NOSE - Allergic Rhinitis

What is allergic rhinitis?

Allergic Rhinitis is an IgE mediated hypersensitivity disease of the nasal mucous membrane, characterized by sneezing and nasal blockage and nasal discharge.

Types of allergic rhinitis:

  • Seasonal allergic rhinitis: It occurs in certain months
  • Perennial allergic rhinitis: Occurs throughout the year

Causes of allergic rhinitis:

  • Environmental: Cold environment triggers off allergy.
  • Hereditary: There are higher chances if both parents have allergy to certain allergens.
  • Age: Common in the 2nd and 3rd decade.
  • Psychological stress: Known to precipitate already existing allergy.

Some of the common allergens:

  1. Dust, pollen
  2. Food: Eggs, prawns, pineapple etc.
  3. Fungi: Cladosporium, Aspergillus
  4. Irritating fumes, vehicular exhaust
  5. Cosmetics, synthetic clothes, shampoo
  6. Intestinal helminths

What are the symptoms of allergic rhinitis?

Some of the common symptoms of allergic rhinitis are:

  • Nasal irritation and obstruction
  • Sneezing episodes
  • Watery discharge
  • Anosmia

Signs on examination:

  • On Anterior rhinoscopy there is turbinate hypertrophy.
  • Ethmoidal polyps may be present in long standing untreated allergy patients.
  • Patients often complain of opthalmic symptoms like conjunctivitis and respiratory symptoms like asthma.

Investigations required for diagnosing allergic rhinitis:

  • Detail history
  • Blood count - eosinophilia
  • CT Scan PNS
  • Nasal smear
  • Radio-Allergo Sorbent Test (RAST)

Management of allergic rhinitis:

  • Avoidance
  • Desensitization by vaccines

Local treatment of allergic rhinitis:

  • Local steroid sprays
  • Chemical cautery by silver nitrate application
  • Auto-immune therapy
  • Steroid injections
  • Cryo-cautery

Systemic treatment for allergic rhinitis:

  • Anti-histaminics
  • Corticosteroids
  • Mast cell stabilizes like sodium chromoglycate
  • Oral decongestants, Analgesics

Surgical treatment of allergic rhinitis:

  • Septal correction and polypectomy
  • FESS( Endoscopic surgery helps in better areation of the sinuses and helps better drug action locally.
  • Vidian Neurectomy



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