Allergic Rhinitis

Overview/prevalence - 

Allergic rhinitis  affects 10-30% of the population. The prevalence of allergic rhinitis is increasing in urban areas. Allergic rhinitis can be seasonal or chronic. 

Risk Factors

Some proposed risk factors for allergic rhinitis include male sex, family history of allergies, firstborns, early use of antibiotics, maternal smoking exposure in the first year of life, exposure to indoor allergens

Symptoms

Allergic rhinitis presents as sneezing, runny nose, nasal obstruction, postnasal drip, itching of the eyes and nose. 

On exam there may be swelling and dark pigmentation beneath the eye, called an allergic shiner, a transverse nasal crease that usually represents repeated rubbing or pushing up of the nose. The nose may be inflamed and fluid may collect in the ear.

Diagnosis

The diagnosis of allergic rhinitis is based on the history and physical examination. 

On physical examination the eyes, ears, nose and mouth should be examined. 

Your doctor may order allergen testing. This may be beneficial to see what is causing the symptoms so that you can avoid those allergens. 

Allergy testing should be sought out for those with severe symptoms or those that do not respond to medication management.

Treatment

Allergic rhinitis treatment involves avoiding the allergen and medication management. 

The first line treatment for allergic rhinitis is intra-nasal glucocorticoids. Antihistamines are also an option, depending on the situation oral or nasal are options. 

Decongestant sprays as a standalone treatment for more than a few days should be avoided.

If symptoms do not improve, your physician may refer you to an otolaryngologist or ENT specialist.