Allergic rhinitis - Highlights

Description

An in-depth report on the causes, diagnosis, treatment, and prevention of common nasal allergies.

Alternative Names

Hay fever; Nasal congestion - allergies

Highlights:

Allergic Rhinitis

Allergic rhinitis is an allergic response to outdoor or indoor allergens. Outdoor triggers of allergic rhinitis include ragweed, grass, tree pollen, and mold spores. Indoor triggers include dust mites, pet dander, or mold that grows in humid indoor places such as carpets. Outdoor allergens cause seasonal allergic rhinitis (also known as hayfever), that typically occurs during the spring and summer. Indoor allergens can cause pereniall (year-round) allergic rhinitis.

Allergic rhinitis tends to run in families. If one or both parents have allergic rhinitis, there is a high likelihood that their children will also have allergic rhinitis. People with allergic rhinitis have an increased risk of developing asthma and other allergies. They are also at risk for developing sinusitis, sleep disorders (including snoring and sleep apnea), nasal polyps, and ear infections.

Symptoms

Common symptoms of allergic rhinitis include:

Runny nose or nasal congestion
Frequent sneezing
Itchy watery eyes
Itching in nose, throat, or roof of mouth

Treatment

Home remedies for allergic rhinitis include nasal wash with a saline solution. Many different over-the-counter and prescription drugs are used to treat allergic rhinitis. These medications include oral and nasal antihistamines, corticosteroid nasal sprays, cromolyn, leukotrine antagonists (such as montelukast [Singulair]), and decongestants. Many of these drugs have side effects. The FDA is currently reviewing whether montelukast causes mood and behavioral changes, including suicidal thoughts. Patients who take this drug should be monitored for these symptoms.

Immunotherapy (“allergy shots”) may also be an option for some patients.

Prevention

In addition to avoiding exposure to allergy triggers, people with allergic rhinitis can take precautions to control their environment. These measures include washing animals weekly, using vacuum cleaners and air conditions with high efficiency particulate air (HEPA) filters, frequent washing of bedding and curtains, reducing humidity in the house, and removing sources of mold.

Resources

www.aaaai.org -- American Academy of Allergy, Asthma & Immunology
www.acaai.org -- American College of Allergy, Asthma & Immunology
www.niaid.nih.gov -- National Institute of Allergy and Infectious Diseases
www.njc.org -- National Jewish Medical and Research Center
www.lungusa.org -- The American Lung Association

References

Al Sayyad JJ, Fedorowicz Z, Alhashimi D, Jamal A. Topical nasal steroids for intermittent and persistent allergic rhinitis in children. Cochrane Database Syst Rev. 2007 Jan 24;(1):CD003163.

Bahls C. In the clinic. Allergic rhinitis. Ann Intern Med. 2007 Apr 3;146(7):ITC4-1-ITC4-16.

Blaiss MS. Safety considerations of intranasal corticosteroids for the treatment of allergic rhinitis. Allergy Asthma Proc. 2007 Mar-Apr;28(2):145-52.

Calderon MA, Alves B, Jacobson M, Hurwitz B, Sheikh A, Durham S. Allergen injection immunotherapy for seasonal allergic rhinitis. Cochrane Database Syst Rev. 2007 Jan 24;(1):CD001936.

Esch RE. Sublingual immunotherapy. Curr Opin Otolaryngol Head Neck Surg. 2008 Jun;16(3):260-4.

Frew AJ. Sublingual immunotherapy. N Engl J Med. 2008 May 22;358(21):2259-64.

Greer FR, Sicherer SH, Burks AW; American Academy of Pediatrics Committee on Nutrition; American Academy of Pediatrics Section on Allergy and Immunology. Effects of early nutritional interventions on the development of atopic disease in infants and children: the role of maternal dietary restriction, breastfeeding, timing of introduction of complementary foods, and hydrolyzed formulas. Pediatrics. 2008 Jan;121(1):183-91.

Saleh HA, Durham SR. Perennial rhinitis. BMJ. 2007 Sep 8;335(7618):502-7.

Scow DT, Luttermoser GK, Dickerson KS. Leukotriene inhibitors in the treatment of allergy and asthma. Am Fam Physician. 2007 Jan 1;75(1):65-70.

Sheikh A, Hurwitz B, Shehata Y. House dust mite avoidance measures for perennial allergic rhinitis. Cochrane Database Syst Rev. 2007 Jan 24;(1):CD001563.

Smits WL, Giese JK, Letz KL, Inglefield JT, Schlie AR. Safety of rush immunotherapy using a modified schedule: a cumulative experience of 893 patients receiving multiple aeroallergens. Allergy Asthma Proc. 2007 May-Jun;28(3):305-12.

Vliagoftis H, Kouranos VD, Betsi GI, Falagas ME. Probiotics for the treatment of allergic rhinitis and asthma: systematic review of randomized controlled trials. Ann Allergy Asthma Immunol. 2008 Dec;101(6):570-9.

Wallace DV, Dykewicz MS, Bernstein DI, Blessing-Moore J, Cox L, Khan DA, et al. The diagnosis and management of rhinitis: an updated practice parameter. J Allergy Clin Immunol. 2008 Aug;122(2 Suppl):S1-84.

Reviewed last on: 6/1/2009
Harvey Simon, MD, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.