Allergic Rhinitis is a common condition where there is swelling and inflammation in the lining of the nose. It is sometimes called hayfever, and the persistent form is sometimes called “sinus”.
Allergic rhinitis symptoms are triggered by allergens such as house dust, grass and tree pollens and pets
Hay fever may run in families. Symptoms are commonly found in the nose itself, but there are also lots of symptoms in other parts of the body.
Many people with hayfever suffer badly from their symptoms, but do not get help as they have just got used it.
Allergic rhinitis is NOT a trivial disease. Uncontrolled allergic rhinitis affects quality of life and limits children’s ability to learn and adult’s opportunity to work to their best ability.
Common symptoms in the nose are:
- blocked nose
- runny nose
- post nasal drip
Other symptoms are
- itchy eyes, ears or palate
- red eyes
- loss of smell
- sore throat
- poor sleep
Allergens are substances to which you are allergic. These differ from patient to patient. There is no “one size fits all” list of triggers for people with hayfever! Your symptoms may be caused by your specific allergy triggers. To find out what triggers your hayfever, your doctor needs to find out where and when the symptoms are worst, and then do skin or blood tests to look for “the allergy antibody”, called IgE. (See what is an allergy)
Common triggers include:
- Pollen (grass/weeds/trees)
- House dust mite
Pollen Allergy is often worse during spring, especially when outdoors or when the wind blows.
Symptoms usually last weeks to months and the sneezing, itchy and runny nose may be prominent as well as problems with red and itchy eyes.
Dust Mite Allergy
Dust mite allergy may be more severe and last longer, because the house dust mite is present the whole year round. People with mite allergy often find it is worse in humid coastal areas where the house dust mite levels are high.
Symptoms are usually worse indoors, especially at night, because the mites love to live in the warm mattress and bedding. Symptoms may be more focussed on the swelling and blockage of the nose and post nasal drip.
It is really important that people with hayfever have allergy tests done before any advice is given about avoiding specific triggers. Many people have non-specific triggers such as cigarette smoke and very cold air, but for allergy triggers, skin tests or IgE blood tests need to be done so that triggers can be identified and avoided. Remember: If you are seeing a doctor for possible allergy skin tests, you need to stop antihistamines for 3 days before your visit. (See skin test brochure)
Nose sprays containing an anti-inflammatory “corticosteroid” is the best treatment for all the symptoms of allergic rhinitis. They need to be used every day because they help with the underlying swelling and inflammation and take a few days before they work, so can’t really be used just occasionally for symptom relief. The way that they are used is really important to make sure that they have the best effect. (See nasal spray and washouts)
Allergy (antihistamine) pills or syrup. Antihistamines are very good for treating the symptoms of itching, running and sneezing, but are less effective than nasal sprays on the blockage and have no effect on the underlying inflammation. All antihistamines are effective, but the older antihistamines can cause you to be very sleepy so are not recommended unless they are the only option available. Newer, “non-sedating” antihistamines are safe to use for a very long time, and are available from a pharmacy without a prescription.
Nasal washouts. Washing out all the allergens and snot from your nose is an excellent and natural way of treating hayfever. It is usually not effective just on its own, but may be an excellent help for the medication to work, especially if it is done before the nose spray is used, so the spray can reach the place where it works best. (See nasal spray and washouts)
“Vasoconstrictor” nose drops are drops or sprays put into the nose to shrink the blood vessels and provide fast relief from blockage. These are very effective for short term use, but should never be used for more than 5 days as otherwise the blood vessels “rebound” and cause even worse blockage. For this reason we don’t recommend them unless all other treatments are being used and even then for short times under the direction of your doctor.
Allergen Immunotherapy. If you are on all these treatments, taking them regularly and have tried to avoid your specific triggers your symptoms should be controlled! If you are still struggling with your allergies you should contact a doctor with experience in allergy to ask whether you qualify for immunotherapy. This is when the doctor actually gives you the thing that you are allergic to (as a drop under your tongue) every day to try to trick your body into becoming resistant to the allergy! This treatment needs a lot of dedication because the drops are taken every day for at least 2 to 3 years! (See immunotherapy brochure)