Allergic rhinitis (Hayfever)
What is allergic rhinitis?
Allergic rhinitis, also known as vasomotor rhinitis, is a condition where the nasal passages become inflammed, watery and itchy. It is very common and has been reported to occur in 20 to 40% of New Zealanders at some stage in their lives 1
What are the symptoms of this condition?
The symptoms of allergic rhinitis are the same as that of the common cold but sufferers have recurrent bouts that can last weeks or months. Classically people who suffer from hayfever get:
- Nasal congestion (blocked nose)
- Watering or itchiness of nose.
- Watering or itchiness of eyes.
- Tickling sensation in the throat.
What causes allergic rhinitis?
These symptoms are set off by an allergen, which is a protein that causes an allergy. The most common allergen is pollen. The most common pollen is from grass but all pollens from trees and flowers can cause the allergy. Other causes include house dust mite, mould and animal hairs.
How is it treated?
The treatment of allergic rhinitis is the same as for all allergies. The first step is avoidance. In order to avoid something you have to know what you are allergic to. This can sometimes be simple but if multiple factors (or allergens) are involved, identification and avoidance may be complex. Occasionally, special tests can be performed on the skin of an affected person to determine the exact allergy.
Sometimes, however, the allergens will never be identified and we simply put it down as seasonal. The amount of allergen in the house can be minimised by having few or no floor coverings or easily cleanable rugs. Few or easily cleanable soft toys are also a good idea. Bedding should be clean, dry and in good condition or buy hypoallergenic mattresses.
Medications that may be used by the doctor or bought with care over the counter are of a few basic types.
Antihistamines - are medicines that calm the cells that cause allergies. These medications can be taken by mouth, as nose drops or eye drops. In tablet form, some cause drowsiness and cannot be taken in association with driving or operating heavy machinery.
- Telfast is a non-sedating antihistamine and has been shown in clinical studies not to reduce alertness while driving or operating heavy machinery.
- Claratyne and Zyrtec are classified by Medsafe as non-sedating, however Zyrtec has a higher incidence of sedation than either Telfast or Claratyne.
- Sedating antihistamines include Phenergan, Histafen and Avil Retard.
- Eye irritation may be helped using eye drops - sodium cromoglycate (mast cell stabiliser) is available as either Opticrom or from pharmacy as Optrex Hayfever Allergy Eye Drops.
Nose sprays - usually can be acute or long term and may contain steroids, antihistamines or mast cell stabilisers, such as Rynacrom. Mast cell stabilisers have almost no side effects. Rynacrom must be taken regularly - two to four time daily - to be effective.
Steroid nose sprays - such as Beconase or Rhinocort must also be used regularly and are useful for chronic (long term) cases. Acute attacks may be better treated with a steroid combined with decongestant (eg Betnesol Aqueous combines betamethasone (steroid) and naphazoline (decongestant).
Decongestants including combination products such as Betnesol should only be used for short periods as they can cause a condition called rebound rhinorrhea (runny nose) with prolonged use.
Immunotherapy - This involves making your body less sensitive to the allergen by giving recurrent small exposures to the body. Some doctors say this therapy is not always successful.
Your doctor can advise you on the most suitable course of treatment for your rhinitis.
- Brian Irvine. NZ Pharmacy. October:36-42, 1995.
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