Allergic Rhinitis

By Dr Paul Lim Vey Hong | Consultant Ear, Nose and Throat Specialist | Tue Mar 08, 2016 10:41am

Allergic Rhinitis

Allergic rhinitis is swelling and inflammation of the entire lining in the nose causing blockage of the nose, ‘running nose’, repeated sneezing, itching and pressure feeling between the eyes.

It is due to hypersensitive reaction of the nose to inhaled allergens such as pollutants, house dust mites, animal fur, pollen, fungus, chemicals and any foreign substances that triggers a hypersensitive reaction from the body.  It is not an infection and therefore not contagious.  It is different from ‘colds’ or ‘flus’ in that it affects the sufferer frequently and repeatedly when he or she is exposed to the allergen. It therefore occurs
daily or periodically, depending on allergen exposure,
without fevers.

Pollen allergy in temperate climates only occurs in spring and summer and is called ‘hayfever’.  In the tropics, we do not have significant variation in our climate, so allergic rhinitis affects sufferers daily throughout the year.  It is a long term condition that causes the sufferer debilitating symptoms which negatively impact on their daily life and productivity.

Imagine having to go to work or attend school every day with watery itching eyes, non-stop sneezing, blocked and running nose, and going through multiple packs of tissue to wipe one's nose until it becomes soreand red!  These symptoms also do not give a good impression of oneself when one is constantly blowing his or her nose and sneezing excessively.  Left untreated, allergic rhinitis can lead to daytime tiredness from poor quality sleep, sinusitis,
nasal polyps and even progress to asthma.  Allergic rhinitis causes loss of productivity and
an untold high number of work days lost to medical sick leave.??

The simplest way to treat allergic rhinitis is to remove the allergens.  This ranges from frequent cleaning of the living environment, avoidance of materials that trap dust and promote growth of house dust mite (such as carpets, stuffed toys, fabric cushions) and use of air-filters or purifiers.  While these may help in some cases, most sufferers require some form of medical intervention to improve their quality of lives.

Nasal douching or irrigation with saline is the simplest method, by washing away the allergens from the lining of the nose.  However, this method is impractical in the long term as one cannot be irrigating or douching his or her nose all the time.  This leaves medical treatment with antihistamines and steroid sprays to the nose as the most effective and practical ways to combat allergic rhinitis on the long term. ?

Antihistamines are drugs that block the allergic reaction in the body.  They are taken orally (usually once daily for the newer generation of antihistamines), to prevent the nasal blockage, sneezing, itching and ‘running’ nose from developing when exposed to the allergens. The older generation of antihistamines can cause drowsiness in some but the newer generation are not sedative. Some are packaged with pseudoephedrine to further reduce the swelling of the lining of the nose to help with the feeling of ‘congestion’.  Pseudoephedrine can however cause palpitation and insomnia in some people. Topical steroid sprays are very effective provided they are used regularly and daily, like antihistamines, to prevent allergic rhinitis.  They are usually sprayed into the nose once or twice daily.  Both oral antihistamines and steroid nose sprays are approved for long term treatment of allergic rhinitis.




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