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Last Updated: Sep 09, 2019
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Allergic Rhinitis: Treatment, Procedure, Cost and Side Effects

What is the treatment? How is the treatment done? Who is eligible for the treatment? (When is the treatment done?) Who is not eligible for the treatment? Are there any side effects? What are the post-treatment guidelines? How long does it take to recover? What is the price of the treatment in India? Are the results of the treatment permanent? What are the alternatives to the treatment?

What is the treatment?

Also known as hay fever, allergic rhinitis symptoms include sneezing, watery eyes, stuffy itchy nose, and a sore, scratchy throat. People also show symptoms like eczema,that is dry itchy skin that can blister and weep.Pollen mainly triggers this allergic reaction and causes the body to overreact and become sensitized. Other possible allergens may include grass, dust mites, cockroaches, cigarette smoke, and perfume.

Hay fever is caused by histamine, a natural chemical which is secreted when our body comes into contact with an allergen. Histamine helps to defend our body from allergens and can cause hay fever.

There are two types of allergic rhinitis- seasonal and perennial. Seasonal fever occurs during spring or fall and is mainly caused by pollens. Perennial prevails throughout the year in response to indoor allergens.

Treatment of allergic rhinitis can be categorized under 3 major heads. These are- (1) environmental control measures and allergen avoidance, (2) pharmacological management, and (3) immunotherapy.

Environmental control measures and allergen avoidance

Environmental and allergen avoidance can be possible if one restricts going out to much in seasons when these can be more harmful. One can take a shower after outdoor exposure as that helps to remove the pollens or allergens from the body. environmental control measures and allergen avoidance Bed linens, carpets and rugs should be washed thoroughly. Carpeting should be removed.

Pharmacological management

Pharmacotherapy of allergic rhinitis include intranasal corticosteroids, oral and topical antihistamines, decongestants, intranasal cromolyn (Nasalcrom), intranasal anticholinergics, and leukotriene receptor antagonists. Intranasal corticosteroid treatment is recommended alone for mild to moderate disease as an initiating therapy.Moderate to severe diseases should be treated with the other mentioned procedures. Patients with severe diseases who do not respond to oral or topical treatments should be referred for immunotherapy.

Immunotherapy

It consists of a small amount of allergen extract placed sublingually or subcutaneously over the course of a few years, with maintenance periods typically lasting between three to five years. Sublingual immunotherapy (SLIT) involves placing a tablet containing a mixture of several allergens under our tongue and is an effective way to treat severe cases of allergic rhinitis. However, side effects may cause anaphylaxis.

Other treatments include acupuncture,nasal saline irrigation,butterbur supplements,honey(raw, organic varieties),probiotics.

How is the treatment done?

For mild and moderate treatment, Intranasal corticosteroids alone is recommended. This treatment includes several categories like Beclomethasone (Beconase), Budesonide (Rhinocort) Ciclesonide (Omnaris) Flunisolide etc. All these treatments require a minimum age of 6 years. It inhibits the influx of inflammatory cells and starts action in less than 30 minutes. These should be taken one or twice daily for a week/month./ year according to doctor’s advice.

For moderate to severe rhinitis treatment, antihistamines are used along with decongestants, intranasal cromolyn (Nasalcrom), intranasal anticholinergics, and leukotriene receptor antagonists.Oral and intranasal antihistamines like cetirizine Desloratadine Levocetirizine help to bocks the H1 receptors and starts action within 15 to 30 minutes. These usually occur in the form of sprays and tablets. Oral decongestants like pseudoephedrine acts by vasoconstriction and requires a minimum age of 12 years. Intranasal cromolyn that is Cromolyn (Nasalcrom) inhibits histamine release and thus prevents the occurrence of rose fever. Mechanism of Intranasal anticholinergics like Ipratropium (Atrovent) include blocking acetylcholine receptors and that of Leukotriene receptor antagonists (Montelukast) include inhibiting leukotriene receptors.

Immunotherapy is applied only when the disease attains a chronic stage and is resistant to the previous cures. Here a small amount of allergen extract is given to the patient sublingually or subcutaneously over the course of a few years to treat allergens. Recombinant DNA technology and Omalizumab (Xolair), an anti-immunoglobulin E antibody are also effective in the treatment of hay fever and have shown positive results.

Who is eligible for the treatment? (When is the treatment done?)

Different treatment procedures of allergic rhinitis or hay fever have different minimum age criterion. However, patients till the age of 56-60 can be eligible for the treatment. Leukotriene receptor antagonists treatment can be started right from the age of 6 months while Fluticasone propionate under Intranasal corticosteroids treatment requires a minimum age of 12 years.

Who is not eligible for the treatment?

Pregnant women are prone to risks for treatment. Women specially under category C that is risk not rukes out should avoid allergic rhinitis treatment during the prenancy months. New born babies are not eligible as they might develop severe sid effects.

Are there any side effects?

Although allergic rhinitis is not an extremely serious condition, it can interfere with many important aspects of life. Possible side effects of undergoing rose fever treatement include itching in the mouth or ear and throat irritation. In rare cases, SLIT treatments can cause anaphylaxis. Patients often feel tired, miserable, or irritable.

What are the post-treatment guidelines?

Athough allergic rhinitis keeps recurring even after treatment, it is best for people to avoid exposure to cigarette smoke, pets, and allergens to which they have a known sensitivity. People should prefer staying indoors during times when pollens are abundant in the air, keep the doors and windows shut during allergy season. Mouth and nose should be covered with masks to prevent inhaling the dust particles and associated allergens. Keeping clean and being precautioned to avoid further complications in allergies must be noted by patients.

How long does it take to recover?

If the symptoms last for less than 6 weeks, then the treatment of rhinitis takes a shorter time period. Medication helps cure the acute disorders and helps restore normalcy. However, if symptoms last more than 6 months then it is termed chronic rhinitis and cure of this is a time taking process. It takes the entire year for the patient to get better. In worse cases, patients continue taking medicines lifelong.

What is the price of the treatment in India?

The cost incurred in the treatment of allergic rhinitis vary from person to person. Medicines as cheap as less than Rs. 5 to more than Rs 100 is available. Fexofenadine (Rs 123.56) is the costliest and Levocetirizine is the cheapest (Rs 2.5). However, the total cost depends on the respective doctors and the duration of treatment depending on the degree of allergy.

Are the results of the treatment permanent?

Allergic rhinitis can be cured permanently by undertaking homeopathy treatment for two to three sessions. Allergies are tough to get rid of. Enhancing body immunity to resist such reactions can help to prevent rhinitis permanently. Treatments help to suppress the symptoms and the root cause and can thus help in permanent resolving of the problem if individuals take proper care endlessly.

What are the alternatives to the treatment?

Minute allergic rhinitis can be brought under contol without medical treatment by using natural alternative methods. To reduce allergy symptoms, a low fat, high carbohydrate diet with lots of water is advised. Vegetable and vitamin intake will help the body improve upon its immunity. Acupuncture is a useful and prevalent way of treating those suffering from allergic rhinitis. herbs like butterbur,stinging nettle, tinospora cordifolia and astragalus help in natural cure of the disease. Also, patients may resort to homeopathy and ayurvedic cure of the disease.

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