Introduction
Allergic rhinitis is an inflammatory disorder of the nose where the nose become sensitized to allergens such as house dust mites and grass, tree and weed pollens.
Classification
It may be classified as follows, although the clinical usefulness of such classifications remains doubtful:
- seasonal: symptoms occur around the same time every year. Seasonal rhinitis which occurs secondary to pollens is known as hay fever
- perennial: symptoms occur throughout the year
- occupational: symptoms follow exposure to particular allergens within the work place
Epidemiology
- Incidence: 2000.00 cases per 100,000 person-years
- Peak incidence: 20-30 years
- Sex ratio: 1:1
| Condition | Relative incidence |
|---|---|
| Viral upper respiratory tract infections | 15.00 |
| Allergic rhinitis | 1 |
| Laryngopharyngeal reflux | 0.25 |
| <1 | 1-5 | 6+ | 16+ | 30+ | 40+ | 50+ | 60+ | 70+ | 80+ |
Clinical features
Features
- sneezing
- bilateral nasal obstruction
- clear nasal discharge
- post-nasal drip
- nasal pruritus
Management
Management of allergic rhinitis
- allergen avoidance
- if the person has mild-to-moderate intermittent, or mild persistent symptoms:
- oral or intranasal antihistamines
- if the person has moderate-to-severe persistent symptoms, or initial drug treatment is ineffective
- intranasal corticosteroids
- a short course of oral corticosteroids are occasionally needed to cover important life events
- there may be a role for short courses of topical nasal decongestants (e.g. oxymetazoline). They should not be used for prolonged periods as increasing doses are required to achieve the same effect (tachyphylaxis) and rebound hypertrophy of the nasal mucosa (rhinitis medicamentosa) may occur upon withdrawal