What is allergic rhinitis?
Rhinitis is a reaction that occurs in the nose when airborne irritants (allergens) trigger the release of histamine. Histamine causes inflammation and fluid production in the fragile linings of nasal passages, sinuses, and eyelids.
There is usually a family history of allergic rhinitis.
What are the types of allergic rhinitis?The two categories of allergic rhinitis include:
- seasonal - occurs particularly during pollen seasons. Seasonal allergic rhinitis does not usually develop until after 6 years of age.
- perennial - occurs throughout the year. This type of allergic rhinitis is commonly seen in younger children.
What are the causes of allergic rhinitis?The most common causes of allergic rhinitis include the following:
- dust mites
- animal dander
What are the symptoms of allergic rhinitis?The following are the most common symptoms of allergic rhinitis. However, each child may experience symptoms differently. Symptoms may include:
- runny nose
- itchy nose, throat, eyes, and ears
- clear drainage from the nose
- recurrent ear infections
- mouth breathing
- poor performance in school
- "allergic salute" - when a child rubs his/her hand upward across the bridge of the nose while sniffing. This may cause a line or crease to form across the bridge of the nose.
How is allergic rhinitis diagnosed?Typically, the diagnosis is made by your child's physician based on a thorough medical history and physical examination. In addition to the above symptoms, your child's physician may find, upon physical examination, dark circles under the eyes, creases under the eyes, and swollen tissue inside the nose.
Treatment for allergic rhinitis:Specific treatment for allergic rhinitis will be determined by your child's physician based on:
- your child's age, overall health, and medical history
- extent of the reaction
- your child's tolerance for specific medications, procedures, or therapies
- expectations for the course of the reaction
- your opinion or preference
- avoidance of the allergens
Avoidance of the allergens that are causing the problem is the best treatment.
- over-the-counter antihistamines
Antihistamines help to decrease the release of histamine, possibly decreasing the symptoms of itching, sneezing, or runny nose. Some examples of antihistamines are diphenhydramine (Benadryl®) or hydroxyzine (Atarax®). These medications may cause drowsiness. Consult your child's physician to determine the proper dosage for your child.
- nonsedating prescription antihistamines
Nonsedating antihistamines work like antihistamines but without the side effect of drowsiness. Nonsedating antihistamines may include cetirizine (Zyrtec®), loratadine (Claritin®), or fexofenadine (Allegra®). Consult your child's physician to determine the proper dosage for your child.
- anti-inflammatory nasal sprays
Anti-inflammatory nasal sprays help to decrease the swelling in the nose. Consult your child's physician to determine the proper dosage for your child.
- corticosteroid nasal sprays
Corticosteroid nasal sprays also help to decrease the swelling in the nose. Corticosteroid nasal sprays work best when used before the symptoms start, but can also be used during a flare-up. Consult your child's physician to determine the proper dosage for your child.
Decongestants help by making the blood vessels in the nose smaller, thus, decreasing congestion. Decongestants can be purchased either over-the-counter or by prescription. Consult your child's physician to determine the proper dosage for your child.
These are a relatively new type of medication being used to control the symptoms of asthma. These medications help to decrease the narrowing of the lung and to decrease the chance of fluid in the lungs. These are usually given by mouth. Antileukotrienes have also been shown to be effective in treatment of allergic rhinitis and one (monteleukast) has been approved for this indication.
How is allergic rhinitis prevented?Allergy rhinitis cannot be completely prevented but its occurrence may be delayed, and symptoms reduced, by avoidance of environmental aeroallergens to which the person is sensitized (eg pollens, house dust mite, molds, animal danders). Sensitivities can be detected at any age by properly performed allergy skin tests or specialized allergy blood tests.
The link between allergic rhinitis and asthma:Controlling asthma may mean controlling allergic rhinitis in some patients, according to allergy and asthma experts. Allergic rhinitis is a common problem that may be associated with asthma.
Guidelines from the World Health Organization (WHO) recognize the link between allergic rhinitis and asthma. Although the link is not fully understood, one theory asserts that rhinitis makes it difficult to breathe through the nose, which hampers the normal function of the nose. Breathing through the mouth does not warm the air, or filter or humidify it before it enters the lungs, which can make asthma worse.
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