Allergic rhinitis or “hay fever” is an inflammatory disease of the nasal mucosa, which is characterized by difficulty breathing, mucous discharge from the nose, and sneezing. The basis of all this is allergic reactions. Also allergic rhinitis is a reaction different people to open or closed allergens.
Common sources of allergic rhinitis include: ragweed, grass, tree pollen, and mold spores. Indoor sources include: dust mites, pet dander, or mold that grows in indoor wet areas- for example, in carpets. Exposed allergens cause seasonal allergic rhinitis (also known as “hay fever”). Allergic rhinitis usually occurs and develops during the spring and summer. Internal allergens can cause long-term chronic allergic rhinitis.
The allergic process, called “atopy” (allergic diseases, in the development of which a significant role belongs to a hereditary predisposition to sensitization), occurs when the human body reacts to certain substances (foreign bodies) as “foreign invaders”. The immune system works continuously to protect the body from potentially dangerous factors such as bacteria, viruses, and toxins. However, it also happens that the causes of this disease are not entirely clear, and some people treat hypersensitivity to substances that are usually harmless. When the immune system mistakenly identifies these substances (allergens) as harmful and foreign, allergic and inflammatory reactions occur in the human body.
Immunoglobulin E (IgE) antibodies are key in allergic reactions. When an allergen enters the body, the immune system produces IgE antibodies. These antibodies then attach to mast cells, which are found in the nose, eyes, lungs and gastrointestinal tract person.
Mast cells (immune highly specialized cells of the connective tissue of vertebrates, analogues of blood basophils) secrete inflammatory chemical mediators, such as histamine, which is the cause of atopic dermatitis (diffuse neurodermatitis, endogenous eczema) with symptoms such as sneezing, itching, coughing, wheezing, etc. Mast cells continue to produce more inflammatory chemical substances, which stimulate the production more IgE, continuing the allergic process.
There are many types of IgE antibodies, and each is associated with a specific allergen. This is why some people are allergic to cat dander, while others may be allergic to pollen. In allergic rhinitis, an allergic reaction begins when the allergen comes into contact with the nasal mucosa.
Allergic rhinitis often runs in families. If one or both parents have allergic rhinitis, then there is a high chance that their children will also have the same condition. People with allergic rhinitis have increased risk development of asthma and other allergies. They are also at risk of developing sinusitis, sleep disorders (including snoring and sleep apnea), nasal polyps and ear infections.
Causes of seasonal allergic rhinitis (hay fever)
Seasonal allergic rhinitis occurs only during periods of intense airborne pollen or spore movement.
In general, sources seasonal allergies there are the following:
Ambrosia. Ambrosia is the most dominant cause allergic rhinitis, affecting about 75% of people with allergies. One plant can release 1,000,000 pollen grains per day. Ragweed usually causes the most severe allergies before noon;
Herbs. The herbs affect people from mid-May to the end of June. Herbal allergies most often occur late in the day;
Tree pollen. Small pollen grains from certain trees tend to trigger allergy symptoms in late March and early April;
Mold spores. Mold spores, which grow on dead leaves and release spores into the air, are common allergens during the spring, summer and fall. Mold spores can peak on dry, windy days in the afternoon and on wet or rainy days in the early morning.
Causes of chronic allergic rhinitis
Allergens in the home can cause people to experience attacks of year-round (perennial) allergic rhinitis. Examples of household allergens:
House dust mites—specifically, mite feces coated with enzymes that contain potent allergens;
- cockroaches;
- pet hair;
- mold and mildew growing on wallpaper, indoor plants, carpeting and furniture upholstery.
Other causes of chronic nasal rhinitis
Aging process. Older people are at high risk of chronic rhinitis, as the mucous membranes become dry with age. In addition, the cartilage that supports the nasal passages weakens, causing changes in air flow.
Peristaltic rhinitis. Peristaltic rhinitis is caused by the body's overreaction to irritants such as cigarette smoke or other air pollutants, strong odors, alcoholic drinks and exposure to cold. The nasal passages become red and bloodshot. This reaction is not an allergic reaction, although it is also associated with an increase in the number of white blood cells called "eosinophils".
Vasomotor rhinitis. Vasomotor rhinitis (a chronic disease of the nose, which is associated with a violation of nasal regulation vascular tone), another type of non-allergic rhinitis caused by hypersensitive blood vessels and nerve cells in the nasal passages - in response to various sources, including smoke, environmental toxins, changes in temperature and humidity, changes in stress, and even sexual arousal. Symptoms of vasomotor rhinitis are similar to most of those caused by allergies, but eye irritation does not occur.
Structural abnormalities of the nose. Certain physiological conditions, such as a deviated nasal septum, can block the nasal passages. In case of deviations, the septum is not straight, but shifted to one side - usually to the left. Sometimes a person may develop a so-called “cleft palate” - excessive fast growth bones in the nose or tumors that cause nasal obstruction. In such cases, surgery may be helpful.
Polyps. These are soft tissues that develop from stem-like structures on the mucosa. They prevent mucus from draining and restrict air flow. Polyps usually develop from the sinuses, which cause an overgrowth of the mucus membrane in the nose. They do not go away on their own; they can multiply and cause significant obstruction to normal breathing.
Medicines and drugs. Row narcotic drugs may cause or worsen a runny nose in people with health problems such as a deviated septum, allergies, or vasomotor rhinitis. Excessive use of decongestant nasal sprays to treat nasal congestion may, over time (3-5 days), cause inflammation in the nasal passages and worsen rhinitis. Snorting cocaine also causes severe damage to the nasal passages and can cause chronic rhinitis.
Other medications that may cause rhinitis include: oral contraceptives, hormone replacement therapy, anti-anxiety drugs (especially Alprazolam), some antidepressants, drugs used to treat erectile dysfunction, and some blood pressure medications, including beta blockers and vasodilators.
Estrogen in women. Increased estrogen levels typically increase swelling and mucus production in the nasal passages, which can cause congestion in these passages. This effect is most obvious in women during pregnancy and usually disappears after childbirth. Oral contraceptives and hormone replacement therapy that contain estrogen may also cause nasal congestion in some women.
Risk factors for allergic rhinitis
Allergic rhinitis can affect people of all ages. Allergies usually first appear in childhood. Allergic rhinitis is the most common chronic disease in children of any age, although it can develop at any age. Almost 20% of cases of allergic rhinitis are caused by seasonal allergies, 40% by perennial (chronic) rhinitis, and the rest by mixed causes.
Family history of allergic rhinitis. Allergic rhinitis most likely has a genetic component. People whose parents have allergic rhinitis have an increased risk of developing allergic rhinitis themselves. The risk increases significantly if both parents have the diagnosis.
Environmental impact. Your home or work environment may increase your risk of exposure to allergens (mold spores, dust mites, animal dander) associated with allergic rhinitis.
Symptoms of allergic rhinitis
Common symptoms of rhinitis are: runny nose and postnasal drip, where drops of mucus in the throat come from the back of the nasal passage, especially when lying on your back. Symptoms may vary depending on the cause of rhinitis. Symptoms of flu and sinusitis also need to be differentiated from allergies and colds.
Symptom phases
Symptoms of allergic rhinitis occur in two stages: early and late.
Early phase symptoms. Early phase symptoms appear within minutes of exposure to allergens. This phase includes:
Runny nose;
- frequent or repeated sneezing;
- watery or itchy eyes;
- itching in the nose, throat or mouth.
Late phase symptoms– appear within 4-8 hours. This phase may include one or more of the following symptoms:
Nasal congestion and;
- stuffy ears;
- fatigue;
- irritability, slight decrease in concentration, memory deterioration and slower thinking;
- decreased sense of smell or taste;
- ear pain;
- headache;
- bleeding from the nose.
If allergies are severe, dark circles may develop under the eyes. The lower eyelid may be swollen.
Diagnosis of allergic rhinitis
In most cases, a diagnosis of allergic rhinitis can be made? without any testing - based on the patient's symptoms. Allergy testing may be used to confirm allergic reaction identified by symptoms.
The doctor may ask the patient the following:
At what time of day and in what season of the year do episodes of allergic rhinitis most often occur; Is rhinitis associated with pollen and external allergens? If symptoms occur throughout the year, the doctor will suspect year-round allergic or non-allergic rhinitis;
- is there a family history of allergies;
- the patient has a history of others medical problems;
- in women - are they pregnant or are they taking medications containing estrogen (oral contraceptives, hormonal replacement therapy);
- whether the patient uses other drugs, including decongestants, which can cause the opposite effect;
- does the patient have pets?
- does the patient have additional unusual symptoms (examples: bloody nose; obstruction of only one nasal passage; tumor; fatigue; sensitivity to cold; weight gain; depression; signs of hypothyroidism).
Medical checkup. The doctor can examine the inside of the patient's nose using a device called a “mirror.” This painless test allows your doctor to check for redness and other signs of inflammation. Possible physical findings of the patient as a result of his examination may include:
Redness and swelling of the eyes;
- swollen nasal mucous membranes;
- swollen turbinates or nasal polyps;
- liquid for eardrum;
- skin rashes;
- shortness of breath.
Skin tests for allergies. Skin tests are a simple method to detect common allergens. Skin tests are rarely needed to diagnose allergic symptoms before they are treated in milder seasons. This type of test is not suitable for children under 3 years of age. Importantly, patients should not take antihistamines for at least 12-72 hours before the test. Otherwise, an allergic reaction, even if it exists in the body, may not be reflected in the test.
Small amounts of suspected allergens are applied to the patient's skin by pricking or scratching, or several cells containing allergens are injected deep into the skin. Test injections may be more sensitive to the patient than standard injections. If an allergy is present, a swollen, red area will form on the patient's skin within about 20 minutes.
Nasal swab. The doctor may take a nasal swab from the patient. Nasal secretions are examined under a microscope for factors that may indicate the cause of the disease. For example, an increase in the number of white blood cells indicates infection or high eosinophils. High levels of eosinophils indicate an allergic condition, but their low number does not exclude allergic rhinitis.
IgE analysis. Blood tests may also be performed to measure the production of IgE immunoglobulin. New enzyme-based tests with IgE antibodies have replaced the old RAST (radioallergosorbent test) test. These tests detect increased level allergen-specific IgE in response to specific allergens. Blood tests for IgE may be less accurate than skin tests. Testing should only be performed on patients who are unable to undergo routine testing or when skin test results are indeterminate.
Visual studies. In patients with chronic rhinitis, it is very important to exclude sinusitis. Imaging studies may be helpful if other test results are equivocal. In this case, the following may be used:
Computed tomography (CT) - may be useful in some cases if sinusitis or sinus polyps are suspected;
- X-ray;
- nasal endoscopy is used for chronic or unconscious seasonal rhinitis to examine every irregularity in the structure of the nose. An endoscopy uses a tube with a tiny camera on the end that is inserted into the nose to view the passages in it.
If rhinitis symptoms are caused by a non-allergic condition, especially if there is associated symptoms indicating serious problems, the doctor should treat any underlying problems. If rhinitis is caused by decongestant medications, the patient may need to stop taking them or find alternatives.
A number of factors must be considered when choosing a treatment method. These include:
Severity of symptoms;
- frequency of symptoms (by season compared to the whole year, as well as within a week);
- age of the patient;
- the presence of other diseases associated with rhinitis, such as asthma, atopic eczema, sinusitis or nasal polyps;
- patient preferences for certain types of treatment;
- type of allergens;
- potential and known side effects of medications.
Treatment Options
Many treatment options are available for patients with allergic rhinitis. For example, such as:
Environmental control measures (can help reduce exposure to allergens);
- nasal rinsing (for some patients this can provide great relief of symptoms);
- various nasal (nasal) sprays, including corticosteroids, nasal antihistamine sprays, nasal spray, cromolyn nasal and nasal decongestant sprays. We do not recommend using decongestant sprays for more than three days in a row;
It is also worth noting that most sprays for the treatment of runny nose in the form of ready-made aerosols involve the procedure of irrigating the nose, and not directly rinsing it. Irrigation, as opposed to rinsing, can only reduce the thick consistency of nasal discharge, but will not solve the problem of removing it along with harmful bacteria. After irrigation, the mucous membrane quickly dries out, which further aggravates a runny nose and provokes swelling. Rinsing helps reduce inflammation, improve the functioning of the nasal mucosa and reduce the risk of developing sinusitis and sinusitis. Modern technique involves washing the nasal passages with special antiseptic agents. For example, the components of the drug "Dolphin" reach the sinuses, diluting mucus clots and naturally bringing them out. - many types of antihistamine tablets. Some of them need to be taken in combination with decongestants. Decongestant tablets can also be used alone;
- other anti-inflammatory drugs, including leukotriene antagonists (leukotriene receptor antagonists - drugs that block leukotriene receptors).
All drug treatments have side effects, some of them very unpleasant and, in particular, in rare cases, can have serious consequences of use. Patients may need to try various drugs until they find ones that relieve symptoms without causing too worrisome side effects.
Treatment of seasonal allergies. Because seasonal allergies usually last only a few weeks, most doctors do not recommend stronger treatments for children.
Medicines are needed only in severe cases. However, in children with asthma and allergies, treatment for allergic rhinitis may also reduce asthmatic symptoms.
Patients with severe seasonal allergies should start taking medications a few weeks before the blooming season and continue taking them until the season ends.
Immunotherapy may be another option for patients with severe forms of seasonal allergies that do not respond to treatment.
Treatment for a mild allergic allergy attack usually involves just reducing exposure to allergens and using a nasal rinse.
There are dozens of treatments for allergic rhinitis. These include:
Periodic use of non-sedating second generation antihistamines;
- decongestants that relieve nasal congestion and itchy eyes in children over 2 years of age and adults;
- non-sedating second-generation antihistamines - such as Cetirizine (Zyrtec), Loratadine (Claritin), Allegra (Fexofenadine) or Desloratadine (Clarinex). These drugs cause less drowsiness than older antihistamines such as diphenhydramine (Benadryl). They are also available as decongestant/antihistamine combinations.
Because seasonal allergies usually last only a few weeks, most doctors do not recommend more strong drugs for children. However, in children with asthma and allergies, treatment for allergic rhinitis may reduce asthma symptoms.
Treatment of moderate to severe allergic rhinitis. Patients with chronic allergic rhinitis or those who have recurring symptoms that are active for most of the year (especially those who also have asthma) may take daily medications such as:
Anti-inflammatory. Nasal corticosteroids are recommended for patients with moderate to severe allergies, either alone or in combination with second-generation antihistamines;
- antihistamines. Non-sedating second-generation antihistamines—such as Cetirizine (Zyrtec), Loratadine (Claritin), Fexofenadine (Allegra), or Desloratadine (Clarinex)—are less likely to cause drowsiness than older antihistamines, such as Diphenhydramine (Benadryl). They are recommended alone or in combination with nasal corticosteroids for the treatment of moderate to severe allergic rhinitis. Nasal antihistamine sprays also work well;
- leukotriene antagonists and Cromolyn nasal spray (may be useful in specific cases of allergies).
Immunotherapy gives good results for many patients with severe allergies who do not respond to other treatments. It may also help reduce asthma symptoms and the need for asthma medications in patients with allergies.
At mild form Allergic rhinitis may remove mucus from the nose along with nasal discharge. You can buy a saline solution at the pharmacy or make it yourself at home (2 cups warm water, 1 teaspoon salt, a pinch baking soda). Saline nasal sprays containing as a preservative antiseptic Benzalkonium chloride may actually increase symptoms.
A simple way to administer medication for nasal discharge:
Throw your head back;
- pour the solution into your palms and inhale it through your nose, each nostril once;
- spit out the remaining solution;
- Gently clean your nose.
Treatment for itchy eyes. Antihistamine tablets can sometimes help relieve itchy and red eyes. Eye drops, however, provide faster relief, so itching and redness may be noticeably reduced. Eye drops for itchy eyes are:
Antihistamines eye drops: Azelastine (Optivar), Olopatadine (Patanol; Opatanol), Ketotifen (Zaditor), Levocabastine (Livostin) - drugs to relieve nasal symptoms, as well as itching and redness of the eyes;
- decongestant eye drops: Naphthyzin (Nafkon), Tetrahydrozoline (Tetrizolin; Vizin, Tizin);
- combination of anticongestive / antihistamine drugs: Visin, Opcon;
- corticosteroids: Alrex, Loteprednol (Lotemax), Pemirolast (Alamast);
- non-steroidal anti-inflammatory eye drops: Ketorolac (Acular).
Common Side Effects and Warnings
All eye drops can cause burning eyes, and some can lead to headaches and nasal congestion. You do not need to continue taking eye drops if there is eye pain, blurred vision, increased redness or irritation, or if this condition lasts more than 3 days.
People who have heart disease have high blood pressure, prostate enlargement, or glaucoma, should consult your doctor before taking any type of eye drop.
Medicines. Antihistamines. Histamine is one of the chemicals that causes the release of antibodies in those patients who react acutely to allergens. This is the cause of many of the symptoms of allergic rhinitis. Antihistamines can relieve itching, sneezing, and runny nose (unless antihistamines are combined with decongestants, they do not work well for nasal congestion).
If possible, take a doctor-prescribed antihistamine before an expected allergy attack.
Many antihistamines include drugs short acting and long-term use, oral tablets and nasal spray.
Antihistamines are usually divided into first and second generation drugs. First-generation antihistamines, which include diphenhydramine (Benadryl) and Clemastine (Tavist), cause more side effects (such as drowsiness) than most newer second-generation antihistamines. For this reason, second-generation antihistamines are generally preferred over first-generation antihistamines, and second-generation drugs are recommended.
Some precautions should be taken when taking any antihistamine:
Antihistamines may thicken mucus secretions and worsen bacterial rhinitis or sinusitis;
- antihistamines may lose effectiveness over time;
- Second generation antihistamines are called “non-sedating antihistamines.” However, both Cetirizine (Zyrtec) nasal spray and the antihistamines Astelin and Patanaz may cause drowsiness when taken in recommended doses. Loratadine (Claritin) and desloratadine (Clarinex) may cause drowsiness when taken in doses higher than the recommended dose.
Second generation antihistamines in tablet form include:
Loratadine (Claritin). Loratadine is approved for children 2 years of age and older. Loratin-D (Loratadine-D, Claritin-D) combines an antihistamine with the decongestant pseudoephedrine. Desloratadine (Clarinex) is similar to Claritin, but is stronger and has a longer shelf life. It is only available by prescription;
- Cetirizine (Zyrtec). Cetirizine is approved for use in internal and external allergies. It is currently the only antihistamine approved for use in infants 6 months of age. Cetirizine-D (Zyrtec-D) is a tablet that combines an antihistamine with the decongestant pseudoephedrine;
- Fexofenadine (Allegra);
- Levocetirizine (Xyzal) is a prescription drug approved for the treatment of seasonal allergic rhinitis in patients 2 years of age and older. It is available in both tablet and liquid form;
- Acrivastine (Semprex-D) and pseudoephedrine - a tablet that combines an antihistamine and a decongestant;
- second generation antihistamines in the form of a nasal spray are better than oral forms of drugs for the treatment of seasonal allergic rhinitis. However, they may cause drowsiness and are not as effective as nasal corticosteroids for treating allergic rhinitis.
Prescribed antihistamine nasal sprays include:
- Azelastine (Astelin, Astepro, Dimista);
- Opatanol (Olopatadine, Patanaz).
Side effects and precautions
Common side effects, including headache and dry mouth and nose, are often only temporary and go away with treatment. Loratadine and cetirizine have ingredients that may cause other symptoms, including nervousness, anxiety, and insomnia.
Somnolence occurs in approximately 10% of adults and 2-4% of children. Taking second-generation antihistamines in the form of sprays causes drowsiness more than taking tablets.
Nasal corticosteroids. Corticosteroids can reduce inflammation associated with allergic reactions. Nasal spray corticosteroids (commonly called "steroids") are considered the most effective medications for controlling symptoms of moderate to severe allergic rhinitis. They are often used either alone or in combination with second-generation oral antihistamines.
Benefits of nasal steroid sprays include:
Reducing inflammation and mucus production;
- improvement of night sleep and daytime alertness (tension) in patients with chronic allergic rhinitis;
- treatment of polyps in the nasal passages.
Nasal corticosteroids in the form of nebulizers (sprays) approved by the official health authorities of most countries include:
Triamcinolone (Nasacort) - for patients aged 2 years and older;
- Mometasone furoate (Nasonex) - for patients aged 3 years and older;
- Fluticasone (Flonaz) - for patients aged 2 years and older;
- Fluticasone and Azelastine (Dimista) - for patients aged 12 years and older;
- Beclomethasone (Beconaz, Vancenaz) - for patients aged 6 years and older;
- Flunisolide (Nazarel) - for patients aged 6 years and older;
- Budesonide (Rinocort) - for patients aged 6 years and older;
- Cyclesonide (Alvesco, Omnaris) - for patients aged 12 years and older.
Side effects of nasal sprays
Corticosteroids are powerful anti-inflammatory drugs. Although oral steroids can have many side effects, nasal sprays only treat the nose and offer less risk of common side effects if not used excessively. Side effects of nasal steroids may include:
Dryness, burning, tingling in the nasal passages;
- sneezing;
- headaches and nosebleeds (if you have such a symptom, you should immediately report it to your doctor).
Long-term complications are also possible. All corticosteroids suppress stress hormones. This effect can produce some serious long-term complications in people who take oral (oral) steroids. Researchers found far fewer problems with inhaled nasal sprays, but they can still cause problems. For example, the following:
Effect on human growth. Nasal steroids are a major problem for children, as are other forms of steroids that negatively affect children's growth. Research shows that most children who take only recommended doses of nasal sprays and do not also take inhaled corticosteroids for asthma have no problems;
- effect on the eyes. Glaucoma is a known side effect of oral steroids. Research to date has not shown that nasal steroids increase the risk of glaucoma, but patients should have their vision checked periodically.
Use during pregnancy. Steroids are likely safe during pregnancy, but a pregnant woman should consult her doctor first before taking them.
Injuries to the nasal passages. Steroid sprays can injure the nasal septum (the bony area that separates the nasal passages from each other) if the spray is directed at it. However, this complication is very rare.
Resistance to infection. People with any infectious disease or any injury to the nose should not take these drugs until the disease is cured.
Cromolyn. Cromoglycic acid (sodium cromoglycate) serves as an anti-inflammatory drug and a kind of allergen blocker. Standard Cromolyn (Nasalcrom) is a nasal spray that is not as effective as steroid nasal sprays but works well for many people with mild allergies. This is one of the preferred treatments for pregnant women with mild allergic rhinitis. Full healing effect This drug may take up to three weeks to wear off. Cromolyn does not have serious side effects, but there are minor ones: nasal congestion, cough, sneezing, wheezing, nausea, nosebleeds, dry throat, and there may also be a burning sensation or irritation.
Leukotriene antagonists. Leukotriene (leukotriene receptor) antagonists are oral medications that block leukotrienes, potent systemic immune factors, which cause the airways to narrow and produce mucus in the types of allergies associated with asthma. They appear to work as well as antihistamines for treating allergic rhinitis, but are not as effective as nasal corticosteroids.
Leukotriene antagonists include: Zafirlukast (Acolat) and Montelukast (Singulair, Singlon). These drugs are used primarily to treat asthma. Montelukast is also approved for the treatment of seasonal allergies and hidden allergies.
These drugs are believed to be associated with behavior and mood changes, including aggression, anxiety, sleep disturbances, hallucinations, depression, insomnia, irritability, restlessness, tremors, and suicidal thoughts and behavior. Patients taking leukotriene antagonists (including those such as Montelukast) should be monitored for signs of changes in behavior and mood. Physicians should consider stopping a patient's use of the drug if the patient has any of these symptoms.
Decongestants or vasoconstrictors. These drugs narrow blood vessels in the nose. They can be taken either orally, i.e. through the mouth and nasally.
Nasal decongestants. Nasal decongestants are applied directly to the nasal passages, along with gel, drops or steam. There are nasal medications different shapes - long acting or short acting. The effects of short-acting decongestants last about 4 hours. The effects of long-acting decongestants last 6-12 hours. The active ingredients in nasal products include: oxymetazoline, xylometazoline and phenylephrine. Nasal forms work faster than oral decongestants and do not cause severe drowsiness. However, they can be addictive and addictive.
The main problem with nasal decongestants, especially long-acting ones, is dependence and side effects. 12-hour medications pose a particular risk of these effects. At long-term use(more than 3-5 days) nasal medications lose their effectiveness and may cause swelling in the nasal passages. The patient then increases the dose. When the nasal condition worsens, the patient may respond with even more frequent doses. This causes addiction and increased nasal congestion.
The following precautions are important for people taking nasal medications:
When using a nasal spray, spray it into each nostril once. Wait a minute to allow the spray to enter the cells of the mucous membranes;
- you should not share droppers and inhalers with other people;
- It is not recommended to leave old sprayers, inhalers or other decongestants at home when treatment is no longer needed. Over time, these devices can become reservoirs for bacteria;
- Do not use nasal medications for more than three days.
Oral decongestants. Oral decongestants are also available different types and have similar ingredients. The most common active ingredients of pseudoephedrine (phenylephrine, mesatone), sometimes in combination with an antihistamine, are found in Sudafed and others. Oral decongestants may cause side effects such as insomnia, irritability, nervousness, and rapid heartbeat. Taking pseudoephedrine in the morning or before bed can help the patient avoid these side effects.
Risk of complications from decongestants
People with certain conditions (diseases, disorders) that make their blood vessels very sensitive to narrowing may be at higher risk of complications. Such conditions include:
Cardiovascular diseases;
- high blood pressure;
- diseases of the thyroid gland;
- diabetes;
- problems of the prostate gland (prostate), which cause urinary difficulties;
- migraine;
- Raynaud's phenomenon;
- high sensitivity to the cold;
- chronic obstructive pulmonary disease (COPD).
Patients with emphysema or chronic bronchitis Excessive sexual contact and short-acting nasal medications should be avoided. None of the nasal products for these conditions should be used orally or without a doctor's prescription.
Pregnant women;
- children. Children typically metabolize decongestants differently than adults. Decongestants should not be given to infants and other children under 4 years of age, and some doctors recommend not giving them even to children under 14 years of age because children are at particular risk for central nervous system side effects such as seizures, rapid heartbeat, loss consciousness and death.
Decongestants can cause dangerous interactions when combined with certain types of drugs, such as antidepressants and MAO inhibitors. They can also cause serious problems when combined with the amphetamine derivative methamphetamine (N-methyl-alphamethylphenylethylamine) or with diet pills. The patient should always tell his doctor about any drugs or herbal remedies he is taking. Caffeine may also increase the stimulant side effects of pseudoephedrine.
Immunotherapy. Immunotherapy (“allergy shots”) is safe and effective remedy for the treatment of patients suffering from allergies. It is based on the premise that people who receive injections of a specific allergen become desensitized to that allergen. The most common allergens used for treatment come from house dust, cat dander, grass pollen and mold.
Benefits of immunotherapy include:
Focus on a specific allergen;
- decreased sensitivity of the respiratory tract, lungs and upper respiratory tract to certain allergens;
- preventing the development of new allergies in children;
- reduction of asthma symptoms and use of asthma medications in patients with known types allergies. Research suggests it may also help prevent the development of asthma in children with allergies.
Immunotherapy may be used for patients with allergies who do not respond to medications and who test positive for the reduction of certain allergens in their body after using it. Latest principles show that immunotherapy is safe for young children and pregnant women, although only half the dose is generally recommended for them.
People who should avoid immunotherapy are those who have:
Positive answer in tests for skin allergies(they may have an allergic reaction);
- shortness of breath;
- uncontrolled severe asthma or any lung disease;
- taking certain medications (for example, beta blockers).
The main disadvantage of immunotherapy is that it requires a long course of weekly injections. The process usually involves regular injections of diluted allergen extracts - usually twice a week (weekly at first, then increasing to maintenance dosage). It usually takes several months to reach a maintenance dose, but this process may take up to 3 years. Then the intervals between injection doses can be 2-4 weeks, and treatment should continue for another 3-5 years.
Patients may experience some relief during the first 3-6 months. If there is no relief within 12-18 months, you should stop using the injections. After stopping immunotherapy, about a third of allergy sufferers no longer have any symptoms, a third have symptoms that improve, and another third experience a relapse of the disease.
Using a series of injections is effective, but patients often do not comply with the treatment regimen. Several other programs that may make the treatment regimen easier are still being researched.
Emergency immunotherapy. Researchers are studying "peak immunotherapy," in which patients reach their full maintenance dose with multiple injections per day over 3 to 5 days. Emergency therapy uses modifications that reduce the risk of serious reactions with excessive doses. Research shows that this therapy is effective and safe, but anaphylaxis and other severe reactions may occur. Patients during this period should be carefully selected and closely monitored.
Oral forms. Trials are underway to test forms of immunotherapy as an alternative treatment for allergy sources. These methods include taking the tablets orally or sublingually (under the tongue - which is not approved in many countries).
Side effects and complications of immunotherapy
Ragweed injections and sometimes dust mites have higher risks of side effects than other sources of allergy immunotherapy. If complications or allergic reactions develop, they usually resolve within 20 minutes, although some may develop up to 2 hours after taking the injection.
Side effects of immunotherapy include: itching, swelling, red eyes, hives, and soreness at the injection site.
Less common side effects include low blood pressure, worsening asthma, or difficulty breathing. This is associated with an extreme allergic reaction - anaphylactic shock. This can also happen if excessive doses are given.
In rare cases, especially with excessive doses or if the patient has serious lung problems, severe life-threatening reactions may occur.
Preventive medications with antihistamines and corticosteroids may reduce the risk of reaction to immunotherapy.
Prevention of allergic rhinitis
Lifestyle changes. Patients with existing species allergies, irritants or allergens such as:
Pollen (it is the main cause of allergic rhinitis);
- dust mites (house dust mites) - in particular, mite feces, which are coated with harmful enzymes containing a powerful allergen. These are the main allergens inside the home;
- animal dander (flakes) and hair from cats, house mice and dogs. Mice are a significant source of allergens, especially for urban children;
- mushrooms;
- cockroaches (are a major cause of asthma and can reduce lung function even in people without a history of asthma).
Some research suggests that early exposure to some of these allergens, including dust mites and pets, may actually prevent children from developing allergies.
Hidden protection against allergens. People who already have pets and are not allergic to them are likely to have a low risk of developing such an allergy in the future. This is why children who have contact with dogs or cats during the first year of their lives have a much lower risk of not only allergies, but also asthma (however, this does not protect them from other allergens - in particular, dust mites and cockroaches) .
If possible, pets should be re-homed or live outside the home, away from children at risk of allergies;
- Pets should at least be restricted from getting too close to children who are allergic to them. Cats have allergens that can even remain on human clothing. Dogs tend to be less of a problem.
Bathing your pets once a week can reduce allergens. Dry shampoos remove allergens from the skin and fur of cats and dogs and are easier to use than wet shampoos.
Limit exposure to cigarette and other smoke. Parents who smoke and have children with allergies should stop smoking. Research shows that exposure to secondary tobacco smoke at home increases the risk of asthma and related attacks in children.
Furniture polish spray is very effective in reducing dust and allergens. Air purifiers, air conditioner filters, and high-efficiency particulate air (HEPA) vacuum cleaners can remove harmful allergen particles and small allergens found indoors. Neither vacuuming nor special shampoos, however, are effective at removing house dust mites. Vacuuming actually spreads allergens from ticks and cats. People with these types of allergies should avoid having carpets or rugs in their homes. If a child has allergies, then vacuuming should only be done when the child is not at home.
Any bed dress and curtains in the homes of people suffering from allergic rhinitis should be washed very thoroughly every week or washed, if possible, in hot or warm water, using detergents.
Reducing humidity in the house and controlling pests. The level of humidity (dampness) should not exceed 30-50%. Living in a damp (damp) environment is counterproductive. Necessary measures to prevent humidity (dampness):
Repair all leaking taps and pipes, eliminate water collections around the outside of the house;
- wash moldy surfaces in the basement or other places in the house more often;
- exterminate pests (cockroaches and mice), use the highest quality exterminators (cleaning the house using standard methods cannot eliminate allergens). When exterminating mice, try to remove all dust, which may contain mouse urine, feces and dander;
- store food and garbage in closed containers, never leave food in bedrooms.
Open protection. How to avoid allergens outdoors. Below are some tips to avoid exposure to allergens:
You should start taking allergy medications 1-2 weeks before ragweed season begins. Don't forget to take allergy medications with you before going outside. If regular medications don't work, ask your doctor about allergy shots;
- camping and hiking should not be planned during the high pollen period (May and June - grass pollen period and September-October - ragweed period);
- patients who have allergies should avoid being in barns, among hay; they should not rake leaves or mow grass; you can wear a respiratory mask while doing things outside to reduce your exposure to pollen;
- Sunglasses can help prevent pollen from getting into your eyes;
- after staying on outdoors, remove excess pollen by bathing, washing your hair and clothes, and by rinsing your nose with salt water;
- during the flowering season, keep the doors and windows in the house closed.
Nutritional factors. Some evidence suggests that people with allergic rhinitis and asthma may benefit from a diet rich in omega-3 fatty acids unsaturated acids(they are found in fish, especially herring, almonds, walnuts, pumpkin and flax seeds), fruits and vegetables. Patients need at least five servings of this diet per day.
Scientists are also studying probiotics - the so-called beneficial bacteria" - such as lactobacilli and bifidobacteria, which are found in a number of dairy products (for example, biokefir, bioyogurt). Some studies have shown that probiotics can reduce the severity of allergic rhinitis symptoms and the effects of its treatment.
Complications of allergic rhinitis
The quality of life. Although allergic rhinitis is not considered a serious condition, it can interfere with many important aspects of a person's life. People with nasal allergies often feel tired, unhappy (depressed), or irritable. Allergic rhinitis can interfere with work or school performance.
People with allergic rhinitis, especially perennial allergic rhinitis, may experience sleep disturbances and daytime fatigue. They often attribute this to allergy medications, but nasal congestion may be the cause of these symptoms. Patients with severe signs of allergic rhinitis tend to have more severe sleep problems (including snoring) than people with mild allergic rhinitis.
High risk development of asthma and other allergies. Asthma and allergies often co-exist. Patients with allergic rhinitis often have asthma or are at increased risk of developing it. Allergic rhinitis is also associated with eczema ( atopic dermatitis; neurodermatitis, diathesis). An allergic skin reaction is characterized by itching, flaking, redness and swelling (edema) of the skin. Chronic, uncontrolled allergic rhinitis can worsen asthma and eczema attacks.
Chronic edema nasal passages (hypertrophy of the nasal concha). Chronic rhinitis, allergies or non-allergic asthma can cause swelling in the nasal turbinates, which may be permanent (turbinate hypertrophy). If nasal hypertrophy develops, it causes persistent nasal congestion and, sometimes, pressure and headaches in the middle of the face and forehead. This problem may require surgery.
Other possible complications allergic rhinitis include:
- sinusitis;
- middle ear infections (otitis media; otitis media);
- nasal polyps;
- sleep apnea;
- dental bite;
- defects in breathing through the mouth.
Today, allergic rhinitis has become widespread. The main feature of the disease is inflammation of the nasal mucosa, which occurs due to the ingress of substances that provoke a reaction. Most often, the appearance of this disease occurs in the spring-summer season. If measures are not taken in a timely manner, there is a risk of developing complications, as well as the progression of the disease to severe chronic form. So, let's look at how to treat allergic runny nose?
What is allergic rhinitis?
This disease belongs to the category of immune diseases. Under the influence of an allergen in human body histamine begins to be produced, which can make changes in the functioning of many systems and internal organs. It affects the blood vessels: small ones expand, and large ones narrow. As a result, the mucous membrane in the nostrils becomes red and swollen, and headaches, coughing, sneezing and runny nose may occur. Such symptoms are not contagious to others. Scientists have found that for the development of the disease great importance has heredity.
Any allergy is based on the interaction of antibodies and antigens. Special cells in the body store data about the substance that once caused a negative reaction. Antibodies are formed in the plasma - protein molecules that are activated when an antigen appears. Both of these components, when combined, create so-called immune complexes. Mast cells contain inactive histamine. It is activated under the influence of immune complexes and penetrates the blood. As a result of these processes, a negative reaction develops.
Depending on the type of course, allergic rhinitis can be seasonal or year-round. With the first type, the reaction continues for several hours, with the second – for several days.
The year-round disease is caused by an allergen that is constantly present nearby. For example, cosmetics, exhaust fumes, dust and others. The seasonal type is associated with pathogens that exist only for a certain period of time. This is pollen, fungi or mold.
Causes of the disease
Allergic rhinitis can occur due to various irritants: insects, animal hair, house dust. Currently, there is an opinion that the cause of allergies is polluted air. In reality, it does not act as a causative agent of a negative reaction, but it may contain irritants that enter the mucous membrane when inhaled.
One of the main reasons is genetic predisposition, which is inherited. If you have allergy sufferers among your relatives, the risk of developing the disease in subsequent generations increases.
Acquired allergic rhinitis is typical for children after the age of three. If the parents did not start treating the child in a timely manner, and also did not attach special importance to preventive measures, then the disease will haunt the person throughout his life.
Often, signs of an allergic rhinitis are associated with a change in place of residence and climatic conditions.
Types of allergies
The causative agents of allergic reactions can be divided into infectious and non-infectious. The first group includes components that are contained in viruses, fungi, and bacteria that enter the body along with the air. A negative reaction to mold is caused by mycelia released into the air by mold fungi. They are constantly near humans, but do not pose any particular danger. In allergy sufferers, they can cause symptoms of the disease.
Mold, viruses and bacteria are present in any space; they can only cause harm to people with hypersensitivity to them. constituent elements. Non-infectious irritants include:
- medications;
- Food;
- insects;
- pets;
- household dust;
- chemical production waste;
- pollen of flowers, trees;
- latex.
Irritants enter the body not only through inhalation of polluted air, but also through the blood, skin, and gastrointestinal tract. Depending on the type of pathogen, there are several variations of allergies.
- A negative reaction to pollen, otherwise called hay fever. This component gets into the mouth, nose, and eyes. When the substance reaches the bronchi and mucous membranes, an allergy begins.
- Allergies to birds and animals are widespread these days. Feathers, fur, saliva, and pet waste products act as irritants. Allergic rhinitis occurs after interaction with farm, wild, and domestic animals.
- Latex can cause a runny nose. After contact with the material, the substances included in its composition penetrate into the body through the air or skin.
- House dust mites often cause household allergies. In some cases, upholstered furniture, book dust, and human hair serve as irritants.
- Food rarely causes allergic runny nose and rhinitis, but this is quite possible.
- An insect reaction appears after contact with various insects. Its inhalation variety occurs due to inhalation of air containing waste products of cockroaches, butterflies and others. Such allergens are sometimes present in house dust. Another type is the contact type, which manifests itself after the bites of bees, bedbugs, mosquitoes, wasps and other insects.
Symptoms
A cold is also accompanied by a runny nose, however, knowing the distinctive features, it will not be difficult to determine rhinitis caused by various stimuli. So, allergic rhinitis is characterized by the following symptoms:
- appears unexpectedly and develops very quickly;
- there is a noticeable itching in the nose;
- frequent ocular drainage of a watery appearance;
- almost complete absence of sense of smell;
- the presence of blue or gray circles near the eyes;
- nasal congestion, which worsens at night;
- prolonged bouts of sneezing when exposed to an allergen;
- the duration of a runny nose will depend on the type of allergen;
- in rare cases, rhinitis is accompanied by eczema;
- the use of antihistamines helps improve well-being;
- absence of symptoms characteristic of colds.
Sometimes one of the symptoms is itching in the ears and eyes, conjunctivitis and swelling of the entire face. Some people feel as if there is something in their throat or nose. foreign body. Launched form The disease is accompanied by hypersensitivity and painful sensations in the eyes. The sense of smell is greatly distorted. Hearing problems may occur. The patient feels weak, tired, and his performance is greatly reduced.
Most often, allergic rhinitis and the symptoms described above first appear in childhood, adolescence and young adulthood.
The course of the disease in children occurs somewhat differently than in adults; it is often confused with a cold symptom. A qualified ENT specialist will help you accurately determine the disease. For this reason, when characteristic symptoms It is worth contacting such a specialist. With age, the signs become less pronounced. Only a doctor can determine the symptoms and treatment of the disease.
Treatment of allergic rhinitis without medications
How to cure allergic rhinitis? The most effective methods that help cope with the disease include:
- Proper nutrition
Some foods can increase the signs of cross-allergy. You can determine which particular plant, flower or tree is causing the irritation depending on what time of year the reaction to pollen occurs. During the period of seasonal exacerbation, it is not recommended to eat honey, pears, apples, and potatoes. From the beginning of August to the end of September, when quinoa and ragweed bloom, it is necessary to exclude watermelons, honey, mayonnaise, and cabbage from the diet.
- Keeping the air clean in your home
The optimal remedy for allergic rhinitis is to ensure the purification of the air in the room in which a person spends the longest time. Accumulators of harmful bacteria and allergens are Stuffed Toys, heavy fabric curtains, carpets. When the “dangerous” season begins, it is necessary to wet clean the room every day, as well as use air purifiers and humidifiers with special anti-allergenic filters.
If the causative agent of the allergy is wool, then all contact with pets will have to be stopped. This problem will not help decide, for example, the purchase of special breeds of cats without hair. The causative agent of the negative reaction is enzymes contained in the skin, saliva, and animal waste products. Keeping fish is also not safe for allergy sufferers. Feeding the inhabitants of the aquarium is usually carried out using dried plankton. It is a powerful allergen.
- Stopping contact with pathogens that cause a negative reaction
With allergic rhinitis, it is much easier to deal with unpleasant symptoms when the cause of their occurrence is known. To determine the source, it is worth contacting an allergist who will take skin tests, as well as a blood test and check the reaction to a variety of allergens. Knowing your enemy exactly, you can protect yourself from its influence. If these are food products, you should stop eating them. If you are allergic to flower or tree pollen, ideal option The solution to the problem will be a trip to another region, preferably to the sea.
- Plasmapheresis
Another treatment method will be mechanical purification of the blood from toxins, allergens and immune complexes. The procedure is carried out only on the basis of the recommendations of a qualified doctor.
This method also has some contraindications, which you should definitely get acquainted with and inform your doctor about them.
Blood cleansing, unfortunately, does not guarantee a long-lasting effect. However, it helps treat the disease. Plasmapheresis in the long term helps to overcome the manifestations of allergies and types of runny nose caused by the irritants listed above.
Traditional medicine recipes
You should not trust the advice of friends and neighbors, as well as blogs on the Internet that offer effective recipes that guarantee the treatment of allergic rhinitis. Only one home procedure is acceptable, which helps relieve unpleasant signs diseases is the use of saline solution to rinse the nose.
Do not forget that this method is not therapeutic, so do not delay in contacting a doctor and carefully following his recommendations.
Before determining how to treat an allergic rhinitis, you should definitely consult a specialist. It is not recommended to make independent attempts to eliminate symptoms or take any medications at your own discretion. Only a qualified specialist will be able to provide real help.
It would seem, what’s special if a person has a runny nose? Indeed, a runny nose does not pose any danger if it lasts no more than a week and the snot is clear. However, if the disease drags on and there is no improvement, many people ask themselves the question - is it allergic in nature? This is especially true for children, since their immune system is not fully formed and parents cannot be sure whether the baby is allergic to something.
It is very easy to confuse an allergic runny nose with a cold. Many symptoms of ARVI can also occur with allergies - sneezing, coughing, watery eyes. What to do in such a situation? How to distinguish one from the other? After all, if the runny nose is of an allergic nature, the principles of treatment change radically.
What is the difference between a cold and an allergic runny nose?
Everyone knows how a viral disease develops, but not everyone is familiar with an allergic reaction. If you have a runny nose, pay attention to the accompanying symptoms.
- Origin. Often a person knows the cause of a viral infection. That is, a runny nose is probably a cold if it appears after hypothermia or after contact with a sick person. Allergic rhinitis most often appears suddenly and develops quickly.
- Pathogen. If you have an allergic runny nose, you can try to track the allergen to which your body reacts. Analyze when a runny nose becomes active. If mucus production increases indoors, pay attention to dust or possible allergens in the home. Sometimes a runny nose occurs on animal fur, after inhaling pollen from certain plants. If your runny nose only becomes active at night, you may have a reaction to the pillow filling.
- Temperature. If your runny nose is a cold, pay attention to your body temperature. If it is even slightly increased (usually in the first days of illness), it means that the nature of the runny nose is a cold. If there is no fever, this does not mean that the runny nose is definitely allergic - sometimes a cold can also go away without an increase in temperature.
- Eyes. When you can't figure out the cause of your runny nose, pay attention to your eyes. If they are very watery, swollen and itchy, you most likely have an allergy. If you feel only a slight pain, tingling and burning in the eyes, these are more like symptoms of a cold. It happens that allergic rhinitis is often accompanied by allergic conjunctivitis.
- Cough. Often a runny nose (both colds and allergies) is accompanied by a cough. Pay attention to this cough. A dry cough can be due to allergies or a cold, but moist cough is an accurate indicator of a viral infection. A dry, prolonged cough over several months can develop into asthma if it is allergic in nature. Usually, with such a cough, the doctor does not hear wheezing, the lungs are clear.
- Snot. If the runny nose is of an allergic nature, then the mucus secreted from the nose is usually transparent. With bacterial rhinitis, the mucus becomes thick, yellow or green.
- Itching. With allergic rhinitis, it appears in the nose severe itching, during a cold, there is no such itching. The nose itches at the very base, which is why allergy sufferers often rub their nose with their hands and wrinkle.
- Smell. During allergic rhinitis, odors are completely absent, while a runny nose only slightly reduces the intensity of the aroma.
- Sneezing. A person can sneeze both during a cold and during allergies. However, the nature of the sneeze can tell us about the pathogen. If you sneeze several times throughout the day, you probably have a cold. But prolonged bouts of sneezing (15-20 times) indicate an allergy.
- Change in skin color. Often, in addition to a runny nose, an experienced allergy sufferer may find dark and blue circles under the eyes.
- Flow time. Another way to identify the type of runny nose is to pay attention to its duration. If the runny nose goes away completely within 7-10 days, then it is most likely ARVI. If you have a runny nose varying degrees accompanies you for a long time(especially in spring and summer) is an allergy.
- Rashes. With allergic rhinitis, the body's reaction is often not limited to snot and cough. An allergy sufferer may experience various skin rashes, hives and even eczema.
- Genes. If parents have allergies, there is a high probability that their child will also suffer from various types of allergic reactions. Predisposition to allergies is a hereditary pathology.
- Antihistamines. It is not difficult to distinguish a cold from an allergy if you have antihistamines on hand. After taking one tablet, a person with a cold will notice only barely relief nasal breathing, since the medicine relieves swelling. If you have allergies, an antihistamine will provide complete relief, albeit temporary.
- Lymph nodes. When you have a cold, they usually increase slightly.
- Wheezing. With an allergic rhinitis, wheezing and even suffocation may occur. This is especially typical for children, since their laryngeal lumen is very small, and even slight swelling completely blocks it.
- Throat. As a rule, with ARVI, the throat becomes very red, sometimes even purulent (if bacterial infection). But with allergic rhinitis, the throat may have only minor redness, which appears from a barking allergic cough.
- Smoking. If you smoke, this is a big risk factor for developing allergies.
- State. A person suffering from a cold changes general health– joint aches appear, appetite is lost, you want to sleep, your head hurts. This is especially noticeable in children - they become capricious, lethargic, and whiny.
These are detailed symptoms that can be used to distinguish a cold from an allergic one. However, sometimes the allergic nature of rhinitis often turns into bacterial, and vice versa. That is why an allergist is the best person to help you cope with this task. He will ask you in detail about your lifestyle, the presence of pets in the house, and also about allergies in relatives. Patients are often prescribed allergy tests, which can detect not only the fact of an allergy, but also help identify the allergen.
How to treat colds and allergic rhinitis
It is not difficult to treat a cold, the main thing is not to start the process. You need to drink plenty of fluids - not a mug of raspberry tea, but 2-3 liters of warm liquid. This will allow you to flush the virus out of your body as quickly as possible. In addition, you need to take antiviral drugs and increase immune activity. Humidify the air in the room, ventilate the room so that the nasal mucosa does not dry out. Inhalation, nasal rinsing, and warming are very effective in treating colds. You can put garlic, onion, aloe and black radish juice into your nose. If your nose is stuffy, use vasoconstrictors, but remember, they cannot be used for more than five days - they are addictive. A few days similar treatment– and the patient will certainly improve.
Dealing with allergic rhinitis is more difficult. Especially if it is not possible to identify the allergen. You need to pay utmost attention to bedding and textiles in the house - curtains, sofa upholstery, bedspreads, carpets. If possible, you should discard them, and those that remain should be vacuumed as often as possible. Wet cleaning should be done daily. Allergies can also be to certain foods, animal dander, medications, or pollen. The main treatment for allergic rhinitis is identification of the allergen and possible prevention contact with him.
For those with allergies, you can install fine filters in your home, stop smoking, and more carefully monitor hygiene in your home. To relieve the symptoms of allergic rhinitis, you should always have antihistamines with you.
If a person suffers from allergies, he can usually distinguish an allergic runny nose from a cold, and is well oriented by his feelings. But parents of small children have a hard time - they are still searching for the correct diagnosis. However, an experienced doctor will help you distinguish one from the other and prescribe adequate treatment.
Video: how to distinguish an allergic cough from an infectious one
Any allergic rhinitis is a sign of dysfunction of the immune system. This kind of runny nose was first identified as a separate disease about 100 years ago. This was done by a scientist who himself suffered during the flowering of plants. In winter, he found himself near mown hay and began to sneeze again. At that moment, he suspected that his well-being was a reaction to certain substances in the air. This disease is also called hay fever.
Types of problems
Experts say that there can be two types of allergic rhinitis. The symptoms and treatment are similar. So, some people only face seasonal problems. At the same time, allergic rhinitis owes its appearance to plant pollen, to which the body reacts. The greater its concentration near a sick person, the more noticeable the manifestations of diseases will be.
But some suffer from a runny nose all year round. In this case, patients most likely react to dust, animal saliva, fur, dust mites, molds or other irritants. Some people experience a reaction to so-called occupational allergens: paints, solvents, varnishes, cement and other chemicals.
Causes and characteristics of the disease
Experts have long said that any allergies are problems with the immune system. It produces histamine upon contact with an irritating substance. This process provokes allergic rhinitis. The reasons for its appearance lie in immediate hypersensitive reactions that occur upon contact with an irritant. It is the immune system that begins to fight inhaled particles and stimulates the appearance of a runny nose.
She considers allergens to be foreign substances. The body that first encountered them begins to produce special antibodies. During subsequent contacts, they begin to fight against familiar allergens. But this releases histamine and other substances that lead to symptoms. Experts call this whole process sensitization.
Symptoms usually appear quite quickly: it can take from a few seconds to 20 minutes. They arise due to the reaction of the peripheral and central parts of the nervous system, which give impetus to changes in the nasal mucosa. Tissue swelling appears, the nasal cavity narrows, breathing is impaired, and the tone of the vessels in the mucous membrane of this organ changes. In addition, there is increased secretion of goblet cells, increased secretory function of the glands, and the appearance of a significant layer of mucus above the cilia of the ciliated epithelium.
In addition, a decrease in the absorption capacity of the nasal mucosa is characterized by an allergic runny nose. The symptoms and treatment of this disease depend on its course and duration. The general well-being of a person is also important.
First signs of problems
When contacting allergens, the body reacts instantly in most cases. The signs may disappear on their own after a few days. The maximum period during which rhinitis can last is 10 days. But we must understand that the disease can only go away when there is no contact with the irritating substance. Otherwise, an allergic runny nose may continue for quite a long time. The symptoms of this disease are always pronounced:
Sneezing: appears a few minutes after inhaling an allergen or in the morning;
Runny nose: the mucus secreted is liquid and transparent, but when a nasal infection is attached, it becomes yellow and viscous;
Discomfort in the nasopharynx, possible coughing;
Itching in the nose, ears, throat.
The eyes also often become inflamed, and slight swelling of the face may occur.
To people who have never encountered such a disease, it seems that this is not so scary. But allergic rhinitis can greatly complicate life, because its manifestations affect well-being, appearance, performance.
Preventing Disease
Many people suffering from acute immune reactions to irritants have never even visited a specialized allergist. But in vain. A specialist could select medications that will alleviate the condition and tell you what needs to be done to prevent allergic rhinitis from appearing. Prevention (symptoms have not yet appeared) is aimed at preventing the development of the disease. The best preventative measure is to avoid contact with the allergen. To do this, it is advisable to do tests and determine what substance you are reacting to.
You can prevent the development of the disease or minimize its manifestations in the following way. We must try not to go out Fresh air early in the morning, avoid any trips to nature. You can cover your windows at home thick fabric so that pollen has no chance of getting into the rooms. It is also recommended to wash your nose and eyes as often as possible. This will help cleanse the mucous membranes of allergens that have entered them and prevent the onset of the disease if you know that your allergic rhinitis may worsen. Komarovsky E. O. claims that this disease also occurs as a reaction to excessive cleanliness and an abundance of household chemicals in the house. He considers nasal rinsing and maximum contact with potential allergens to be the best preventive measure. He says that before the baby arrives in the house, you can even get a dog, this will also help prevent the child from developing allergies.
But other doctors do not recommend keeping flowers at home or using cosmetics for people with hypersensitivity (with the exception of special hypoallergenic series). Following these recommendations may not completely get rid of allergies, but it can significantly alleviate your condition.
Symptoms of the disease
If at first a person is only bothered by a runny nose, frequent sneezing and itching, then over time other signs arise, by which a specialist can diagnose an allergic runny nose. Symptoms that occur over time may include:
Increased photosensitivity;
Sniffling, constantly stuffy nose;
Irritability caused by;
Prostration;
Deterioration of sleep;
Mouth breathing (occurs due to constant nasal congestion);
Altered sense of smell;
Hearing problems, feeling of pressure in the ears;
Unpleasant sensations in the face;
Allergic bruises are dark circles appearing under the eyes.
The intensity of symptoms may vary throughout life. IN certain moments they can worsen, in other periods they can practically disappear. Allergic rhinitis often occurs during pregnancy. Children are considered more sensitive to allergens. It happens that as they grow older, they become less susceptible. Frequent use perfumery, work involving strong odors, contact with wood or cigarette smoke only make the situation worse.
If you notice an exacerbation of allergies in the spring and summer, then most likely you have a reaction to pollen. But there are people who are much worse in winter, a period when they have to spend most of their time indoors. In this situation, allergens must be looked for among dust, household mites, animals living in the house, and plants on the windowsill.
Action tactics
If you have a feeling of itching, sneezing and mucous discharge from the nose, do not try to immediately run to the pharmacy for antihistamines - the cause of the malaise may be completely different. Now let's talk about how to distinguish an allergic runny nose from a cold. With absolutely identical symptoms, different treatments are required. Colds in most cases are accompanied by others characteristic of acute respiratory diseases symptoms. This may include fever, body aches, cough, pain in the neck, or hoarse voice. In addition, when infectious diseases The discharge is often viscous and yellow or greenish in color.
If you know what exactly you are allergic to, then everyone should possible ways minimize contact with the irritant. During seasonal manifestations of the disease, it is necessary to spend as little time as possible outside, constantly wash your nose, try to travel by car, bus, minibus, and close the windows at home. This is the only way to reduce the manifestations that characterize allergic rhinitis.
A collection of tips may recommend relieving the condition with antihistamines. First generation drugs can eliminate symptoms, but they have many side effects. They depress the nervous system, weaken attention, provoke a feeling of lethargy and constant fatigue. These include drugs such as Suprastin and Diphenhydramine. More modern drugs only block histamine receptors and do not affect general state. In addition, to achieve the desired effect, drinking the new generation of products once a day is enough. These include medications “Claritin”, “Zyrtec”, “Aleron” and others. Systemic drugs in the form of tablets, capsules or syrup, as a rule, they are prescribed in cases where the patient is bothered by several symptoms at once, and not just an allergic runny nose.
Prevention and treatment of mucous discharge from the nose is carried out using local remedies. If necessary, hydrocortisone injections may be given to the inferior turbinate area. But such radical measures are used in extreme cases. Most often, for allergic rhinitis, eye drops and nasal sprays are recommended, which can provide some relief in less than an hour. An allergist can prescribe medications such as Cromoglin and Cromosol - they are used for mild forms of pathology. In more severe cases, corticosteroids are recommended - Nasobek, Nazarel, Nasonex, Benorin.
Another method of control is the injection of allergens. But such tactics can only be used when the stimulus has been established. Therapy is carried out as follows: first, the allergen is introduced into the body in small doses, then its concentration is increased. This is done until tolerance to the irritants that cause allergic rhinitis is developed. With this approach to treatment, you will no longer need prevention, because the body stops responding to the substance that caused the disease.
Seasonal problems
Experts distinguish several stages of the pathology we are considering. And all of them are accompanied by an allergic runny nose. Symptoms and treatment will depend on the severity of the manifestations and on what type of disease it can be classified as.
Seasonal rhinitis is classified as a hay fever syndrome, which primarily affects the mucous membranes of the nose and eyes. If a patient has a hereditary predisposition to the disease, then his body begins to produce antibodies to irritants. As a result, well-known manifestations arise. They can be expressed both in the form of copious mucous discharge from the nose, and in combination with conjunctivitis. In severe cases, to indicated symptoms bronchial asthma may occur. In this case, a person often experiences signs of intoxication: fatigue, irritability, sleep disturbances, and even an increase in temperature.
As a rule, allergic rhinitis develops against the background of general health during the period of active flowering of plants. A sharp feeling of itching appears in the nose, it is accompanied by repeated sneezing and copious transparent mucous discharge. For most people, attacks last for a couple of hours and can occur several times a day.
During an attack, the nasal mucosa is saturated with blood, it can become bluish and swollen. At the same time, they increase and block the passages. Some also note irritation of other mucous membranes - the larynx and trachea suffer. A cough appears, viscous sputum is produced, and
Exacerbations stop when active flowering of plants ends. When examined in a healthy state, no pathological changes No. True, some are diagnosed with mucous polyps and contact spines.
Chronic manifestations
But there are people who may be bothered by allergic rhinitis all year round. Symptoms and treatment in this case will be slightly different. This type of allergy differs in that there are no pronounced exacerbations and the frequency cannot be tracked. But the symptoms are less pronounced than with seasonal rhinitis.
Chronic allergic rhinitis has 4 conventional stages:
Aperiodic transient seizures;
Polyp formation;
Carnification.
The first stage is characterized by the fact that the symptoms are moderate, with occasional minor exacerbations. Patients react to hypothermia and drafts, this provokes an exacerbation of the disease. At the same time, they periodically have a stuffy nose, a feeling of dry mouth, lethargy, poor sleep, increased fatigue, and sometimes attacks of shortness of breath may occur. Also at this stage, the permeability of cell membranes begins to be impaired. This type of allergic rhinitis during pregnancy is quite common.
If the doctor notes that signs of degeneration of the nasal mucosa have appeared, this means that the situation is getting worse. This indicates the beginning of the second stage. In this case, the mucous membrane becomes pale, and gray shade, granular formations visible at the ends of the middle and inferior turbinates. At this stage, breathing is constantly difficult, and the sense of smell is practically absent. The effect of using vasoconstrictor drugs is almost not noticeable.
After some time (it can take several months or about 4 years), polyps grow in the nasal passage. They look like formations, similar to bags, hanging into the lumen of the nasal passage on a stalk. In most cases, they are sandwiched between the nasal septum and its lateral wall.
At the stage of carnification, the tissues of the lower and partially middle concha of the nose noticeably thicken and become insensitive to vasoconstrictors. This process may be accompanied by the appearance of attacks of bronchial asthma. The general symptoms that characterize the disease become permanent.
Children's diseases
Unfortunately, a child may often develop an allergic runny nose. Symptoms and treatment, as in the case of adults, will depend on the form and course of the disease. Babies may have seasonal or year-round rhinitis. The disease progresses in the same way as in adults. But in children, a runny nose that appears due to allergies often reduces the body’s overall resistance. Because of this, the disease is complicated by the addition of viral or bacterial infections.
Seasonal or chronic allergic rhinitis in children is accompanied by swelling of the nasal cavity and active secretion of mucus. Children complain of itching in the nose and eyes, they constantly sneeze. The disease is often accompanied by a cough. But this, by the way, may be a sign of the development of bronchial asthma.
Any allergic rhinitis in a child often gives complications in the form of acute (and sometimes chronic) otitis media, sinusitis, and the addition of various acute respiratory infections. If the baby is not treated, this can lead to the development of inflammation in the paranasal sinuses.
If possible, it is necessary to eliminate the irritant or reduce the baby’s contact with it to a minimum. In other cases, you need to know how to distinguish an allergic runny nose from a cold, and begin proper treatment on time. It is better to select all medications together with your doctor. The child should be treated either by a pediatrician or a pediatric allergist. The doctor selects age-appropriate medications and calculates the required dosage.
Occupational therapy
Allergic rhinitis in children and adults should not be ignored. This can only worsen the situation. Therapy can be symptomatic (elimination of manifestations of the disease) and allergen-specific. The patient is prescribed medications that mitigate the manifestation of allergic reactions, sedatives and vasoconstrictors. You can reduce swelling and eliminate congestion with the help of drops and sprays that have a vasoconstrictor effect: “Xylometazoline”, “Naphazoline”, “Sanorin”, “Naphthyzin”, “Nazivin”, “Tizin” and others. But you should not use them for more than 10 days in a row.
However, it can give the expected results only if it is possible to eliminate the irritant. Otherwise, it is also necessary to use antihistamines, corticosteroids or immunotherapy. The first group of drugs includes drugs such as Zyrtec, Aleron, Claritin, Ketotifen and other similar ones.
If the patient's condition is too advanced, allergists recommend the use of corticosteroids. Your doctor may prescribe medications such as Fluticasone or Beclomethasone. They must be used, as a rule, for a month. They are also suitable for those who suffer bronchial asthma. These medications are also prescribed when a child develops an allergic rhinitis. Symptoms and treatment are similar in children and adults.
Immunotherapy involves a series of procedures designed to reduce sensitivity to an allergen. The irritant can be introduced into the human body so that he gets used to it and stops reacting. Start with small doses, which are increased over time.
Traditional methods
Doctors never tire of saying that it is fraught to let an allergic rhinitis take its course. You can, of course, find a collection of advice on treatment with folk remedies, but you should not hope to get rid of the disease only with their help.
Among the most popular recommendations are the following. Many supporters alternative medicine It is advised to bury your nose with the juice of calendula, red geranium or coltsfoot. In addition, you can gargle with an aqueous infusion of valerian or motherwort.
You can relieve swelling using various physical exercise. This recommendation is based on the fact that the load stimulates the sympathetic nerves, and as a result, blood vessels constrict and allergic rhinitis decreases.
Treatment with traditional herbs is also possible. Some recommend brewing celandine, leaving it for at least 4 hours and drinking it. It is believed that duckweed also helps with a runny nose. Its infusion (prepared from 1 tablespoon of herb and 0.5 liters of water) should be drunk in the morning for several weeks.
Even if you are an ardent supporter traditional medicine and don't recognize conservative methods treatment, know: if you have allergies, it is better to make an exception. After all, this disease not only significantly complicates life, but can also lead to a number of serious complications.
Allergic rhinitis is a variant of the human body's reaction to certain irritating particles. The most common external triggers are plant seeds, ragweed, pollen, and mold spores.
Also, the reasons for the development of the deviation include dust mites, particles of skin and hair from pets. At the same time, external allergens provoke seasonal rhinitis (popularly known as hay fever), and exposure to internal triggers provokes chronic (year-round, persistent) runny nose and sneezing.
Interesting to know! If one or both parents have been diagnosed with allergic rhinitis, the disease will most likely be found in their children. People who suffer from hay fever also have an increased risk of developing asthma, sinusitis, sleep disorders (including snoring and apnea), and ear and eye infections.
Allergic rhinitis: code according to ICD 10
According to the International Classification of Diseases, 10th revision, the disease belongs to class J (respiratory diseases); group 30-39 (“Others”). ICD 10 code for allergic rhinitis: J30.
Unlike the 9th version of the classifier, in which spasmodic runny nose and disease complicated by asthma were classified into different subgroups, ICD 10 collected all manifestations of allergic rhinitis under one code.
Characteristic symptoms of the disease
The first signs of acute allergic rhinitis usually appear immediately after exposure to the trigger. These include frequent sneezing and runny nose, itchy nose, and swelling of the sinuses. After prolonged exposure to irritants, you may notice following symptoms allergic rhinitis:
- Pain, sore throat;
- Watery eyes;
- Itching under the eyelids;
- Dark circles under the eyes;
- Frequent headaches;
- The appearance of extremely dry, itchy skin;
- Hives;
- Constant excessive fatigue.
Of course, such signs are very similar to common cold. But since allergic rhinitis needs to be treated according to a completely different scheme, it is important to independently be able to distinguish hay fever from a cold. After all, a runny nose and sneezing does not mean that an allergy is developing.
For more information about what can cause such symptoms, read the article: “?”.
For convenience, you can use a comparison table that will tell you how to distinguish an allergic runny nose from a cold, and find out which disease other symptoms indicate.
| Sign | Cold | Allergic rhinitis |
|---|---|---|
How long does a runny nose last? | From several days to several months. Persistent allergic rhinitis may be accompanied by a chronic runny nose until contact with the trigger is eliminated. |
|
When did the runny nose and other accompanying symptoms appear? | Most often in autumn or winter. | It appears during flowering of plants, and persistent - at any time of the year. |
How quickly did the symptoms progress? | A runny nose, sneezing and other related symptoms develop a few days after infection with the virus. | The manifestation of unpleasant symptoms is observed immediately after contact with allergens. |
Appears in almost 100% of cases and can be wet or dry. | Dry, appears extremely rarely. |
|
Body aches | Develops in the first days of the disease. | Absent. |
Increased body temperature above 38°C | A characteristic symptom. | Absent. |
Itching in the eyelid area, obvious redness of the eyes | Absent (extremely rarely appears in the first days) | The manifestation of the symptom is observed in almost 100% of patients. |
Sore throat | Acute, appear frequently | Enough rare symptom, manifests itself in the form of swelling of the laryngeal tissues. |
Even if the information in the above table directly indicated that allergic rhinitis is developing, start self-treatment not worth it. It is imperative to consult a doctor to accurately identify the trigger allergen.
How is the disease diagnosed?
If the allergic reaction manifests itself once, then it is likely that only an external examination by a local physician will be required. If you suspect allergic rhinitis in a child, you should contact your pediatrician.
But for those whose unpleasant symptoms do not disappear for a long time, or constantly appear again and again, it is recommended to make an appointment with a professional allergist. Before developing a treatment program for allergic rhinitis, the specialist will definitely give directions for:
- Blood test for specific immunoglobulins;
- General blood analysis;
- Skin cell scraping.
To determine what exactly triggers allergic rhinitis in adults, a doctor may place a small amount of potential triggers on the skin and monitor the reaction. The body will respond to potential triggers by producing a lump.
Treatment methods for allergic rhinitis
Most effective method treatment of allergic rhinitis in adults and children: complete exclusion of contact with allergens. You may need to clean your home very thoroughly, removing dust, skin particles, and pet hair on a daily basis.
Seasonal hay fever sufferers are advised to stay indoors as much as possible during the flowering season.
Pharmaceutical drugs and folk remedies aimed at eliminating unpleasant symptoms. But it is much easier to avoid a problem than to treat its consequences. But even symptomatic treatment should not be ignored. After all, in advanced cases Immunotherapy may be needed.
Groups of medications used to treat the disease
Pharmacists identify several groups of medications for allergic rhinitis. However, only a professional allergist should combine them. In particular, the following may be prescribed:
- Antihistamines (Claritin, Loratadine, Benadryl);
- Decongestants (Afrin, Zyrtec);
- Immunomodulators (Sinupret, Euphorbium compositum).
It is important to understand that decongestants should not be taken if the disease is persistent, as side effects may develop in the long term. Herbal immunomodulators have no proven effectiveness, but are nevertheless actively used in domestic medicine.
Drops and sprays for allergic rhinitis
Nasal sprays and drops for allergic rhinitis are the first choice drugs. They help well when a runny nose is accompanied. This form of medication has far fewer side effects than tablets (except for a bitter taste in the mouth).
What to choose: spray or drops for allergic rhinitis, everyone decides for themselves. Often all drugs have two (or more) release forms. So, for example, if a spray for allergic rhinitis begins to irritate your sinuses, you can switch to drops (and vice versa).
Sprays and nasal drops used for allergic rhinitis can be divided into several groups:
Antihistamines
Doctors recommend treating allergic rhinitis with this type of medication. Such medications contain substances (cetirizine, desloratadine, fexofenadine, etc.) that block receptors in the nose, prevent the release of the hormone histamine, and prevent the development of allergic inflammation.
They will also help get rid of congestion, sneezing, and itching. Conventionally, antihistamines are divided into drugs:
First generation.
The main disadvantage is less effectiveness, short duration of action, pronounced side effects: drowsiness, addiction, increased appetite.
Second generation.
They have higher efficiency and minimal side effects.
Third generation.
They have a high price, but a significant effect from taking them.
It is better to give preference to 2nd and 3rd generation products; they are more effective, have fewer side effects and are aimed at maximally suppressing the allergic reaction, rather than its symptoms, like 1st generation products. Antihistamine action drops have the following:
Some of them (Fenistil, Allergodil), in addition to the antihistamine, also have a vasoconstrictor and decongestant effect. In terms of duration of action, Allergodil is considered the most persistent among these drops of the 2nd generation - up to 12 hours, but it cannot be used by children under 6 years of age, pregnant and nursing mothers.
Salt
Saline solutions quickly and safely relieve swollen sinuses and remove excess mucus. The main advantage of the drugs is that they do not have a sedative effect, and they can also be purchased without a prescription. You can also safely treat the noses of newborns with saline solutions.
Popular representatives: Aqualor, Marimer, Dolphin, Aquamaris.
Steroid (hormonal)
The most effective sprays and drops for allergic rhinitis, which will not only eliminate most allergy symptoms, but also stop the inflammatory process. The advantages include speed of action.
Popular representatives: Nasonex, Aldecin, Rizonel.
Preventive
Preparations based on cromolyn sodium help prevent the development of allergies. They are produced not only in the form of drops, sprays, but also aerosols. It is recommended to take 2-3 weeks before the plants begin to flower.
Popular representatives: Nazaval, Prevalin.
Traditional recipes for eliminating the symptoms of allergic rhinitis
If an adult has been suffering from seasonal allergies for many years and has consulted with doctors more than once, then they can use some home remedies to combat unpleasant symptoms.
Firstly, it is recommended to do inhalations for allergic rhinitis. This procedure has no side effects. Just pour a few cups of hot water, 5-6 drops essential oil eucalyptus in a bowl and inhale the healing vapors (remembering to cover your head with a towel).
The procedure can be performed not only on adults, but also on children. You can also use drops from cyclamen root and rinse your nose with a homemade saline solution.
Allergic rhinitis in a child
As mentioned above, if both parents suffered from allergies, then the risk of developing the same disease in a child is close to 95%. Often the first negative reaction to various triggers appears at the age of 3-5 years.
Symptoms of the disease in children are no different from signs of the disease in adults. However, very often rhinitis is complicated by conjunctivitis and asthma. Allergic rhinitis is especially dangerous in a child under one year old; if the allergen is not identified and eliminated, the baby may suffocate.
It is best to use for treating children saline solutions. But in consultation with a doctor, Loratadine and Suprastin can be used for runny noses in even the smallest children.
Allergic rhinitis during pregnancy
If a woman had allergic rhinitis before pregnancy, it is likely that the disease will manifest itself after conception. It is best to try to avoid allergens for 9 months, since any medications can improve the health of the pregnant woman, but at the same time worsen the condition of the fetus.
If it was not possible to avoid the disease, then after the first symptoms appear, you should consult a doctor. The specialist will recommend using a saline spray or nasal rinse saline solution. If the woman’s condition worsens, allergic rhinitis during pregnancy can be cured with antihistamines (in particular Loratadine).
Modern medicine offers many options for eliminating hay fever. But the best method of control remains prevention and avoidance of the allergen.
We recommend reading
Disease 7. Psychosomatics. Chicago Seven. Psychiatrist Consultations
I suffer from high blood pressure, my heart is pinched, I got punched in the nose by a flight attendant
Excessive alcohol consumption is harmful to your health
At night someone constantly calls me: what could this be connected with?
