Allergic rhinitis affects about 500 million people throughout the world, and its incidence is increasing, reports ARIA, the Allergic Rhinitis and its Impact on Asthma workshop expert panel. Proper management of this condition entails accurate diagnosis, appropriate medication, patient education, and prevention. A wide range of treatments are available to relieve allergic rhinitis. Experts recommend tailoring treatment for each patient, using a stepwise management approach. Prescribers should adhere to new treatment guidelines, such as those issued by ARIA.
Proper Diagnosis
Although correct diagnosis of allergic rhinitis has increased because of the standardization of allergen tests, many people do not consult a doctor for nasal symptoms related to allergies. Instead they buy over-the counter drugs at the pharmacy that do not appropriately treat their condition, reports ARIA. Allergy rhinitis is most often managed by general practitioners, who may not always recognize the difference between allergy and the common cold.
Stepwise Management
ARIA recommends a stepwise approach to treating allergic rhinitis, with more extreme measures such as allergy shots or surgery reserved until other options have been tried. The therapy chosen should be individualized for each patient and should consider the severity and duration of allergy, the patient's preference, as well as the cost and availability of each medication.
Nasal Steroids
Nasal steroids, which are available only by prescription, are the single most effective drug for the treatment of allergic rhinitis in both children and adults, reports ARIA. Nasal steroids help prevent and treat nasal congestion, one of the most bothersome symptoms, and relieve nasal itching and runny nose as well, reports ARIA and the Mayo Clinic. These agents also relieve eye symptoms.
Antihistamines
An antihistamine pill is the first treatment choice for mild allergic rhinitis and may be added after one week of therapy with nasal steroids for moderate or severe allergy, according to the ARIA guidelines. Both ARIA and the Mayo Clinic recommend using the newer over-the-counter antihistamines such as loratadine instead of older agents such as diphenhydramine, which are more likely to cause drowsiness. Antihistamines are available as pills, nasal sprays and eyedrops, which should be used when eye symptoms are especially troublesome, reports ARIA.
Prevention
Taking steps to limit exposure to allergens is an important part of managing seasonal allergies, reports the Mayo Clinic. Preventive measures include closing doors and windows and not hanging laundry outside during pollen season. Using an air conditioner, dehumidifier, or specialized air purifer such as a HEPA filter also reduces allergic reactions. Experts also recommend avoiding going outdoors in the early morning when pollen counts are the highest.
Asthma
People with allergic rhinitis, especially those whose symptoms are severe or persistent, should be checked for asthma, according to ARIA experts. Effectively treating allergies can prevent asthma from developing.
References
- "Allergic Rhinitis and its Impact on Asthma (ARIA) 2008 Update"; Bousquet J, et al. Allergy.
- MayoClinic.com: Hay Fever
