Rhinitis, allergic

Diagnosing allergic rhinitis

Your GP will often be able to diagnose allergic rhinitis from your symptoms and your personal and family medical history.

They'll ask you whether you've noticedany triggers that seem to cause a reaction, and whether it happens at a particular place or time.

Your GP may examine the inside of your nose to check for Polyps, nose .

Nasal polyps are fleshy swellings that grow from the lining of your nose or your sinuses, the small cavities inside your nose. They can be caused by the inflammation that occurs as a result of allergic rhinitis.

Allergic rhinitis is usually confirmed when medical treatment starts. If you respond well to antihistamines , it's almost certain that your symptoms are caused by an allergy.

Allergy testing

If the exact cause of allergic rhinitis is uncertain, your GP may refer you to a hospital allergy clinic for allergy testing.

The two main allergy tests are:

skin prick test where the allergen is placed on your arm and the surface of the skinis pricked with a needle tointroduce the allergen to your immune system; if you're allergic to the substance,a small itchy spot (welt) will appear
blood test to check for the immunoglobulin E (IgE) antibody in your blood; your immune system produces this antibodyin response to a suspected allergen

Commercial allergy testing kitsaren't recommended because the testing is often of a lower standard than that provided by the NHS or an accredited private clinic.

It's alsoimportant that the test results are interpreted by a qualified healthcare professional with detailed knowledge of your symptoms and medical history.

Further tests

In some cases furtherhospital tests may be needed to check for complications, such as nasal polyps or sinusitis .

For example, you may need:

a nasal endoscopy where athin tube with a light source and video camera at one end (endoscope) is inserted up your nose so your doctor can see inside your nose
a nasal inspiratory flow test where a small device is placed over your mouth and nose tomeasure the air flow when you inhale through your nose
a computerised tomography (CT) scan a scan that uses X-rays and a computer to create detailed images of the inside of the body

Medically Reviewed by a doctor on 28 Nov 2016

Articles for rhinitis, allergic

Introduction

Allergic rhinitis is an inflammation of the inner nose which is caused by allergens, such as flower pollen, dust or animal hairs. Many individuals suffer from this condition, hence it is very common. Allergic rhinitis is associated with similar symptoms to the common cold, such as sneezing, a congested, dry nose, itching etc. In some individuals these symptoms are mild, and in others they are more severe and present at all times. In some patients, symptoms are present all year round, whereas for others, they only appear seasonally.

Causes of allergic rhinitis

Allergic rhinitis is caused by an allergic reaction which occurs in the human body when it falls in contact with an allergen, which may be dust, flower pollen, animal hair etc. The allergens trigger the onset of several symptoms. Our natural immune systems interpret the presence of allergens as they would the presence of an infectious agent, and hence the immune response to allergens is the same response that your body would organize against a bacterium or virus. People who are highly sensitive to allergens produce antibodies against them. Several common allergens include:1. Common house dust (in linens, carpets and other household items)2. Flower pollen (usually in spring and autumn)3. Remnants from domestic animals (dogs, cats, horses, rabbits), which include hair, urine, spit etc. People with a family history for allergies are more likely to develop allergic rhinitis.

Diagnosing allergic rhinitis

After inquiring for a thorough family history of the patient, the doctor may order the following tests:1. Scratch test (the arm is scratched with a needle containing an allergen, and the skin is observed for any subsequent development of a rash).2. A blood test to measure for the levels of IGE immunoglobulins, which are elevated in case of an allergic reaction. Another indicator is the elevated level of eusinophiles. 3. In cases when the condition concurrs with another condition, (like for example nasal polyps or sinusitis), other examinations are required, such as : nasal endoscopy, or a nose scanner.

Treating allergic rhinitis

Treatment depends on the severity of the symptoms of rhinitis. Medication usually involves interfering in order to relieve congestion in the nose. An allergic patient should know that the best means of treatment is avoiding or eliminating exposure to the allergen. Other types of medication used do not cure the allergy, they just treat the symptoms. Types of treatment used include:1. Salt solutions used to rinse out the nose, they may be applied up to several times a day.2. Taking anti-histamines, which lower the levels of histamines in the bloodstream. Histamines are the compounds which trigger an allergic reaction. 3. Cortisones are a type of medication which helps in lowering inflammation and secretion. They can be taken in the form of a nasal spray or a tablet. 4. Leukotriene antagonists: leukotrienes serve as one of the mediators of inflammation, and antagonists of such compounds serve as decongestants. If all of the above yields no satisfactory results, then immunotherapy is employed, as well as the usage of vaccines with allergen content, in order to lower the patient's sensitivity to the allergen.

Complications of allergic rhinitis

Continous suffering from the symptoms of allergic rhinitis may be cause for other health complications which include:1. The development of nasal polyps (small tissue masses similar to a teardrop, which are caused by constant inflammation).2. Large polyps may cause breating difficulties, especially while asleep, a reduced sense of smell, a blockage of the sinuses, and at times resulting in chronic sinusitis. 3. Middle ear infections, an infection of the eustachian tube may spread to the middle ear. Symptoms associated with this is ear pain, high fever, reduced hearing capability. 4. A case of allergic rhinitis which has been medicated poorly or has gone unmedicated, may lead to the development of a bronchial asthma or in cases of preexisting asthma, a worsening of the asthma symptoms.

Preventing allergic rhinitis

Preventing the condition is the best medication available for allergic rhinitis, meaning either avoiding or eliminating exposure to the allergen. This is not an easy feat to perform, and not always possible. 1. To prevent the formation of house dust the patient is advised to use: antiallergenic mattresses, linens and other types of covers. The house should always be cleaned with a vacuum cleaner.2. When the allergy is caused by domestic animals: if you cannot remove the animal from the house, then you must make sure they do not enter your bedroom, and the house must be cleaned often. Do not allow the animals to tread upon carpets. 3. When the allergy is caused by pollens: avoid pollination season (usually spring/autumn), use sunglasses, and ventilate the house frequently, avoid grassy areas and parks.4. When the allergy is caused by spores, maintain a dry and well-ventilated household.

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