Allergic Rhinitis

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What Is Allergic Rhinitis?

Rhinitis is an inflammation and irritation of the mucous membrane inside the nose. It results either from a viral infection or due to an allergic reaction.

Alternate names

  • Coryza

Is this a medical emergency?

Coryza is not a medical emergency.

Types of this condition

Coryza is mainly classified as follows:

  • Allergic Rhinitis: It is caused due to an allergic reaction to allergens and irritants such as pollen, dust, mold, smoke, etc.
  • Non-allergic Rhinitis: It is a type of coryza that is caused due to various reasons other than an allergy. They include:
    • Infectious rhinitis: It is caused due to a viral or bacterial infection. This type of coryza includes acute and chronic rhinitis.
    • Hormone-induced rhinitis: It is caused due to certain conditions that are related to hormonal changes such as hypothyroidism, contraceptive pills, menstrual periods, and pregnancy.
    • Occupational rhinitis: It develops in individuals who work as furriers, farmers, bakers, food processing workers, woodworkers, etc.
    • Vasomotor rhinitis: It is caused due to temperature changes, exposure to strong odors like perfumes, or alcohol ingestion.
    • Gustatory rhinitis: It is caused by hot and spicy foods.
    • Atrophic rhinitis: It is caused due to enlargement of muscle tissue or glands in the nose.
    • Drug-induced rhinitis: It is caused as a side-effect of certain medications.
  • Mixed Rhinitis: In some cases, non-allergic rhinitis can co-exist with allergic rhinitis. This is termed mixed coryza.

Causes of rhinitis

Coryza may be caused by the following:

  • Virus and bacterial infections
  • Allergens like pollen, mold, dust mites, and animal dander
  • Irritants like tobacco smoke, fumes, and strong odors
  • Hormonal changes
  • Temperature and environmental changes
  • Certain foods and spices
  • Certain medications

Risk factors for rhinitis

The risk of developing coryza is high in individuals who are:

  • Having allergic diseases such as asthma, eczema, etc.
  • Having more exposure to pets
  • Having exposure to traffic-related pollutants, fumes, smoke, etc.
  • Having a weak immune system
  • Using more decongestant nasal sprays or drops
  • Working as furriers, farmers, bakers, food processing workers, woodworkers, etc.
  • Undergoing emotional or physical stress

Triggering factors

Factors that trigger and worsen the condition of Coryza include the following:

  • Exposure to environmental factors such as dust, smoke, strong odors, animal dander, air pollution, fuel fumes, etc.
  • Certain medications like aspirin and other non-steroidal anti-inflammatory drugs(NSAIDs)
  • Weather changes
  • Certain foods like hot and spicy foods as well as beverages like alcohol
  • Infections such as a common cold

Symptoms & signs of rhinitis

Common symptoms of rhinitis include the following:

  • Runny nose
  • Stuffy nose
  • Sneezing
  • Itchy and watery eyes
  • Itchy nose and throat
  • Ear pain and ear infections
  • Loss of smell
  • Clear discharge from the nose
  • Nosebleeds
  • Snoring
  • Breathing through the mouth

Investigations

There are no specific tests to diagnose Coryza. The diagnosis of rhinitis is made on reviewing the symptoms and considering the findings of the physical examination, which includes:

  • Signs and symptoms as described above
  • Dark circles and creases under the eyes
  • Swelling of tissues inside the nose
  • Breathing through the mouth

Other tests that are performed to evaluate the type cause of Coryza include:

Allergy tests: In most cases, Coryza is caused due to allergies. Allergy testing is done to identify the substances, which cause an allergic reaction. Allergy tests include:

  • Skin Test: A small drop of liquid food extract is dropped on the skin, or a lower dose of medication is injected into the skin. The appearance of a small red bump on the skin indicates an allergic reaction to that certain food or medication.
  • Blood Test: A blood sample is tested to measure the immune system’s response to a specific allergen

Nasal Endoscopy: This test is performed to identify any deformities in nasal passages and sinuses such as nasal polyps or a deviated septum.

Imaging tests: CT scan imaging is performed to capture the images of sinuses to rule any abnormalities.

Diagnosis of rhinitis

The diagnosis of Coryza is made by reviewing the symptoms, findings of the physical examination, and the results of investigations done. Diagnosis is confirmed as allergic rhinitis if the allergy tests are positive. The diagnosis of non-allergic rhinitis is made based on symptoms such as nasal congestion, a runny nose, negative allergy tests, and a negative history of sinus problems.

Rhinitis treatment options

Staying away from the allergens and irritants is the best way to treat Coryza; however, if symptoms are not relieved through self-care measures, an appropriate medical treatment plan is required.

A. Medical treatment

Medical treatment of Coryza includes the following:

  • Intranasal corticosteroids: These medications prevent and treat nasal inflammation, itching, and runny nose.
  • Intranasal antihistamines: These medications help to treat nasal itching, sneezing, and runny nose.
  • Saline nasal sprays: Distilled saline nasal sprays are used to rinse the nasal passages to relieve nasal congestion.
  • Decongestants: These medications are available in the form of tablets, nasal sprays, or liquids. They help to relieve nasal congestion.
  • Allergy shots: An individual is repeatedly exposed to the allergen in the form of allergy shots to help the immune system gain resistance towards the allergen.
  • Anti-drip anticholinergic nasal sprays: These medications are used for asthma and help to relieve a runny nose.
  • Other medications: Other medications for allergic rhinitis include cromolyn sodium, leukotriene modifiers, and nasal ipratropium.

B. Role of diet/exercise/lifestyle changes/preventive measures

Preventive measures for rhinitis include the following:

  • Staying away from allergens
  • Avoiding irritants that trigger the symptoms
  • Avoiding being around animals
  • Limiting the usage of nasal decongestants
  • Infectious rhinitis can be prevented with vaccinations
  • Using a bulb syringe or neti pot to rinse nasal passages
  • Avoiding outdoor activities as much as possible during the pollen season
  • Keeping the home environment clean from dust, mold, and cockroaches

Complications of rhinitis

Coryza can lead to the following complications:

  • Sinusitis
  • Nasal polyps
  • Ear infections
  • Worsening of asthma
  • Sleeping problems
  • Reduced quality of life

Prognosis

The overall prognosis of Coryza is good. Most of the symptoms resolve with self-care and appropriate medical treatment.

When to contact the doctor/How to identify complications?

Medical consultation for coryza is recommended if:

  • Symptoms do not subside with over-the-counter medications or self-care
  • This leads to worsening of asthma
  • This leads to frequent sinus infections
  • Affects sleep and quality of life

Indications for hospitalization if required

Rhinitis generally does not require hospitalization.

Suggested clinical specialists/Departments to consult for this condition

Infectious Disease, Allergy, and Immunology.

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