Allergic Rhinitis

What is allergic rhinitis?
Every time we breathe, we inhale large numbers of small particles of dust, smoke, pollutants, pollen, animal fluff, etc. Most of us do not suffer bad effects from this, but some of these particles can set off an allergic reaction for many people. This can cause an itchy & runny nose and eyes, sneezing, nasal blockage, an itchy palate and other symptoms. This is called allergic rhinitis. Rhinitis means inflammation of the lining of the nose.

Who gets allergic rhinitis?
It is quite common, affecting almost 1 in 5 people. It can run in families. The symptoms may improve with age.

What is Hayfever?
Some people get their symptoms at a particular time of the year, usually in spring & summer when the pollen is plentiful. This is called seasonal rhinitis or hayfever. In other people, their allergic rhinitis symptoms may occur all year round. This is called perennial rhinitis.

What sorts of things trigger allergic rhinitis?
Substances that trigger allergic rhinitis are called allergens. Most of the allergens causing allergic rhinitis are inhaled into the nose. Pollen usually triggers seasonal rhinitis. House dust mites can cause symptoms all year round. Other allergens may be animal dander (especially cats and dogs) and fungal spores.

Is it possible to identify what the trigger factor is?
Often the patient can identify that exposure to something causes their symptoms, e.g. cats. Skin testing and a special blood test (RAST) can help identify some allergens, but none of the tests is completely accurate.

Treatment of Allergic Rhinitis
The treatment has 4 possible components.

  1. Avoidance of the allergen
    Avoid or reduce your exposure to the allergen.
    To reduce pollen exposure, avoid mowing lawns, forests, grassy areas and bush when it is pollen season (usually spring and summer). Keep the doors and windows of the house closed on a windy day to prevent pollen from blowing into the house. Keep car windows up and the air circulation on recycle to prevent pollen from gathering in the car.
    To reduce fungal exposure, keep the house mould free. A dehumidifier in damp areas of the house may help. Do not disturb mounds of old fallen leaves.
    If you are allergic to animals, do not have any. If you do, then keep them out of the house or at the very least out of your bedroom.
    Read the information sheet on avoiding the house dust mite.
    Avoid other irritants such as cigarette smoke, perfumes, rapid changes in temperature etc.
  2. Medications
    These can help to relieve the symptoms but only work when you take them. Possible medications include
    Saline douches – washing the nasal lining with salt water cleanses the nose, removes debris and mucus, and washes away the allergens. It is safe and natural.
    Steroid nasal sprays – these reduce inflammation in the nose. They affect the nose only. If instilled incorrectly, they can dry out the nose and make it bleed. They have no other effect on the body and are safe for pregnant women. These sprays only work if taken continuously. They do not work if only taken intermittently.
    Antihistamines – these may be taken orally or by nasal spray. They help block part of the allergic reaction. The newer antihistamines are not sedating.
  3. Surgery
    Surgery is of limited benefit. It is used to relieve nasal obstruction, which helps to improve the delivery of nasal medicines. It is sometimes used to treat sinusitis which can be a complication of allergic rhinitis. Cautery or reduction of the inferior turbinates, correction of a septal deviation, removal of polyps or sinus surgery may help improve the effectiveness of the antiallergy medicines.
  4. Immunotherapy
    This can be useful in some patients, particularly those who are allergic to pollen or the house dust mite. This tries to desensitize the patient to these allergens, so they don’t react to them. The treatment involves monthly injections over 2 to 3 years. Patients need to be committed to the whole course of treatment.

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