Allergic rhinitis is inflammation or swelling of the lining of the nose. It may be intermittent or seasonal, or it may persist throughout the year. It results in nose symptoms such as a blocked, sneezy, runny and itchy nose. In severe cases it causes snoring, frequent ear infections, poor sleep and may interfere with daily activities.
What is the cause
Allergic rhinitis tends to run in families and so your child is more likely to have it, if a parent or a sibling also suffers from allergic rhinitis. Allergic rhinitis is usually triggered by an allergy to something in the environment eg. House dust mites, pets, mould or grass. In some cases, no allergen is identified, but symptoms are still present.
How is allergic rhinitis diagnosed
Your doctor will take a detailed history of your symptoms, and examine the inside of your nose. Usually the nasal passages are seen to be narrowed due to the swelling, together with a post nasal drip. Children with allergic rhinitis often have tired faces with dark circles under their eyes. This is from the congestion in the nose and sinuses.
If allergic rhinitis is suspected, allergy tests to aero-allergens (allergens in the environment) will be done. The cheapest and most accurate test is a skin prick test (see information on skin prick tests).
What is the treatment
Avoidance
If an allergen is identified, avoidance is the most important part of management. Sometimes certain allergens are very difficult to avoid because they are everywhere, like Grass and house dust mites. Your doctor will explain avoidance measures that you can try in these scenarios.
Drug treatment
Nose sprays with steroids form the most important drug treatment in controlling and managing the symptoms. They work by reducing the inflammation and swelling in the nose. Your doctor may also prescribe oral antihistamines if predominant symptoms include a itchiness or a runny nose. Allergic rhinitis can be managed but not cured, so it is very important to take the treatment regularly. Once discontinued, the symptoms recur.
Immunotherapy
In severe cases where avoidance measures and drug treatment do not help, immunotherapy may be considered. This is a vaccine containing the allergen, which builds up a natural immunity to the allergen. It is usually given orally (under the tongue), or by injection, for a period of three to five years.
Importance of diagnosis and treating allergic rhinitis
Although allergic rhinitis is not life threatening, it can affect quality of life significantly, especially in young children. It can cause poor quality sleep, tiredness during the day and poor concentration.
It is very common for asthmatics to have allergic rhinitis as well. If the allergic rhinitis is not well controlled, the asthma can be very difficult to manage. This is because the lungs and the nose passage are united and work together. Therefore all children with asthma should be assessed for allergic rhinitis and vice versa.
