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Allergic Rhinitis: Treatment, Procedure, Cost and Side Effects

Last Updated: Oct 07, 2021

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.

What triggers Allergic Rhinitis?

Allergic Rhinitis can be triggered by different environmental factors like:

  • House dust mites: House dust mites are small insects mostly found in the home furniture. They usually feed on dead human skin sheds so they bite a human but their excrement is composed of harmful chemicals that can cause Allergic Rhinitis if inhaled.
  • Pollen and spores: These are present in small trees and flowers which can be seen active in the atmosphere around the spring season. They can be allergic to an individual if inhaled. Also, spores produced by moulds and fungi can also be harmful to you.
  • Allergies: Apart from pathogens that generally cause Allergic Rhinitis, allergies of an individual can also be the reason for heavy sneezing. Common allergies from animals and their excretion, wood dust, and even latex can also trigger the allergy.

How long does Allergic Rhinitis last?

It is considered a temporary medical condition because of its short duration of time. In most cases, Allergic Rhinitis fades away on its own within days without any extensive medication.

In other cases where people have specific allergies, Allergic Rhinitis can be frequent and holds a longer duration than usual. This is also known as the chronic stage as an episode of Allergic Rhinitis can last up to weeks or months.

Is Rhinitis and Sinusitis the same?

No, they might be interconnected but they both have different medical conditions. Prolonged exposure to Allergic Rhinitis can develop a blockage in the nasal passage causing sinister effects but it cannot be the other way around.

In the case of Allergic Rhinitis, one acquires it by inhaling external pathogens resulting in inflammation and swelling of the nasal passage. They are very short-lived and generally fade away on their own.

But on the other hand, sinusitis is a condition where prolonged infection develops excess mucus in the respiratory tract resulting in blockage. They can be both acute and chronic. This is a serious medical condition as it can lead to fever, common cold, breathlessness, and nasal polyps.

Is Allergic Rhinitis viral or bacterial?

Depending upon what triggers your Allergic Rhinitis, it can be both bacterial and viral in nature. It also depends on what affects you the most, for instance, some may get more dry cough than mucus one will often get dry Allergic Rhinitis.

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.

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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.

What will happen if Allergic Rhinitis is left untreated?

In most cases, the condition heals on its own without any medical support, although fewer cases may need medical attention as they can be prolonged. In this case, one should see their doctor as untreated allergies can affect other parts of the body like ears and the whole respiratory system.

Untreated long-lasting Allergic Rhinitis can cause ear infection and inflammation, sinus, hives, and can worsen your eczema and Asthma.

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.

Is Ginger good for Allergic Rhinitis?

Yes, Ginger contains antioxidative, anti-inflammatory phytochemical compounds which are effective against respiratory issues like throat swelling and irritation, nasal passage discomfort, runny nose, etc.

The key benefit of ginger is versatility, they can be used in any form dried or fresh and doest make any difference in their effect. Ginger is also away from any side effects that most allergic treatment has.

What foods good for Allergic Rhinitis?

Here is the list of vitamins and minerals that can be beneficial in case of Allergic Rhinitis:

  • Vitamin C:

    Known as a natural antioxidant, vitamin C cuts down histamines which are produced when one gets triggered by Allergic Rhinitis. The chemical is responsible for sneezing and a runny nose. Foods that are enriched with vitamin C can help you detoxify and have better results during allergies.

  • Bromelain:

    Abundantly found in pineapple, bromelain is efficient against swelling and sinus congestion.

  • Magnesium:

    Patients suffering from any respiratory disorder have shown a drop in magnesium levels. They help an individual to build up a better immunity system. Nuts are one of the best sources of magnesium.

  • Vitamin D:

    Like magnesium, vitamin D is also indirectly linked to the whole process. They are the support system for other minerals and vitamins that will help you recover at a better pace. Seafood and sun are one of the best sources of Vitamin D.

  • Gingerol and EGCG:

    It has the ability to dry up bacterial growth development in the nasal passage. They are only found in ginger and green tea.

  • Quercetin and curcumin:

    Like vitamin C, also helps in reducing the production of histamine. Fruits like apples, peppers, and berries are filled with quercetin, on the other hand, turmeric is the only source of curcumin.

  • Omega-3 fatty acids:

    It is the good fat that helps you grease out the mucus by reducing the stuffiness and nasal swelling. Fishes are a common source of omega-3 fatty acids.

  • Probiotics:

    Also known as healthy bacteria, will help you maintain a healthy and strong digestive system. Research is still looking for its direct impact on allergies, but it helps you boost your immune system by making your body healthy. Fermented foods and dairy are high in probiotics.

What are the alternatives to the treatment?

Minute allergic rhinitis can be brought under control 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 the natural cure of the disease. Also, patients may resort to homeopathy and ayurvedic cure of the disease.

Summary: Allergies reactions like runny nose and sneezing caused by exposure to external pathogens are known as Allergic Rhinitis. It is a mental medical condition that can be cured with home remedies.

References

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Written ByDr. Bhupindera Jaswant Singh Doctor of Medicine,MD - Consultant Physician,MDGeneral Physician
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