About Your Diagnosis
In individuals with allergic rhinitis, the nasal passages are much more
sensitive to environmental irritants or allergic triggers. Symptoms
may be seasonal (especially in the spring and/or fall) or continuous
(perennial). Allergic rhinitis is also known as "hay fever."
The diagnosis of allergic rhinitis is based on the clinical presentation
and positive allergy skin tests (especially to house dust, animal danders,
or pollen). In patients with more constant or long-term problems, sinus
changes, nasal polyps, loss of sense of smell, and itchy red eyes may
also be present.
Although there are many irritants that produce nasal symptoms in individuals
without allergies, irritants such as smoke and smog may cause more problems
in individuals with allergic rhinitis. Other common triggers, especially
in individuals with seasonal symptoms, may result from exposure to certain
pollens, molds, or dust. This condition is not contagious or curable
but may require medication and other forms of allergy treatment for
Living With Your Diagnosis
Symptoms may be seasonal (especially in the spring and/or fall) or continuous
(perennial), and can range from being mild to interfering with daily
activities. Sneezing, runny nose, nasal congestion, and an itchy nose,
often with itchy eyes and a scratchy throat, are the most common symptoms.
In severe cases, frontal headaches, sinus involvement, and sleep deprivation
caused by nighttime symptoms are seen.
The best treatment usually involves reducing or avoiding exposures to
the potential allergens, in combination with the use of antihistamines
and topical intranasal steroids. In more severe cases, a short course
of oral corticosteroids and nasal decongestants may be required. Preventive
therapy with agents such as cromolyn, as well as the use of a mask,
may also be helpful. Finally, allergy injections (desensitization) for
specific types of allergic rhinitis may be considered for individuals
who have a poor response to drug therapy. Possible side effects may
include excessive sleepiness (especially with oral antihistamines),
palpitations or changes in blood pressure control (oral decongestants),
and occasional thinning of the nasal mucosa (intranasal steroids).
Surgery by an ear, nose, and throat specialist may be necessary if problems
persist despite trying the previous measures.
* It is important to work with your care provider in trying to identify
possible triggers of your nasal symptoms. Keeping a diary of indoor
and outdoor activities in relation to any nasal symptoms may provide
clues for avoidance in the future. For individuals with seasonal symptoms,
starting your preventive medications at least 23 weeks before
the season that gives you problems may reduce the potential for a severe
flare. For patients who have asthma and nasal polyps, additional precautions
may be required, because some of these individuals are also sensitive
to aspirin and aspirin-type products; for example, ibuprofen.
* Overuse of nasal decongestant preparations may lead to reactive "after
congestion," excessive heart rate or high blood pressure, and nosebleeds.
It is important to review your medication use and options with your
doctor and pharmacist, especially if you are taking other medications.
Avoiding the possible allergic triggers is very helpful but not always
When to Call Your Doctor
* Call your doctor if your symptoms become constant and keep you awake,
your nasal discharge becomes thickened and colored (especially if associated
with fever and sinus headaches), or you think you are having a problem
with your medications. Your doctor may refer you to an allergist for
possible immunotherapy (allergy shots), or to an ear, nose, and throat
specialist for advice on long-term management.
For More Information
American Academy of Allergy, Asthma, and Immunology
64 East Wells Street
Milwaukee, WI 53202-2887
Asthma and Allergy Foundation of America (AAFA)
1125 15th Street NW
Washington, DC 20005
American Lung Association
1118 Hampton Avenue
St. Louis, MO 63139