Allergic Rhinitis

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Allergic rhinitis is an allergic reaction that happens when the immune system overreacts to inhaled substances, such as pollen.

Allergic rhinitis can be seasonal in which it occurs during a specific season, or it can occur throughout the year the condition is called perennial allergic rhinitis.
The substance that is foreign to the body and when inhaled can cause an allergic reaction is called Allergen.Some food, molds,pollen’s are the common allergens.
Allergic rhinitis leads to a person having frequent nasal congestion,sneezing,and clear runny nose,itching in the eyes and excessive tear production.Allergic rhinitis can lead to other diseases like asthma and sinusitis.

As allergic rhinitis is a condition chiefly affecting the respiratory system,it is important to understand some details about the lining and anatomy of the respiratory system.The nose, through which one inhales air,lets inhale in the air through the nostrils.

The lining tissue of the nose,called the nasal mucosa filters the air by trapping dust, pathogens etc.,forming one of the physical barriers.It is an essential part of the human immune system. Such a physical barrier helps to prevent the pathogens from entering the respiratory system & from being a potential cause of an infection or pathology.

Our immune system protect us against infections.It eliminates the germ that enters our body.But when immune system starts to react against harmless inhaled particles it causes allergies.Food allergy is caused when it reacts against food particles; we get asthma and allergic rhinitis when it reacts against inhaled particles.Eczema is caused by some food and inhalant allergens.

Inflammation of mucous membranes of nose, ears, eyes, sinuses and pharynx occurs in allergic rhinitis. There is a complex interaction of inflammatory mediators. Extrinsic allergen causes allergic reaction is also called immunoglobulin E (IgE) mediated response.
When the allergic pollen is inhaled it gets bind to mast cells and result in immediate release of number of mediators. These mediators are histamine, chymase, tryptase, kinins and heparin. These mediators are responsible for symptoms of rhinorrhea.
In 4-8 hours other inflammatory cells also enters mucosa such as neutrophil, eosonophil,lymphocyte and macrophages.This inflammatory phase remains for few hours or days.It leads to fatigue, sleepiness and malaise.
Age/Sex of Allergic Rhinitis

Allergic rhinitis is common in boys as compared to girls.It is a common childhood condition.But it can occur in early adulthood and the prevalence in men and women is equal.

Causes of Allergic Rhinitis

An allergic reaction occurs when the immune system attacks a usually harmless substance called an allergen that enters in the body.

The immune system has a protective substance called immunoglobulin E (IgE) antibodies to fight invading allergic substances.

Normally everyone has some IgE but an allergic person has an unusually large number of these IgE defenders.

When this large number of IgE attacks the invading allergen,the mast cells get injured in that process.The injured mast cells release a variety of chemicals into the tissues and blood, one of which is known as histamine.These chemicals frequently cause allergic reactions resulting in itching, swelling, and fluid leaking from cells.Allergic chemicals can cause muscle spasm and results in lung and throat tightening and loss of voice.
Seasonal allergic rhinitis is triggered by outdoor allergens include:
• Ragweed — the most common seasonal allergen (fall)
• Tree pollen, in spring
• Fungus, mold growing on dead leaves, common in summer and fall
• Grass pollen, in late spring and summers
• House mites.
• Animal dander.
• Mold spores.

Other causes of perennial allergic rhinitis are:
• Cleansers
• Chemicals
• Construction material gases.
• Perfumes
• Cosmetics
• Industrial chemicals
• Cigarette smoke

Allergic Rhinitis Signs and Symptoms

Allergic rhinitis can cause many symptoms, including the following:
• Rhinorrhoea (excessive nasal secretion).
• Sore throat.
• Nasal congestion.
• Post-nasal drip.
• Swollen nasal turbinates.
• Itchy mouth, throat, ears, and face.
• Fatigue.
• Dry cough.
• Sneezing.
• Red, itchy, and watery eyes.
• Swollen eyelids.
• Headache, facial pain or pressure.
• Partial loss of hearing, smell, and taste.
• Poor concentration.

Differential diagnosis of Allergic Rhinitis

Allergic rhinitis should be differentiated from sinusitis (acute and chronic).

Investigations for Allergic Rhinitis

Diagnosis is based on history of a patient.
Skin testing is done as follows:
• A small amount of the suspected allergy substance is placed on the skin.
• This is known as the prick-puncture method. In this method skin is scratched through small drop with a sterile needle.
• Intradermal method: In this method a small amount of the test substance is injected into the skin.
• If the skin reddens and swells, then an individual is said to be “sensitized” to the particular allergen.
• Skin testing is not done when a person is at risk of a severe (anaphylactic) allergic reaction, who have certain skin conditions, or who are taking certain medications.
• Various blood tests may be done in place of skin test.

Treatment for Allergic Rhinitis

• Low-dose steroid nasal sprays.
• Decongestant tablets and sprays.
• Antihistamine medications.
• Desensitisation immunotherapy

Diet / management of Allergic Rhinitis

• Stay indoors, and close the windows.
• Use an air conditioner in your home and car.
• Do not hang laundry outside to dry.
• Bath or shower and change your clothes after being outside.

If you have year-round allergies:
• Cover your pillows and mattress with dust mite covers.
• Use blinds instead of curtains.
• Keep pets out of the bedroom.
• Use a HEPA filter on your vacuum.

• Avoid cold food as it causes bronchospam by constricting the bronchial tubes resulting in symptoms worsening.
• Packed food should be avoided, as some preservatives causes worsening of the symptoms.
• Food should be well cooked as it kills the allergens.
• Vitamin C rich diet should be consumed as it raises immunity.

Homeopathic treatment for Allergic Rhinitis

Arsenicum album
• Nose discharge is thin and excoriates the upper lip.
• Dull, throbbing headache in frontal region.
• Scab and ulcer formation in the nose.

Arum triphyllum
• Nose stopped up, must breathe through mouth.
• sneezing, worse at night
• acrid fluent coryza and still nose feels stopped up
• nose, lips and face chapped as from a cold wind
• aversion to light

• Nostrils are stuffed that prevents breathing.
• Constant sneezing; profuse discharge from nose and eyes.
• Aggravation: in open air, amelioration: in closed room.

Euphrasia officinalis
• Profuse coryza with lachrymation and photo-phobia.
• Cough and expectoration of mucus.
• Soreness and painfulness of inner nose.

Sanguinaria canadensis 
• Frequent sneezing, aggravation: by odors; watery acrid discharge with much burning; depraved smell
• pain in frontal sinuses
• dry cough
• Pain, oppression and soreness in upper part of the chest.
• Asthma with desire to take a deep breathe.

Allium Cepa
• Sneezing on entering a warm room.
• Copious, watery and extremely acrid nasal discharge.
• Fluent coryza with headache, cough and hoarseness.
• Aggravation in the evening and warm room.
• Better in open air and cold air.

• Sneezing with fullness at the root of the nose.
• Dryness of nasal fossae.
• Swelling of nasal turbinates.
• Acute coryza with dull headache and fever.
• Watery, excoriating discharge.

• Spasmodic sneezing with a runny nose.
• Coryza with severe frontal pain with redness of eye and lachrymation.
• Copious watery nasal discharge.

Ambra grisea
• Difficult breathing with eructations.
• Spasmodic cough with hoarseness and eructations in morning.
• Hollow, barking and spasmodic cough.
• Choking on hawking phlegm.

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