Symptoms and remedies of allergic rhinitis
Allergic rhinitis is an inflammation of the nasal mucous membranes caused by substances called allergens. Dust mites, animal hair, mould spores, pollen: these are the main causes of allergic rhinitis, a very common disorder that manifests itself with the more ‘typical’ symptoms of a cold
Some are present all year round, such as dust mites, while others are present mainly at certain times of the year, such as pollen.
In any case, exposure to these substances can have a negative impact on the sufferer’s life.
What is allergic rhinitis
In general, allergic rhinitis is an inflammation of the nasal mucous membranes.
It is caused by contact with harmless substances, called allergens, which the immune system of the allergic person recognises as foreign.
Exposure to these allergens results in the release of a high amount of histamine, a substance that has an irritating effect on the nasal mucosa and airways, causing swelling, excessive mucus production and the onset of allergic rhinitis.
But that’s not all. The allergic reaction also leads to an increase in immunoglobulin E – IgE (antibodies), which in turn can cause inflammation with symptoms in different organs and systems (lung, skin, eyes and nose).
Causes of allergic rhinitis
Allergic rhinitis can be suffered all year round, because it is caused by exposure to household inhaled allergens, which can always be present.
In this case, we speak of permanent rhinitis.
The main ‘perennial’ allergens responsible for the disorder are:
- dust mites (or specifically the droppings of this tiny animal);
- mould spores;
- pet dander (or rather fragments of skin, urine and saliva).
- The causes of seasonal allergic rhinitis
- However, there is also seasonal allergic rhinitis.
In this case, the disorder is caused by plant allergens, pollen, which vary depending on the time of year.
Generally, the highest concentration of pollen in the air is in spring (mainly grasses, birch, cupressaceae and meadowsweet), but in summer and autumn there are also plants that flower and can cause ‘reactions’.
Allergic rhinitis manifests itself with symptoms similar to those of a common cold, namely:
- itching of the nose;
- watery and itchy eyes;
- production of mucus;
- congestion of the nasal mucous membranes.
While in most cases the complaints are mild, in others they can be more intense and persistent, such as difficulty breathing (dyspnoea) and tightness in the chest, causing sleep problems and interfering with daily life.
Finally, for those who already suffer from asthma, allergic rhinitis can lead to further worsening of asthma symptoms.
In general, it is important not to underestimate the problem, because if not treated properly, it can lead to the onset of other diseases.
The main ones are: nasal polyposis, otitis media, chronic sinusitis, bronchial asthma and sleep apnoea syndrome (known risk factors for heart attack and stroke).
Diagnosing allergic rhinitis
In order to find out which allergen triggers rhinitis, it is first necessary to undergo a specialist allergy examination.
The specialist will mainly rely on the person’s medical history and, if necessary, indicate which diagnostic tests to perform:
- blood tests;
- This investigation is used to check the amount of immunoglobulin E (IgE) in the blood;
- skin or allergy tests, the most common of which is the prick test’.
The Prick test
The prick test is an easy-to-perform test that consists of applying a drop of the substance suspected of causing the allergy (allergen) to the inner surface of the forearm.
It is penetrated into the first layer of the skin by inserting a lancet (an instrument with a small sharp tip).
This is the time it takes for mediators to be released from the skin mast cells (the cells of the immune system involved in allergic reactions).
The skin is then examined to assess the reaction to the allergens, which is manifested by the appearance of pomphi, a swollen and reddened area of varying size.
A positive response is usually judged (and the person is therefore allergic) when the relative swelling is at least a quarter of the diameter of the reference pomphoid.
Remedies to keep allergens at bay
The most effective treatment is evaluated by the specialist, after establishing the type of allergen responsible for the rhinitis and assessing the severity of the symptoms.
In general, the first measure to limit the risk of the problem occurring is to limit exposure to the allergen as much as possible.
Remedies against dust mites
If allergic rhinitis is triggered by dust mites, it is necessary to clean up the home environment:
- reduce the humidity level in the rooms;
- wash curtains, sheets, pillowcases and soft toys frequently and at high temperatures (60 degrees) in the case of children.
Remedies against animal hair
If the allergy is to animal hair, it would be advisable to
- keep dogs, cats, rabbits, etc. outdoors as much as possible and, where this is not possible, do not allow them into the bedroom;
- regularly wash bedding, sofas, pillows etc;
- regularly wash the bedding, blankets or pillows.
Remedies against mould spores
To reduce the risk of contact with mould spores you should
- encourage ventilation and air exchange in the home and in closed rooms;
- do not use humidifiers;
- clean refrigerator seals regularly;
- regularly wash sinks, bathtubs, shower curtains and washable walls in the bathroom and kitchen with bleach;
- avoid drying clothes indoors or storing damp clothes in wardrobes.
Finally, if you are allergic to pollen, you should:
- consult the pollination calendar to find out when the plant you are allergic to flowers;
- keep the windows mostly closed at that particular time;
- avoid outdoor sports activities in the middle of the day.
The most effective treatment would require complete removal from the allergic source, which is clearly not always possible.
However, following these measures can help keep the problem under control and limit discomfort.
Treatment of allergic rhinitis
In order to alleviate symptoms in the acute phase of allergic rhinitis, the specialist may consider prescribing topical, i.e. local, medication.
These are usually nasal sprays containing corticosteroids, which have an anti-inflammatory effect and reduce swelling of the nasal mucous membranes.
A class of drugs also used are antihistamines, which reduce the release of histamine into the bloodstream and alleviate most symptoms, particularly itching, sneezing or watery eyes, but unfortunately have no anti-inflammatory power and therefore are not curative in contrast to topical therapy.
The typical side effect of the old generation of oral antihistamines, namely drowsiness, is nowadays very limited.
If topical therapy or therapy with antihistamines does not produce the desired results, specific immunotherapy, the so-called vaccine, may be an alternative to treat more severe cases and to provide longer-lasting protection against allergic reactions.
This is based on administering small amounts of the allergen extracts that cause the allergic reaction to the allergic person, so that the immune system is induced to tolerate the allergen itself.
It is particularly useful for those suffering from respiratory allergies (pollen, mites, moulds) and hymenoptera allergies (bee, wasp, hornet).
Immunotherapy can be administered in 2 ways:
- sublingual: the allergen is left under the tongue for a few minutes. This form is generally well tolerated and can be administered by the patient at home;
- subcutaneous: the allergen can be injected under the skin by the allergist in a hospital setting in increasing doses, until the maximum therapeutic dose is reached.
For both types of administration, the duration of the treatment cycle varies from 3 to 5 years, depending on the allergen involved.
This therapy,’ concludes the specialist, ‘rarely causes side effects and these are minor local reactions such as:
- itching or swelling at the injection site;
- occasional tingling in the mouth;
- swelling at the sublingual site if taken sublingually.