Non-allergic rhinitis

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Non-allergic eosinophilic rhinitis

Non-allergic eosinophilic rhinitis is an inflammatory disease of the nasal mucosa, non-IgE-mediated, associated with the influence of non-specific non-allergic and non-infectious triggers: meteorological, chemical, medication.

Table of contents:

The main clinical manifestations of non-allergic eosinophilic rhinitis are difficulty in nasal breathing, runny nose, and mild sneezing. Concomitant allergic diseases are not detected, allergy tests are negative. When examining nasal secretions, an increased content of eosinophils, neutrophils and mast cells is detected. The basis of treatment is intranasal glucocorticosteroids.

Non-allergic eosinophilic rhinitis

Non-allergic eosinophilic rhinitis (non-allergic rhinitis with eosinophilic syndrome) is a non-IgE-mediated disease characterized by nonspecific inflammatory damage to the nasal mucosa. The main clinical manifestations are progressive impairment of nasal breathing, rhinorrhea, sneezing attacks, a tendency to develop polypous rhinosinusitis and aspirin-induced bronchial asthma . According to statistics, non-allergic eosinophilic rhinitis accounts for about 20% of all cases of non-infectious non-allergic rhinitis. The disease was first described by RL Jacobs et al in 1981. It is the least studied form of inflammation of the nasal mucosa.

Causes

The main causes of non-allergic eosinophilic rhinitis are not fully understood. The provoking role of unfavorable environmental factors (changes in temperature and humidity of atmospheric air, exhaust from automobiles and industrial enterprises, exposure to tobacco smoke and certain medications) is assumed.

The pathological process in the nasal cavity is characterized by the development of eosinophilic inflammation, which becomes chronic and contributes to the appearance of hypertrophic growths (micropolyposis). There are 4 variants of the inflammatory process in non-allergic eosinophilic rhinitis. The first is a typical variant, characterized predominantly by eosinophilic inflammation; the second is an option in which mast cells mainly take part in the development of the inflammatory process; the third is non-allergic rhinitis with predominantly neutrophilic inflammation; the fourth is a mixed variant, in which eosinophils and mast cells participate in inflammation.

In addition, non-allergic eosinophilic rhinitis can become the initial stage of the formation of hypersensitivity to non-steroidal anti-inflammatory drugs, including aspirin, and lead to the development of aspirin-induced bronchial asthma.

Symptoms

The clinical picture is similar to the symptoms of year-round allergic rhinitis. The presence of profuse watery discharge from the nose, sneezing attacks and increasing difficulties in nasal breathing are noted. Often there is a decrease in the sense of smell, up to its absence. As a rule, itching in the nasal passages with non-allergic eosinophilic rhinitis does not bother or is mild. Symptoms tend to intensify under the influence of unfavorable meteorological factors, upon contact with strong odors (household chemicals, perfumes, industrial emissions, etc.).

General well-being is often disturbed - sleep and appetite worsen, fatigue and weakness appear, and performance decreases. Patients suffer from frequent colds with symptoms of nasopharyngitis, laryngotracheitis, and bronchitis. Over time, chronic polypous rhinosinusitis, laryngospasm, broncho-obstructive syndrome, and sleep apnea may occur.

Diagnostics

Examination of patients with non-allergic eosinophilic rhinitis includes the collection of anamnestic information about past diseases, intolerance to certain organic and inorganic substances, medications and natural environmental factors. A clinical examination involves consultations with an otorhinolaryngologist, an allergist-immunologist, an infectious disease specialist, a pulmonologist and other medical specialists. Laboratory allergy tests and skin tests performed in allergology are performed to exclude hypersensitivity caused by immune mechanisms. In this case, skin testing, provocative tests and determination of the level of specific immunoglobulins of class E give a negative result.

The clinical picture of non-allergic eosinophilic arthritis may include the so-called aspirin triad, including intolerance to acetylsalicylic acid or other non-steroidal anti-inflammatory drugs, asthma attacks and difficulty in nasal breathing with the presence of polyps. Examination of mucous discharge from the nasal cavity (rhinocytogram) often shows pronounced eosinophilia. Rhinoscopy reveals pallor and cyanosis of the mucous membrane of the nasal turbinates, the presence of polypous changes in the middle and lower nasal passages, as well as in the paranasal sinuses. When performing radiography and computed tomography of the paranasal sinuses, changes characteristic of sinusitis are detected. The non-allergic nature of rhinitis is evidenced by the fact that there is no effect from the use of antihistamines.

Differential diagnosis is carried out with other rhinitis (allergic, medicinal, infectious) and sinusitis of various etiologies. Unlike allergic rhinitis, eosinophilic inflammation of the nasal cavity is characterized by complaints mainly of difficulty breathing through the nose and rhinorrhea, the absence of damage to the conjunctiva, the connection of exacerbations with changes in climatic factors and the appearance of strong odors, negative allergy tests and the ineffectiveness of antihistamines.

Treatment

The main drugs used for non-allergic eosinophilic rhinitis are intranasal glucocorticosteroids with a pronounced anti-inflammatory effect (mometasone fuorate, fluticasone propionate, etc.). Leukotriene receptor inhibitors are sometimes prescribed, but the effectiveness of such drugs is low. As for antihistamines, no significant positive results were found when using them in patients with non-allergic eosinophilic rhinitis. In some cases, when treating patients with established intolerance to acetylsalicylic acid, desensitization may be used. In case of severe polypous rhinosinusitis, surgical intervention is performed according to indications.

Non-allergic eosinophilic rhinitis - treatment in Moscow

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Source: http://www.krasotaimedicina.ru/diseases/allergic/eosinophilic-nonallergic-rhinitis

Non-allergic rhinitis

Non-allergic rhinitis is defined as inflammation of the nasal mucosa not associated with exposure to allergens. The absence of allergies must be confirmed by negative results of skin tests with a standard set of inhalant allergens. Table 19-1 shows the classification of non-allergic rhinitis.

Table 19-1. Classification of non-allergic rhinitis [54]

Bacterial Atrophic rhinitis Non-allergic rhinitis with eosinophilia Rhinitis with nasal polyposis Nasal mastocytosis Non-inflammatory Drug-induced

systemic means Hormonally induced

during pregnancy Caused by structural defects:

deviated nasal septum

traumatic brain injury with liquorrhea

Among these disorders, the most common is non-allergic vasomotor rhinitis, a disease of unknown origin, which is characterized by persistent nasal congestion, rhinorrhea and nasopharyngeal discharge. This form of rhinitis is characterized by the absence of symptoms of eye irritation. In typical cases, symptoms of rhinitis increase in the early morning and are aggravated by exposure to tobacco smoke, irritants, perfumes, and various pungent odors. Manifestations of rhinitis occur immediately after a sharp change in temperature. In allergic patients with severe symptoms of vasomotor disorders, mixed persistent rhinitis is diagnosed. Purulent nasal discharge suggests infectious rhinitis; pain in the sinuses may indicate concomitant acute or chronic sinusitis. Atrophic rhinitis is a disease of unknown origin that is often observed in the elderly and is characterized by the formation of dry, foul-smelling crusts in the nasal cavity [55]. Non-allergic rhinitis with eosinophilia is an inflammatory disease in which eosinophils are found in nasal secretions, and skin reactions with a standard set of inhalation allergens are negative. Rhinoscopy reveals swollen, pale, purple-tinged nasal turbinates, reminiscent of the picture characteristic of AllR. The cause of this disease is also unknown; suggest that it may precede nasal polyposis. Mast cell rhinitis (nasal mastocytosis) is a rare disease characterized by an abundance of mT cells in the mucous membrane. If symptoms of rhinitis develop as a result of prolonged use or abuse of local or systemic drugs, they are regarded as manifestations of Table 19-2. Drugs that cause rhinitis medicamentosa Antihypertensive drugs Reserpine Hydralazine Guanethidine Methyldopa R - Adrenoble ocators Prazosin ACE inhibitors Psychotropic drugs Thioridazine Chlordiazepoxide, amitriptyline Hormonal ovarian drugs Oral contraceptives for rhinitis medicamentosa. A list of drugs that can lead to the development of this pathology is presented in Table 19-2 [54]. ACE inhibitors can cause rhinorrhea and vasomotor disorders in combination with cough, which disappear after discontinuation of the drug [57]. Excessive use of topical vasoconstrictors (phenylephrine, oxymetazoline) can cause epistaxis, nasal congestion associated with the known rebound phenomenon, and sometimes septal perforation. Severe congestion in the nose is detected in patients with hypothyroidism (myxedema). During pregnancy, approximately a third of women report nasal congestion and the presence of rhinorrhea, which is likely due to the dilation of nasal vessels under the influence of hormones (progesterone or estrogen) and increased secretion of the mucous membranes. In differential diagnosis, other possible causes that can lead to impaired nasal breathing should be taken into account. The causes of unilateral obstruction and unsuccessful drug treatment may be a severe curvature of the nasal septum, as well as a tumor or foreign body. Liquororrhea, which occurs in 5% of cases of fracture of the base of the skull, is distinguished by a transparent discharge. The diagnosis can be clarified by performing a glucose test: a glucose concentration in the discharge of 40 mg/ml or higher confirms the diagnosis of liquorrhea. Recognizing the causes of rhinitis begins with a careful study of the medical history and examination using a nasal speculum. A deviated nasal septum is usually clearly visible. Pale and flabby turbinates, characteristic of AllR, can also be seen in patients with eosinophilic nonallergic rhinitis or nasal polyposis. The mucous membrane with hemorrhages, as well as red, reminiscent of meat, is characteristic of patients with drug-induced rhinitis. Cytological examination of a smear from the nasal mucosa reveals many neutrophils, which confirms the infectious nature of rhinitis [59]. Eosinophilia of secretions is characteristic of AllR, eosinophilic non-allergic rhinitis or nasal polyposis. The absence of inflammatory cells in the smear should suggest non-inflammatory rhinopathies.

Treatment

Treatment tactics for non-allergic rhinitis depend on the diagnostic results. When choosing therapy, it is necessary to take into account the nature of the disease (inflammatory or non-inflammatory genesis). Non-inflammatory rhinitis Patients with drug-induced rhinitis should stop taking the appropriate medications. A pronounced positive effect is produced by nasal forms of HA, which reduce swelling of the mucous membrane. For vasomotor disorders associated with hormonal changes during pregnancy, medications should be avoided if possible; If necessary, safe and effective GCs (for example, beclomethasone) can be applied topically. Nasal congestion due to hypothyroidism (myxedema) resolves when the deficiency of thyroid hormone is corrected.

Obstruction caused by a deviated nasal septum can be corrected by surgery (septoplasty). Liquor rhea resolves on its own in half of the patients. In case of persistent liquorrhea, intravenous antibiotic therapy is used to prevent meningitis; it is often necessary to perform surgical removal of the meningeal defect. Treatment of vasomotor rhinitis is, as a rule, a difficult task. Patients should avoid external provoking factors (tobacco smoke, caustic fumes, other irritants). The selection of drugs and treatment regimens for vasomotor rhinitis is carried out empirically. Decongestants (pseudoephedrine, phenylpropanolamine) have a positive effect. In patients with combined (allergic and vasomotor) rhinitis, improvement occurs when antihistamines are prescribed, as well as their combination with decongestants. If oral decongestants are ineffective, nasal forms of GC should be prescribed. In case of year-round non-allergic rhinitis, a positive effect of the anticholinergic drug ipratropium bromide 80 mg 4 times a day was noted [60], the effectiveness of which is associated with the suppression of cholinergic hyperreactivity characteristic of vasomotor rhinitis. In most patients, symptoms of vasomotor rhinitis are successfully controlled by oral sympathomimetic drugs in combination with nasal GCs or ipratropium.

Source: http://www.proallergiyu.ru/bolezni/Neallergicheskiy_rinit.html

Allergic rhinitis

Allergic rhinitis or allergic rhinitis is an inflammation of the mucous membrane of the nasal cavity that occurs when allergens enter the human body when exhaled through the mucous membrane of the nasal cavity. The allergen is plant pollen, house dust, found in large quantities in carpets, books and other places. This disease is one of the most common in the world; for example, in Russia, according to statistics, from 11 to 24% of the population suffers from rhinitis of allergic origin.

The main factors that cause allergic rhinitis are allergens contained in the air. They are usually divided into three groups:

  • aeroallergens of the external environment - plant pollen;
  • aeroallergens of homes - mites contained in house dust or animal hair, insects, mold and yeast allergens, some house plants and food products;
  • occupational allergens.

Triggering points can be: spicy food, stressful situations, hypothermia, emotional overload. Often the cause may be a genetic predisposition.

According to its form, allergic rhinitis is divided into three classes:

  • seasonal (intermittent) allergic rhinitis - an allergy to the appearance of pollen from flowering plants and trees in the air. Since pollen can be spread by wind over very long distances, it is impossible to completely avoid contact with it, there are chances to reduce the danger.
  • year-round (persistent) allergic rhinitis – can appear all year round. The cause is house dust, or rather, microscopic mites living in dust or the hair of some animals. Manifestations of year-round allergic rhinitis are usually somewhat weaker than seasonal ones.
  • occupational rhinitis due to allergic irritants - occurs in people while working in certain conditions, perhaps also from dust, but the exact nature of its occurrence has not been studied.

According to clinical manifestations there are:

  • mild form, which is insignificant and the patient can do without treatment;
  • moderate severity - in this case, the symptoms of allergic rhinitis can significantly worsen the quality of life and interfere with the patient;
  • severe form - the patient is in serious condition, cannot live normally and fully work or study, the disease disrupts sleep.

Symptoms of allergic rhinitis

First of all, speaking about the symptoms of allergic rhinitis, we must list the signs that cannot be ignored and you need to consult a doctor:

  • itching in the nose that often occurs during the day;
  • sneezing, often paroxysmal;
  • nasal congestion, runny nose, worse at night;
  • watery discharge from the nose, in case of infection, it can take on a mucopurulent character;
  • swelling of the nasopharynx, loss of smell;
  • paroxysmal cough and sore throat;
  • redness of the eyes and suppuration, sometimes circles or swelling appear under the eyes.

Taking antihistamines usually alleviates the patient's condition.

These symptoms of allergic rhinitis are not unique to this disease. All rhinitis has similar symptoms, each of which requires specific treatment, and therefore it is advisable to carry out an accurate diagnosis by an allergist.

Diagnosis of allergic rhinitis

To confirm the diagnosis of allergic rhinitis, it is necessary to analyze a nasal smear for eosinophils. The presence of eosinophils in a smear of more than 5% of all detected cells indicates an allergic cause of nasal congestion.

In the future, to clarify the diagnosis, it is necessary to identify the substance that causes symptoms and is the cause of allergic rhinitis - a causally significant allergen.

Diagnosis of allergic rhinitis has two types: skin testing and a special blood test.

Setting up skin tests. A prerequisite is that you stop taking any antihistamines 5 days in advance and the patient’s age is from 4 to 50 years. Several small incisions are made on the forearm, into which 1-2 drops of a specific allergen are dripped. After some time (15-30 minutes), the bubble that appears is examined and measured. Skin testing is one of the reliable, common and economical types of allergy diagnosis. The test is not performed on pregnant or breastfeeding women.

A general blood test for specific IgE-specific immunoglobulins. The level of total IgE at birth is about zero and gradually increases as people grow older. In an adult, a reading above 100-150 U/L is considered elevated. The method is not particularly widespread due to the high cost of the study; the cost of an allergen panel reaches 16 thousand rubles. Another disadvantage is unreliability, often producing false positive results.

With those allergens that give a positive skin reaction, an additional intranasal provocation test is performed. This diagnosis of allergic rhinitis involves provoking the body to react. To do this, inject 2-3 drops of distilled water into one nostril, then gradually increase the concentration of the tested allergen: 1:100, 1:10 and a whole solution. If a reaction appears within minutes - congestion, sneezing, burning, runny nose, the test is considered positive.

It is possible to conduct research using radioallergosorbent, radioimmune, immunoenzyme or chemiluminescent methods, however, due to the high cost, these methods are not widely used.

Treatment of allergic rhinitis

Treatment consists of relieving allergic inflammation of the mucous membranes and conducting allergen-specific therapy.

For mild and moderate forms of allergic rhinitis, antihistamine therapy is used, preferably second-generation (Claritin, Cetrin, Zodak) or third-generation (Zyrtec, Telfast, Erius) drugs. Prescribed orally 1 time per day in accordance with recommended age dosages. Duration of treatment is at least 2 weeks.

If treatment of allergic rhinitis does not give the desired effect, sodium cromoglycate derivatives (Cromohexal, Cromoglin, Cromosol) are prescribed. The drugs are available in the form of sprays; a noticeable effect is noticeable no earlier than after 5-10 days.

Patients who have contraindications to these medications are prescribed allergen-specific immunotherapy. Treatment is carried out by an allergist in a hospital setting. The point of treatment is to administer small doses of the allergen, which are gradually increased, thereby achieving the development of tolerance of the body to the allergen. At the same time, they try to alleviate the symptoms of allergic rhinitis.

Those suffering from allergic rhinitis should know that treatment is necessary, even in mild cases, otherwise the disease may take on new, more severe forms, such as, for example, bronchial asthma.

The doctor advised me to drink immunomodulators and at the same time spray my nose with Aquamaster, after about a month all the symptoms subsided. So if anyone is worried, you can take note. But in general, of course, it’s better not to self-medicate

The nose is stuffy, that’s okay, you can drop a vasoconstrictor, although for me personally they only help for half an hour with allergic rhinitis. But I also have severe itching, I can start sneezing and sneezing ten times in a row, and then you realize that you are just like a hostage to allergies, completely helpless. And if you start sneezing while driving, it’s really scary, because you don’t control the situation at all, and your eyes also reflexively close when you sneeze. For a long time I tried different remedies, and so far I only like the nasal spray, Allergodil, it is not hormonal and immediately relieves the itching well, you can calmly go outside after 15 minutes.

I have allergic rhinitis, I kind of need to get used to it, but I can’t when my nose is stuffy. Therefore, if my nose is stuffy, I immediately use Xylene spray. This drug comes in the form of drops and a spray, but I take the spray because it is better for me to use. It costs around 70 rubles and relieves congestion for a long time.

Marina, how much do these drops cost? And how often should they be used?

I am allergic myself and have already tried a bunch of different drops and sprays. Recently, at a pharmacy they advised me to buy morenasal, so I decided to buy it and try it, especially since it costs a penny. I was very pleased. It removes nasal congestion well and moisturizes the mucous membrane. I spray it twice a day, and everything is great.

I like the spray better. I use morenasal. It uses calcined salt diluted with special water, which is more effective than just sea water. And by the way, it’s inexpensive.

I tried many options and found it! On doctor's advice. The most effective, simply monstrously effective way to quickly get rid of allergic rhinitis is: Buy one ampoule of DEXAMETHASONE and any nasal drops at the pharmacy. Pour the contents of the ampoule into nasal drops and shake well. Apply nasal drops as needed. The result is noticeable immediately. It’s easier to breathe, there are no snot and tears.

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Ira: I switched to tenoten after valerian and sedatives stopped helping me.

Kaloshin Sergey: Educational, useful.

Valentin: grapes, bananas, chocolate, cocoa, tea and coffee, white rice - what harm did they do? If known.

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Source: http://medside.ru/allergicheskiy-rinit

Non-allergic rhinitis

Non-allergic rhinitis is a medical term that describes a set of symptoms that are similar to allergies but occur without a known cause. This type of inflammation of the nasal mucosa is characterized by symptoms such as:

Non-allergic rhinitis typically develops in adulthood and symptoms may occur year-round.

Unlike allergic rhinitis, non-allergic rhinitis does not affect the immune system. The prevalence of both of these types of rhinitis is quite high. Thus, according to statistics from the United States, about 58 million Americans suffer from allergic rhinitis. By comparison, 19 million people in this country suffer from symptoms of non-allergic rhinitis.

The disease typically develops in adulthood and symptoms may occur year-round

Non-allergic rhinitis can cause no less problems and troubles than rhinitis caused by allergies. Its appearance may be associated with complications and conditions such as:

  • sinusitis, which is manifested by inflammation or swelling of the mucous tissue of the sinuses (sinuses), located in the zygomatic bones of our skull.
  • Eustachian tube dysfunction; Eustachian tubes are passages connecting the middle ear cavity and the pharynx.
  • chronic ear infection, which is known as otitis media (inflammation of the middle ear);
  • deterioration of the sense of smell or complete loss of smell (anosmia);
  • bronchial asthma;
  • stopping breathing during sleep (obstructive sleep apnea).

Both types of rhinitis are fraught with:

  • decreased productivity at work, low performance;
  • an increase in the number of visits to the doctor;
  • side effects from treatment - such as drowsiness, nosebleeds, dry nose.

Both of these types of inflammation of the nasal mucosa are so similar that even a doctor can distinguish one type from the other only on the basis of blood tests for allergies.

Causes of non-allergic rhinitis

Often the cause of non-allergic rhinitis cannot be detected, and this diagnosis can be confirmed only after excluding other diseases - allergic rhinitis and various infections.

Allergic and non-allergic rhinitis may even have common “environmental” irritants that can be found both at home and at the patient’s workplace.

Provoking factors

Here are examples of what can become a trigger for the development of non-allergic rhinitis:

with this disease the immune system is not affected

  • automobile exhausts;
  • being near chlorine-containing chemicals;
  • cigarette smoke;
  • cleaners;
  • various adhesives;
  • Polish for hair;
  • latex;
  • detergents;
  • metal salts
  • perfume;
  • smog;
  • wood dust;

When such triggers (substances that trigger the disease) cause non-allergic rhinitis, they can often also cause bronchial asthma.

Medications

Some medications can also cause non-allergic rhinitis. These may include medications such as:

  • NSAIDs - non-steroidal anti-inflammatory drugs - such as aspirin and ibuprofen;
  • oral contraceptives;
  • medications that affect blood pressure - such as ACE inhibitors (captopril, etc.), beta blockers (for example, atenolol);
  • antidepressants;
  • tranquilizers;
  • drugs used to treat erectile dysfunction (impotence).

Food

Foods and even drinks can also sometimes act as substances that cause non-allergic rhinitis. These include:

  • hot foods (such as soup);
  • spicy food;
  • alcoholic drinks, especially beer and wine.

Other provoking factors:

Treatment of non-allergic rhinitis

Unfortunately, there is currently no cure for this disease. However, there are ways to control the disease and reduce its manifestations:

  • try to avoid triggers that cause manifestations of the disease;
  • use home remedies such as nasal rinses (nasal irrigations);
  • Use over-the-counter medications to treat runny nose and congestion.

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Allergic rhinitis - symptoms and treatment regimen

Allergic rhinitis is an inflammatory process of the nasal mucosa, which occurs as a result of exposure to various allergic irritants, and in this case, allergens.

Simply put, allergic rhinitis is a runny nose caused by an allergic reaction. Under the influence of allergens, inflammation begins in the nasal mucosa, which leads to illness. Statistics show that rhinitis, like allergic cough, is one of the most common complaints among patients turning to allergists.

This disease occurs most often in preschool children, when the child begins to encounter substances that can cause allergies. However, cases of allergic rhinitis in adults are not uncommon - the symptoms and treatment of which we will discuss in this article.

Forms

Depending on the severity of allergic manifestations, rhinitis is distinguished:

  • mild - the symptoms are not very disturbing (may manifest as 1-2 signs), do not affect the general condition;
  • moderate - symptoms are more pronounced, there is sleep disturbance and a slight decrease in activity during the day;
  • severe - painful symptoms, disturbed sleep, significant decrease in performance, the child’s performance at school worsens.

Based on the frequency and duration of manifestations, they are distinguished:

  • periodic (for example, in the spring during the flowering of trees);
  • chronic - throughout the year, when allergies are associated with the constant presence of allergens
  • environment (for example, dust mite allergy).
  • intermittent - acute episodes of the disease last no more than 4 days. per week, less than 1 month.

With periodic rhinitis, symptoms last no more than four weeks. Chronic rhinitis lasts longer than 4 weeks. This disease not only causes great discomfort in everyday life, but can also lead to the development of asthma. Therefore, if you notice rhinitis of an allergic nature in yourself or your child, you should start treatment as quickly as possible.

Causes

Why does allergic rhinitis occur and what is it? Symptoms of the disease appear when the allergen gets into the eyes and nasal passages of a person who is hypersensitive to certain substances and products.

The most popular allergens that can cause allergic rhinitis are:

  • dust, and it can be both library and household;
  • plant pollen: small and light particles carried by the wind, falling on the nasal mucosa, form a reaction leading to a disease such as rhinitis.
  • dust mites and pets;
  • a certain food product.
  • fungal spores.

Persistent allergic rhinitis, which lasts throughout the year, is caused by house dust mites, pets and molds.

Symptoms of allergic rhinitis

If the symptoms of allergic rhinitis in adults do not reduce performance or interfere with sleep, this indicates mild severity; moderate severity is indicated by a moderate decrease in daytime activity and sleep. In the case of severe symptoms in which the patient cannot work, study, engage in leisure activities during the day and sleep at night, a severe degree of rhinitis is diagnosed.

Allergic rhinitis is characterized by the following main symptoms:

  • watery nasal discharge;
  • itching and burning in the nose;
  • sneezing, often paroxysmal;
  • nasal congestion;
  • snoring and snoring;
  • voice change;
  • desire to scratch the tip of the nose;
  • deterioration of smell.

With prolonged allergic rhinitis, due to constant copious secretion from the nose and impaired patency and drainage of the paranasal sinuses of the auditory tubes, additional symptoms arise:

  • irritation of the skin at the wings of the nose and above the lips, accompanied by redness and swelling;
  • nosebleeds;
  • hearing impairment;
  • ear pain;
  • coughing;
  • a sore throat.

In addition to local symptoms, general nonspecific symptoms are also observed. This:

  • disturbances in concentration;
  • headache;
  • malaise and weakness;
  • irritability;
  • headache;
  • bad dream.

If allergic rhinitis is not treated in time, other allergic diseases may develop - first conjunctivitis (of allergic origin), then bronchial asthma. To prevent this from happening, you need to start adequate therapy on time.

Diagnostics

To make a diagnosis of allergic rhinitis, you will need to:

  • clinical blood test for the level of eosinophils, plasma and mast cells, leukocytes, total and specific IgE antibodies;
  • instrumental techniques – rhinoscopy, endoscopy, computed tomography, rhinomanometry, acoustic rhinometry;
  • skin testing to identify causative allergens, which helps to accurately determine the nature of allergic rhinitis;
  • cytological and histological examination of nasal secretions.

The most important thing in treatment is to identify the cause of the allergy and avoid contact with the allergen if possible.

What to do for year-round allergic rhinitis

A year-round runny nose caused by an allergic reaction occurs throughout the year. A similar diagnosis is usually given to a person if exacerbations of the runny nose occur at least twice a day for nine months per year.

In this case, you should adhere to certain recommendations:

  • Avoid rinsing your nose yourself.
  • knock out blankets and pillows.
  • Do not use drops for runny nose.
  • clear your nose of mucus.
  • no smoking.
  • carry out wet cleaning of the apartment weekly.
  • use bedding made from synthetic fibers.
  • ventilate the bed well.
  • get rid of things that are the main sources of house dust.

The development of this disease is most often based on a high concentration of an allergen that has been affecting the human body for a long time.

Treatments for allergic rhinitis

Based on the mechanisms of development of allergic rhinitis, treatment of adult patients should be directed to:

  • eliminating or reducing contact with causally significant allergens;
  • elimination of symptoms of allergic rhinitis (pharmacotherapy);
  • conducting allergen-specific immunotherapy;
  • use of educational programs for patients.

The primary task is to eliminate contact with the identified allergen. Without this, any treatment will bring only temporary, rather weak relief.

Antihistamines

Almost always, to treat allergic rhinitis in adults or children, you need to take antihistamines orally. It is recommended to use medications of the second (Zodak, Cetrin, Claritin) and third (Zyrtec, Erius, Telfast) generations.

The duration of therapy is determined by a specialist, but is rarely less than 2 weeks. These allergy pills have virtually no hypnotic effect, have a prolonged effect and effectively relieve the symptoms of allergic rhinitis within 20 minutes after administration.

Those suffering from allergic rhinitis are advised to take Cetrin or Loratadine orally, 1 tablet each. in a day. Cetrin, Parlazin, Zodak can be taken by children over 2 years old in syrup. The most powerful antihistamine today is Erius, the active ingredient is Desloratadine, which is contraindicated during pregnancy, and can be taken in syrup for children over 1 year of age.

Nasal rinsing

In the case of seasonal allergic rhinitis, treatment should be supplemented with nasal rinsing. For these purposes, it is very convenient to use the inexpensive Dolphin device. In addition, you don’t have to buy special bags of rinsing solution, but prepare it yourself - ¼ teaspoon of salt per glass of water, as well as ¼ teaspoon of soda, a few drops of iodine.

The nose is often washed with seawater sprays - Allergol, Aqua Maris, Quix, Aqualor, Atrivin-More, Dolphin, Goodvada, Physiomer, Marimer. Sea water, by the way, is great for helping with a runny nose.

Vasoconstrictor drops

They have only a symptomatic effect, reducing swelling of the mucous membrane and vascular reaction. The effect develops quickly, but is short-lived. Treatment of allergic rhinitis in children is recommended without vasoconstrictor local agents. Even a small overdose can cause the baby to stop breathing.

Mast cell membrane stabilizers

Allows you to relieve inflammation in the nasal cavity. Sprays that have a local effect are often used.

These include cromones - Kromohexal, Kromosol, Kromoglin. These drugs also prevent the body from developing an immediate reaction to the allergen and are therefore often used as a prophylactic agent.

Desensitization

A method consisting of the gradual introduction of an allergen (for example, grass pollen extract) in increasing doses under the skin of the patient's shoulder. Initially, injections are given at weekly intervals, and then every 6 weeks for 3 years.

As a result, the patient's immune system no longer reacts to this allergen. Desensitization is especially effective if a person is allergic to only one allergen. Check with your doctor to see if it is possible to desensitize your immune system to the allergen.

Enterosorbents

Also, for allergic rhinitis, treatment with enterosorbents has a positive effect - Polyphepan, Polysorb, Enterosgel, Filtrum STI (instructions) are products that help remove waste, toxins, and allergens from the body, which can be used in the complex treatment of allergic manifestations.

It should be remembered that their use should be no more than 2 weeks, and should be taken separately from other medications and vitamins, since their effect and absorption are reduced.

Hormonal drugs

The disease is treated with hormonal drugs only if there is no effect from antihistamines and anti-inflammatory therapy. Medicines with hormones are not used for a long time, and only a doctor should select them for his patient.

Forecast

The prognosis for life is, of course, favorable. But if there is no normal and correct treatment, the disease will certainly progress and develop further, which can be expressed in an increase in the severity of signs of the disease (skin irritations appear under the nose and in the area of ​​the wings of the nose, sore throat, coughing, odor recognition deteriorates, nosebleeds, severe headaches) and in expanding the list of causally significant allergen irritants.

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10 comments

I have allergic rhinitis, I’ve tried a lot of remedies - tablets, drops of all sorts, nothing helps. And if it helps, then you need to drip almost every 20 minutes, the addiction is terrible.

I myself am already tired of treating allergies, the pills don’t help right away and you don’t feel very good, you constantly want to sleep and feel weak. This year my doctor recommended me Allergodil nasal spray. Firstly, it helped in ten minutes the nose could breathe) and secondly, it works from morning to evening, and long-term use is also possible (up to 6 months). And for me this is just a plus; I spray it all spring and summer.

I understand you very well, I myself am allergic and suffer, especially from birch blossoms in the spring. I tried a lot of different remedies and took pills, but settled on a spray called Allergodil, which helps cope with swelling and runny nose, in general, with all the “delights” of allergies. I smell it and after about 15 minutes my nose begins to breathe. And the morning “zilch” is enough for the whole day.

I suffer from fluff. As soon as it starts flying, everything is a stream of snot. Fortunately, the doctor recommended morenasal spray. It cleanses the mucous membrane well and flushes out allergens. Now the reaction to fluff is not so strong.

The pharmacy recommended a spray for allergic rhinitis called Allergodil. This is an antihistamine spray that works within 15 minutes, my nose breathes freely, my runny nose doesn’t bother me, I enjoy spring and summer with pleasure. The most important thing is that one application lasts for 12 hours!

But I also prefer using nasal sprays, since the pills make me sleepy and don’t work right away...

I discovered allergic rhinitis 35 years ago, I think I cured it, but it took years of annual treatment, histoglobulin, 3 years of seasonal acupuncture, day therapy, it seems to have cured it. Now sometimes there is not much nasal congestion, but they say I snore, I think it’s because of nasal congestion.

Previously, I was constantly bothered by a long runny nose. In the spring it became really bad, I went to the otolaryngologist and it turned out that I had allergic rhinitis (( He prescribed AquaMaster rinsing and antihistamines. This complex helped eliminate allergies, I was able to calmly be on the street and breathe freely through my nose. I still use AquaMaster for preventive purposes from flu and colds.

AquaMaster is also in our first aid kit now, I use it to rinse my child’s nose. Works effectively, irrigates the entire nasal mucosa well. My husband simply used this spray when he had a runny nose, he said he coped well with congestion, and using it made breathing easier.

I have Morenasal spray in my medicine cabinet for such cases. It cleanses the mucous membrane well of allergens and immediately makes breathing easier. In addition, I noticed that an allergic reaction occurs less often with it. And the convenient bottle lasts a long time.

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Source: http://simptomy-lechenie.net/allergicheskij-rinit/

Allergic rhinitis: symptoms and treatment of the disease

Allergic rhinitis (runny nose) is a symptom of allergies. This condition is accompanied by sneezing, mucus from the nose, difficulty breathing and itching. Most often, it is these symptoms that force a person to seek help from an allergist.

What is an allergic rhinitis

Allergic rhinitis is usually classified as an immune disease, that is, unpleasant symptoms appear when a person interacts with an allergen. In this case, the human body releases the active form of histamine, which leads to changes in the functioning of the entire body. Histamine dilates small vessels and narrows large ones, increasing capillary permeability. This causes the nasal mucosa to become red and swollen, blood pressure to drop, and a cough and runny nose to appear.

The disease does not threaten human life, but if it is not treated, it begins to progress. With proper drug treatment, you can completely get rid of unpleasant symptoms for a certain period of time. For remission to last longer, it is necessary to completely eliminate contact with the allergen.

Causes of allergic rhinitis:

  • Heredity;
  • Increased permeability of the nasal mucosa;
  • Frequent use of antibiotics;
  • Low blood pressure;
  • Contact with the allergen for a long time;
  • Frequent colds.

Currently, doctors divide rhinitis into two types: seasonal and year-round. Each of them has its own characteristics.

Seasonal runny nose

The cause of the development of this type of rhinitis is pollen from flowering plants, as well as fungal spores. The onset of the disease occurs in the warm season: April, May - trees bloom at this time; June, July – cereal plants bloom; August and early September – weeds bloom.

Year-round rhinitis

This type of disease can be caused by house dust. House dust includes: dust from books, soft toys, contact with down and feather pillows. In addition, a year-round runny nose can be caused by: medications, mold, household chemicals, and cosmetics.

Professional allergic rhinitis

Allergic occupational rhinitis is a special form of the disease. It differs from other types of allergic rhinitis in that it does not develop immediately, but gradually. This is due to the fact that the amount of allergen in the body increases slowly. And the symptoms of the disease make themselves felt when the concentration of the allergen in the body is high enough.

Allergic rhinitis in children

Allergies can occur even in an infant. In addition to pollen, the source of the allergen can be:

  • House dust;
  • Animals;
  • Fungus;
  • Soft toys and bedding;
  • In children under one year of age, allergies can be caused by food.

Indirect reasons for the development of childhood allergies can be:

  • Immaturity of the nervous and endocrine systems;
  • Improper metabolism;
  • Disruption of the gastrointestinal tract and liver;
  • Pathologies of nasopharynx development;
  • Blood diseases;
  • Presence of allergies in relatives;
  • Forced prolonged contact with allergens;
  • Frequent treatment with antibiotics.

Seasonal runny nose appears in a child during the flowering period of plants. At the same time, the baby suffers from nasal congestion, itching in the nose, ears and even on the skin of the face. At the same time, the child sneezes, eats poorly, and his eyes may water. Once flowering stops, allergy symptoms disappear.

But a year-round runny nose causes more problems for the baby’s parents. Allergy symptoms can occur throughout the year. Because of this, the child constantly walks with a stuffy nose, eats and sleeps poorly. Over time, the mucous membrane of the nasopharynx becomes thinner, and nosebleeds may appear. Children begin to breathe through their mouths, which leads to coughing and enlargement of the adenoids. It is also possible to develop ear pathologies. Due to insufficient oxygen supply to the body, headaches and shortness of breath appear. Such children are characterized by rapid fatigue and absent-mindedness.

Allergic rhinitis in adults

Allergies in adults are caused by the same allergens as in children. But they also add:

  • Various aerosols;
  • Cosmetical tools;
  • Cigarette smoke;
  • Household chemicals;
  • Car exhausts.

In adults, the disease develops in three stages:

  • Periodic nasal congestion. This symptom indicates that vascular tone is reduced.
  • Nasal congestion appears regularly. To alleviate this condition, the patient drips vasoconstrictor drugs into the nose.
  • The appearance of edema. Upon examination, the doctor may notice a bluish discoloration of the nasopharyngeal mucosa. In addition, the patient complains of difficulty breathing, which does not improve even with drops.

How to distinguish an allergic runny nose from a normal one

Normal rhinitis is accompanied by fever, headache, and cough. But allergic rhinitis is accompanied only by nasal congestion and swelling of the mucous membrane.

An allergic runny nose appears after contact with an allergen, and a regular runny nose appears after contact with a sick person.

Rhinitis that appears against the background of an acute respiratory infection goes away in 1-2 weeks. Allergic rhinitis lasts for months. In this case, a moment of remission of the disease is possible.

Allergies are characterized by watery, clear nasal discharge. A common runny nose is accompanied by thick yellow or green mucus.

Diagnosis of the disease

To make a diagnosis, the doctor only needs to examine the patient, hear complaints, study the results of a clinical blood test, immunological data, and also look at the results of specific allergy tests.

In the overall analysis, an increase in the number of eosinophils plays an important role. The most informative and fairly simple analysis is an allergen skin test. It is done as follows: cuts are made on the skin of the forearm and 1-2 drops of the allergen are applied. After 30 minutes they look at the reaction. Based on the area of ​​reaction and redness, the presence of an allergy to a particular substance is judged. The analysis is done quickly and has no contraindications. But before taking an allergen test, you need to stop taking antihistamines. The study is not carried out on children under 5 years of age and pregnant women.

Immunological analysis is based on determining the number of immunoglobulins, which are released in large quantities during allergies. The analysis allows you to identify the allergen itself, but is quite expensive.

In some cases, the doctor may prescribe additional tests. These include rhinomanometry (the patency of the nasal passages is studied), bacterial culture of the nasal mucosa (done to determine pathogenic microflora).

How to treat allergic rhinitis

Treatment is prescribed to the patient depending on the severity of the disease and age. Of course, it is not possible to completely cure allergies, but it is possible to significantly alleviate the symptoms of the disease.

Antihistamines are prescribed as the main remedy. For year-round rhinitis, they are taken during exacerbations, and for seasonal rhinitis, it is recommended to start taking the tablets before the plants begin to bloom.

If your nose is stuffy, your doctor may prescribe vasoconstrictor drops. They will help make breathing easier and reduce the amount of mucus produced.

To relieve inflammation of the nasopharyngeal mucosa, mast cell membrane stabilizers are prescribed. These are sprays that have a local effect.

If there is no improvement from the use of antihistamines and anti-inflammatory drugs, then hormonal drugs are prescribed. They can only be used as prescribed by a doctor.

Enterosorbents will help get rid of toxins. They are discharged for several days.

When it is known which allergen causes rhinitis, hyposensitization can be done. This means that a minimal dose of the allergen is introduced into the patient’s body. Over time, the body gets used to the effects of the allergen and the allergy either goes away or hardly manifests itself. This method is performed under the supervision of a doctor, and the full course can take more than one year.

Source: http://lessday.ru/zdorove/allergicheskiy-rinit-simptomy-i-lechenie-zabolevaniya