What is allergic rhinitis?

Hay fever is the common name to describe allergic rhinitis and involves a recurrent runny, stuffy, itchy nose, and frequent sneezing. It can also affect your eyes, sinuses, throat and ears. 

Like any other allergy, allergic rhinitis is an inappropriate immune system response to an allergen – most commonly house dust mite, pet, pollen and mould. The allergen comes into contact with the sensitive, moist lining in your nose and sinuses and sets off the allergic response.

What is the link between allergic rhinitis and asthma?

Allergic rhinitis has been found to be an extremely common trigger for asthma in both children and adults. Allergic rhinitis can also exacerbate asthma, and it can make the diagnosis of asthma more difficult. Around 80 per cent of people with asthma suffer from allergic rhinitis, and around one in four with allergic rhinitis has asthma. 

There is now very good evidence to support the idea that asthmatics who look after their upper airways well need less asthma medication and fewer hospital or GP visits. 

When treating both asthma and allergic rhinitis, the first step is to find out the cause of your problem. Once the causes have been identified, management regimes can be put into place to minimise the impact of the allergy, and this then reduces the need for medication. 

What causes allergic rhinitis?

The most common triggers for people with allergic rhinitis are pollen, dust mite, pet and mould allergens. Seasonal allergic rhinitis (hay fever) is usually triggered by wind-borne pollen from trees, grass and weeds. Early spring symptoms point to tree pollen, while nasal allergy in late spring and summer indicates that grass and weed pollens are the culprits. And overlapping the grass season is the weed pollen season, which usually starts in late spring and extends through to the end of summer. 

Allergic rhinitis that persists year-round (perennial allergic rhinitis) is usually caused by house dust mites, pets, or mould. People with allergic rhinitis are often allergic to more than one allergen, such as dust mite and pollen, so may suffer from symptoms for months on end or all year round. 

Irritants such as strong perfumes and tobacco smoke can aggravate this condition. Foods do not play as big a role as had been thought in the past.

Signs and symptoms

Symptoms of allergic rhinitis can be any combination of itching in the back of the throat, eyes or nose, sneezing, runny eyes or nose, and blocked nose.

How is it diagnosed?

Your doctor will confirm the specific allergens causing your rhinitis by taking a complete symptom history, doing a physical examination, and performing skin prick tests.

How is allergic rhinitis treated?

It is useful to identify your triggers and try and avoid them. This can be difficult.

Pets: Make sure you keep it outside and never let it in the bedroom. It is never easy trying to decide on a new home for a pet, but in some cases this might be the best option. Even after you have removed your pet from your home, the allergens remain in furnishings for long periods afterwards and can cause symptoms. You will need to thoroughly clean your walls, floors and carpets to remove the allergen.

Dust mites: House dust mite reduction measures include mite-proof covers for the mattress, duvet and pillows. Removing items that collect dust from the bedroom will help. A good quality vacuum cleaner with HEPA filter for the exhaust air is essential to ensure that allergen is not disseminated in the atmosphere. Bedding should be washed frequently in water hotter than 55ºC. If you have soft toys, freeze them overnight and air in the sun.

Pollen: It is difficult to avoid pollen, however you can avoid going outside when pollen counts are high. The amount of pollen in the air is highest:
• In the morning
• Outside
• On windy days
• After a thunderstorm

Medication

  • Non-sedating antihistamine tablets or liquid are useful in alleviating some of the symptoms of rhinitis. 
  • Corticosteroid (anti-inflammatory) nasal sprays reduce the inflammation in the lining of the nose. 
  • Decongestant nasal sprays can be used to unblock the nose.
  • Eye drops.
  • Saline washes may help to clear your nose and soothe the lining of your nose.

Source: Allergy New Zealand

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