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Allergic Rhinitis

Summary

Allergic rhinitis is a condition caused by an allergic reaction to airborne substances such as pollen, dust mites, or pet dander. It leads to inflammation inside the nose, triggered by the immune system’s response to allergens. Common symptoms include a runny nose, sneezing, nasal congestion, and itching in the nose, throat, or eyes. Coughing may also occur.

Diagnosis is usually based on symptoms, but it can be confirmed through tests that detect specific allergic antibodies (IgE) in response to environmental allergens. Routine food allergy testing is not recommended for allergic rhinitis.

Treatment focuses on avoiding allergens, using medications, and in some cases, immunotherapy. Intranasal corticosteroids are the most effective treatment for managing symptoms.

Diagnosis and When to Seek Help

A doctor may diagnose allergic rhinitis based on symptoms and medical history. Parents should seek medical advice if:

  • Symptoms persist despite over-the-counter treatments.
  • Nasal congestion or sneezing significantly disrupts daily activities or sleep.
  • There are frequent ear or sinus infections.
  • Symptoms are severe or year-round, affecting overall well-being.

Management

Managing allergic rhinitis involves reducing allergen exposure and using medications to control symptoms. Treatment options include:

  • Allergen Avoidance: Minimizing exposure to triggers such as pollen, dust mites, mold, and pet dander by keeping windows closed during high pollen seasons, using air purifiers, and frequently washing bedding.
  • Medications:
    • Intranasal corticosteroids (most effective for controlling symptoms)
    • Antihistamines (to relieve sneezing, itching, and runny nose)
    • Decongestants (to reduce nasal congestion, though not for long-term use)
    • Saline nasal rinses (to help clear allergens from nasal passages)
  • Immunotherapy: Allergy shots or sublingual tablets may be recommended for children with persistent or severe allergic rhinitis that does not respond well to medications.

Follow-Up and Monitoring

Ongoing care is important to manage allergic rhinitis effectively. Parents should:

  • Monitor symptom patterns and potential triggers.
  • Ensure consistent use of prescribed treatments.
  • Seek follow-ups with a healthcare provider if symptoms worsen or interfere with daily life.
  • Discuss long-term management strategies, especially if symptoms are severe or associated with asthma or recurrent infections.

With proper treatment and management, most children with allergic rhinitis can enjoy symptom relief and improved quality of life.

History and Exam

Key diagnostic factors

  • presence of risk factors
  • sneezing
  • nasal pruritus

Other diagnostic factors

  • palate, throat, ear, and eye itching
  • eye redness, puffiness, and watery discharge
  • fatigue and irritability
  • nasal congestion

Risk factors

  • other atopic conditions or family history of atopy
  • age <20 years
  • exposure to aeroallergens (pollen, moulds, house dust milets, pollution)
  • exposure to animal dander 

Diagnostic Investigations

1st investigations to order

  • therapeutic trial of antihistamine or intranasal corticosteroid 

Investigations to consider

  • allergen skin-prick testing
  • in vitro specific IgE determination 

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    Other Related Conditions

    food allergy

    eczema

    ASTHMA

    anaphylaxis

    urticaria (hives)

    drug allergy

    insect sting allergy

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      1 Reason for referral *

      2 Parent Surname *

      3 Patient First Name *

      4 Email *

      5 Patient Surname *

      6 Phone *

      7 Child’s date of birth *

      8 ADDRESS