Allergic rhinitis is an inflammatory process of the nasal mucosa characterized by the presence of nasal congestion, itching, sneezing and nasal discharge. The table is triggered by an allergic immune response in the presence of inhaled allergens in sensitized individuals.
It is estimated that allergic rhinitis affects up to 25-30% of the adult population in developed countries.
What causes allergic rhinitis in a patient
Many patients, in addition to nasal symptoms, also have eye symptoms, such as ocular itching, tearing, or swelling of eyelids. Moreover, allergic rhinitis is a predisposing factor for the development of sinusitis, otitis media and pharyngolaryngeal pathology factor.
There is also a close relationship between rhinitis and bronchial asthma: up to 30% of patients with rhinitis has bronchial asthma, and 80% of patients with asthma have rhinitis, predating, in many cases, rhinitis to appearance of bronchial asthma.
Sometimes if rhinitis symptoms are severe, refer patients fatigue, decreased concentration, irritability and decreased work and school performance.
Type allergens that cause allergic rhinitis
Inhaled allergens are derived from plants or animals, in susceptible individuals, can generate rhinitis or conjunctivitis and asthma proteins.
They can be classified as being:
- Indoor allergens: dust mites, allergens fungi (alternaria, aspergillus ...) or allergens from animals: dog, cat, hamster or guinea pig, among others.
- Outdoor Allergens like pollens (grasses, cypress, olive, salsola, Parietaria ...) and allergens from fungi: Alternaria or others.
Types of allergic rhinitis
Depending on the frequency of symptoms we can distinguish two types of allergic rhinitis:- Seasonal: Symptoms usually appear especially in spring and sometimes in late summer, the most common triggers pollen from plants, trees or even fungal spores.- Perennial: You have symptoms throughout the year. The most common causes are often dust mites, skin products animals (dog or cat) or fungi.Coexist in many patients with both forms of rhinitis symptoms but perennial seasonal exacerbation.
How to diagnose allergic rhinitis
Allergy diagnosis is based on performing a detailed medical history, followed by performing skin tests (prick test) and / or determination of serum IgE.
The skin tests are a tool with high diagnostic sensitivity and allows the results to the expert in allergology in 15-20 minutes.
It is essential in diagnosing the correlation between clinical history and skin test results.
Management and treatment of allergic rhinitis
In general, the first step before the allergic rhinitis is allergen avoidance. While in many cases, as with pollens, avoidance is impossible, in others, as with mite s, strict measures only avoidance can partially improve symptoms.
At present the pharmacological treatment of rhinitis is based on the use of antihistamines, intranasal corticosteroids and, sometimes, decongestants.
Nasal corticosteroids are the most effective in reducing nasal congestion, with few side - effects, nasal irritation and bleeding of the nasal mucosa the most common treatment.
Second - generation antihistamines are available as nasal preparations topical or oral. They are useful for improving sneezing, nasal itching ... and, in general, are well tolerated with very few side effects.
The combination of the two types of treatment usually provides a greater improvement in symptoms not used in isolation.
In cases of severe nasal obstruction that does not improve with the previous medication, decongestants can improve such symptoms, although they should not use more than six or seven days.
In moderate to severe allergic rhinitis, immunotherapy alergen administered will subcutaneously or sublingual is a treatment that improves disease symptom resolution and also has a role in preventing new sensitization and development bronchial asthma.
Edited by Patricia Crespo Pujante