cause ear fullness or ear pain.
Other symptoms include postnasal drip causing phlegm in the throat, throat itching, irritation, and cough, but these do not occur all day and only happen when exposed to allergens or changing weather. Other nonspecific symptoms such as dullness or forehead pressure between the eyebrows are caused by nasal swelling or fatigue. Additionally, other allergic conditions may coexist such as skin allergic rash and asthma, along with a family history of allergies.
Treatment Approaches for Allergic Rhinitis
- Avoid allergens or triggers
- Nasal saline irrigation when having nasal discharge
- Oral antihistamines
- Nasal steroid sprays for severe cases, such as more than 4 times per week
- Consult a doctor for evaluation before using medication
- Oral or nasal decongestants when congested or having difficulty breathing; consult a doctor for evaluation before use
Self-care and Prevention of Allergic Rhinitis
- Avoid allergens or suspected allergens such as cold air, dust, and smoke
- Boost immunity by eating fresh clean fruits rich in vitamins and antioxidants, exercising, and getting sufficient deep sleep of at least 7 hours without waking up at night or sleeping late past 11 PM
Complications to Watch For
Easy nasal or cold infections. Swelling and inflammation may cause swelling of the middle ear pressure adjustment tube, leading to easy hearing loss.
Doctor’s Recommendations
Allergic rhinitis, if treated continuously, can be controlled. The nose is the first gateway for air entering the body. If the nose is healthy and breathing is clear, the body will be refreshed and strong as well.
