Allergic rhinitis is an allergic reaction that causes sneezing, congestion, running nose, itchy nose and sore throat. Pollen, pet dander, mold and insects can lead to allergic symptoms. Allergic rhinitis make a person feel awful, but can find relief with lifestyle changes, allergy medications and immunotherapy (allergy shots). Allergic rhinitis is a common condition  affecting wide range of population across the globe. Estimates of its prevalence vary widely but approximately 20 to 30% of adults and up to 40% of children are affected. It is caused by inhalation (breathing through nose or mouth) of dust, pollen, animal dander, pollution and various other allergens. The symptoms of allergic rhinitis are quite bothersome and have a significant negative impact on the patients’ quality of life, often interfere with sleep, and contribute to poor performance at work and school. Patients with moderate to severe allergic rhinitis have significantly more anxiety, depression, fatigue, disturbances in social interactions and perceived signs of cognitive dysfunction.  

Allergies are usually inherited (passed down through families). A person is more likely to have allergic rhinitis if he has a parent or family member with allergies. People who have asthma or eczema are more likely to develop allergic rhinitis.

The potential effect of climate change on the severity and extent of allergic rhinitis has been examined. Increasing temperature and carbon dioxide exposure have been shown to increase the production of pollen from individual plants. Sometimes, environmental factors may not only induce allergic rhinitis but may also aggravate the condition. In particular, an increase in air pollutants in the environment has been found to be associated with increased incidence of allergic respiratory diseases.

Allergic rhinitis can be divided into seasonal allergic rhinitis and perennial allergic rhinitis based on the type of allergy producing substances (allergens). A person can have allergic rhinitis any time of the year. Seasonal allergies occur in the spring, summer and early fall when trees and weeds bloom and pollen counts are higher. Perennial allergies can happen year-round. They result from irritants that are always around, such as pet dander, cockroaches and dust mite. In this regard, outdoor allergens, such as grass and tree pollens, are normally the main allergens for seasonal allergic rhinitis whereas indoor allergens, such as dust, mite, dander are the allergens for perennial allergic rhinitis. 80% of patients with allergic rhinitis have a mixed pattern of disease i.e. both seasonal and perennial. The studies have found different allergens to be prevalent in different regions across the countries and even within the countries.   

SYMPTOMS:

• Nasal stuffiness (congestion), sneezing and runny nose.
• Itchy nose, throat and eyes.
• Headaches, sinus pain and dark circles under the eyes.
• Increased mucus in the nose and throat.
• Fatigue and malaise (general feeling of discomfort).
• Sore throat from mucus dripping down the throat (postnasal drip).
• Wheezing, coughing and trouble breathing.

RISK FACTORS:

Some external factors that can trigger or worsen allergic rhinitis. These include:

• Cigarette smoke
• Chemicals
• Cold temperatures
• Humidity
• Wind
• Air pollution
• Hairspray
• Perfumes
• Colognes
• Wood smoke
• Fumes

MANAGEMENT:

Management of allergic rhinitis continues to revolve around avoidance of allergen like dust, pollen etc, medications for symptomatic relief (anti-allergics), anti-inflammatory and specific immunotherapy. Anti-allergic drugs are commonly used by majority of patients to ameliorate the symptoms. Intranasal drugs and injectable biologics are some of the recent development in the treatment of allergic rhinitis.  

TIPS TO PREVENT ALLERGIES:

1. Stay indoors when pollen counts are high.
2. Avoid exercising outdoors early in the morning.
3. Take showers immediately after being outside.
4. Keep your windows and doors shut as frequently as possible during allergy season.
5. Keep your mouth and nose covered while performing yard work.
6. Try not to rake leaves or mow the lawn.
7. Bathe your dog at least twice per week to minimize dander.
8. Remove carpeting from your bedroom if you’re concerned about dust mites.