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rhinitis

 
Medical Encyclopedia: Rhinitis
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Definition

Rhinitis is inflammation of the mucous lining of the nose.

Description

Rhinitis is a nonspecific term that covers infections, allergies, and other disorders whose common feature is the location of their symptoms. In rhinitis, the mucous membranes become infected or irritated, producing a discharge, congestion, and swelling of the tissues. The most widespread form of infectious rhinitis, is the common cold.

The common cold is the most frequent viral infection in the general population, causing more absenteeism from school or work than any other illness. Colds are self-limited, lasting about 3-10 days, although they are sometimes followed by a bacterial infection. Children are more susceptible than adults; teenage boys more susceptible than teenage girls; and adult women more susceptible than adult men. In the United States, colds are most frequent during the late fall and winter.

— Rebecca J. Frey


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Dictionary: rhi·ni·tis   (rī-nī'tĭs) pronunciation
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n.
Inflammation of the nasal mucous membranes.


Dental Dictionary: rhinitis
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n

Inflammation of the mucous membranes of the nose, usually accompanied by swelling of the mucosa and a nasal discharge. Rhinitis may be acute, allegic, atrophic, or vasomotor.

Alternative Medicine Encyclopedia: Rhinitis
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Definition

Rhinitis is inflammation of the mucous lining of the nose.

Description

Rhinitis is a nonspecific term that covers nasal congestion due to infections, allergies, and other disorders. In rhinitis, the mucous membranes of the nose become infected or irritated, producing a discharge, congestion, and swelling of the tissues.

The most widespread form of infectious rhinitis is the common cold. The common cold is the most frequent viral infection in the general population. Colds are self-limited, lasting about three to 10 days, although they are sometimes followed by a bacterial infection.

Causes & Symptoms

Colds can be caused by as many as 200 different viruses which are transmitted by sneezing and coughing, by contact with soiled tissues or handkerchiefs, or by close contact with an infected person.

The onset of a cold is usually sudden. The virus causes the lining of the nose to become inflamed and produce large quantities of thin, watery mucus. The inflammation spreads from the nasal passages to the throat and upper airway, producing a dry cough, headache, and watery eyes. After several days, the nasal tissues become less inflamed and the watery discharge is replaced by a thick, sticky mucus. This change in the appearance of the nasal discharge helps to distinguish rhinitis caused by a viral infection from allergic rhinitis.

Allergies are another frequent cause of rhinitis which is called allergic rhinitis. Allergies occur when a person's immune system overreacts to a substance called an allergen. Airborne allergens can be just about anything but are commonly mold, pollen, dust mites, and pet dander. Symptoms of allergy include watery eyes, nasal discharge, sneezing, and headache.

Diagnosis

Viral rhinitis is diagnosed based on symptoms. Symptoms that last longer than a week may require further testing to rule out a secondary bacterial infection, or an allergy. Allergies can be evaluated by blood tests, skin testing for specific substances, or nasal smears.

Treatment

The many alternative treatments for colds and allergies will not be addressed here. Treatments specifically for rhinitis, regardless of the cause, are described.

Herbal Remedies

Flavonoids have anti-inflammatory activities and can be found in many plants including licorice, parsley, legumes (beans), onions, garlic, berries, and citrus fruits. Herbals which may help lessen the symptoms of rhinitis include:

  • astragalus (Astragalus membranaceous) root
  • baical skullcap (Scutellaria baicalensis) decoction
  • echinacea (Echinacea spp.)
  • elderflower (Sambucus nigra) tea
  • garlic, which contains anti-inflammatory compounds
  • goldenseal (Hydrastis canadensis)
  • horehound (Marrubium vulgare) tea relieves congestion
  • licorice (Glycyrrhiza glabra) has anti-inflammatory activity
  • mullein (Verbascum thapsus) is a decongestant and soothes mucous membranes
  • nettle (Urtica dioica) tea stops nasal discharge
  • onion, which contains anti-inflammatory compounds
  • thyme (Thymus vulgaris) tea, which is anti-inflammatory and soothes sore nasal tissues
  • walnut (Juglans nigra or regia) leaf tea, which stops nasal discharge

Other Remedies

Other natural remedies for rhinitis include those from traditional Chinese medicine. Chronic rhinitis is treated with acupuncture, ear acupuncture, and herbals taken internally or used externally. The most common rhinitis remedy is Bi Yan Pian (Bi is for nose.) There are many others, depending on the specific pattern of the patient. Magnolia flower and xanthium are commonly used herbs for rhinitis.

Less common Chinese remedies include Huo Dan Wan (Agastache and Pig's Gall Bladder Pill) taken three times daily. A decoction of Yu Xing Cao (Herba houttuyniae) may be taken internally. The patient can apply 30% Huang Lian Shui (Coptis Fluid), Huang Bai Shui (Phellodendron Fluid), Yu Xing Cao (Herba houttuyniae) juice, E Bu Shi Cao (Herba centipedae) decoction, or 1% ephedrine solution directly to the nose.

Colored light therapy is based upon the theory that an unhealthy body is lacking a specific color frequency. Green colored light therapy may relieve chronic rhinitis.

Homeopathic physicians prescribe any of 10 different remedies, depending on the appearance of the nasal discharge, the patient's emotional state, and the stage of infection.

Vitamin C is a natural antihistamine. Vitamin A and zinc may also be helpful.

Allopathic Treatment

There is no cure for the common cold; treatment is given for symptom relief. Medications include aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs) for headache and muscle pain, and decongestants to relieve stuffiness or runny nose. Antibiotics are ineffective against viral infections. Allergies are treated with anti-histamines (Benadryl).

Expected Results

Most colds resolve completely in about a week. Complications are unusual but may include sinusitis (inflammation of the nasal sinuses), bacterial infections, or infections of the middle ear. Allergies may resolve or may be lifelong.

Prevention

There is no vaccine effective against colds, and infection does not prevent one from getting colds. Prevention depends on washing hands often, minimizing contact with persons already infected, and not sharing hand towels, eating utensils, or water glasses. In 2002, researchers discovered a new antiseptic skin cleanser that may prevent hand-to-hand transmission of the rhinovirus that causes colds. The cleaner's active ingredient is salicylic or pyroglutamic acid, and each showed promising results for killing the virus on subject's hands.

Allergies may be prevented by avoiding the cause of the allergy, although this is not always possible or practical. Patients may become desensitized to the offending allergen by receiving a series of injections. In 2002, Australian researchers discovered a new potential vaccine that might boost immune response to allergens without the risk of side effects that come with some desensitizing vaccines available today.

Resources

Books

Berman, Stephen, and Ken Chan. "Ear, Nose, & Throat." Current Pediatric Diagnosis & Treatment. Edited by William W. Hay, Jr., et al. Stamford, CT: Appleton & Lange, 1997.

Jackler, Robert K., and Michael J. Kaplan. "Ear, Nose, & Throat." In Current Medical Diagnosis & Treatment 1998, edited by Lawrence M. Tierney Jr., et al. Stamford, CT: Appleton & Lange, 1997.

King, Hueston C., and Richard L. Mabry. "Rhinitis." In Current Diagnosis 9, edited by Rex B. Conn, et al. Philadelphia: W. B. Saunders Company, 1997.

Ying, Zhou Zhong, and Jin Hui De. "Common Diseases of the Nose." Clinical Manual of Chinese Herbal Medicine and Acupuncture. New York: Churchill Livingston, 1997.

Periodicals

"Antispetic Skin Cleansers May Prevent Rhinovirus Transmission." Clinical Infectious Diseases (February 1, 2002): ii.

Cocilovo, Anna. "Colored Light Therapy: Overview of its History, Theory, Recent Developments and Clinical Applications Combined with Acupuncture." American Journal of Acupuncture 27 (1999): 71–83.

"Potential Vaccine Boosts Hope for Pollen Relief." Immunotherapy Weekly (March 6, 2002): 3.

[Article by: Rebecca Frey; Belinda Rowland; Teresa G. Odle]

Children's Health Encyclopedia: Rhinitis
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Definition

Rhinitis is inflammation of the mucous lining of the nose.

Description

Rhinitis is a nonspecific term that covers infections, allergies, and other disorders whose common feature is the location of their symptoms. In rhinitis, the mucous membranes become infected or irritated, producing a discharge, congestion, and swelling of the tissues. The most widespread form of infectious rhinitis is the common cold. Doctors sometimes designate two different forms of rhinitis. These are allergic rhinitis and nonallergic rhinitis. Allergic rhinitis is cause by allergies, and nonallergic rhinitis is caused by other conditions such as the common cold.

Transmission

Nonallergic rhinitis is generally transmitted in the same ways as the common cold. It is transmitted from person to person. The sick person touches his or her nose and then another person's hands. If that person then touches his nose, mouth, or eyes, the infection is transmitted. Infection can also be transmitted through sharing of cups, silverware, or eating utensils, or by coughing or sneezing. Allergic rhinitis cannot be transmitted from person to person.

Demographics

The most frequent cause of nonallergic rhinitis is the common cold. The common cold is the most frequent viral infection in the general population, causing more absenteeism from school or work than any other illness. Colds are self-limited, lasting about three to 10 days, although they are sometimes followed by a bacterial infection. Children are more susceptible than adults; teenage boys more susceptible than teenage girls; and adult women more susceptible than adult men. In the United States, colds are most frequent during the late fall and winter. Allergic rhinitis is less common that nonallergic rhinitis. Allergic rhinitis affects between 20 and 40 million people in the United States. Children are more at risk for allergic rhinitis if one or both parents has allergies.

Causes and Symptoms

The onset of a cold is usually sudden. The virus causes the lining of the nose to become inflamed and produce large quantities of thin, watery mucus. Children sometimes develop a fever with a cold. The inflammation spreads from the nasal passages to the throat and upper airway, producing a dry cough, headache, and watery eyes. Some people develop muscle or joint aches and feel generally tired or weak. After several days, the nose becomes less inflamed and a thick, sticky mucus replaces the watery discharge. This change in the appearance of the nasal discharge helps to distinguish rhinitis caused by a viral infection from rhinitis caused by an allergy.

Allergic rhinitis is caused by allergens such as pollen, animal dander, dust mites, or grass. The symptoms of allergic rhinitis are similar to those of nonallergic rhinitis, except that they are usually much longer lasting and are rarely accompanied by a fever. These symptoms often occur at specific times of year if they are not constant.

When to Call the Doctor

If the symptoms of rhinitis persist for more than a week, or it they frequently occur in specific situations or during specific times of year, a doctor should be consulted. The doctor can then do tests to determine if the rhinitis is viral, bacterial, or caused by allergies and treat it accordingly.

Diagnosis

There is no specific test for viral rhinitis. The diagnosis is based on the symptoms. In children, the doctor will examine the child's throat and glands to rule out other childhood illnesses that have similar early symptoms. If the symptoms last for more than a week, the child may be tested further to rule out bacterial infections or allergies. Allergies can be evaluated by blood tests, skin testing for specific substances, or nasal smears.

Treatment

There is no cure for viral nonallergic rhinitis; treatment is given for symptom relief. Medications include aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs) for headache and muscle pain, and decongestants to relieve stuffiness or runny nose. Patients should be warned against overusing decongestants, because they can cause a rebound effect. Over-the-counter (OTC) antihistamines are also available; however, most anti-histamines carry warnings of drowsiness and the inability to do some tasks while medicated. Claritin is a prescription-strength OTC non-drowsy antihistamine that helps relieve symptoms of rhinitis. Antibiotics are not given for viral nonallergic rhinitis because they do not kill viruses. Supportive care includes bed rest and drinking plenty of fluid. Treatments under investigation, as of 2004, included the use of ultraviolet light and injections of interferon. If the nonallergic rhinitis has a bacterial cause at its root, antibiotics can be given; however, bacterial causes of rhinitis are not very common.

Allergic rhinitis is treated in a number of ways, including seasonal allergy medication, nasal sprays, and decongestants. If the cause of the allergies is determined to be an indoor allergen such as dust mites or pet dander, steps can be taken to rid the home of some of the allergens. Injections, or allergy shots, are also sometimes used to treat allergic rhinitis. A small amount of the allergen is injected at first, with tolerance built up over weeks or months. The shots are given frequently at first, but when a maintenance level of the allergen is reached, they are given less frequently. After a few years, they are no longer given at all. These shots have been found to be very effective in some cases, but there are often problems with compliance. Children may also find the experience of regular injections over such a long period to be distressing.

Alternative Treatment

Homeopaths might prescribe any of 10 different remedies, depending on the appearance of the nasal discharge, the patients emotional state, and the stage of infection. Naturopaths may recommend vitamin A and zinc supplements, together with botanical preparations made from echinacea (Echinacea spp.), goldenseal (Hydrastis canadensis), licorice (Glycyrrhiza glabra), or astragalus (Astragalus membraneceus) root.

Prognosis

Most rhinitis caused by a cold resolves completely in about a week. Complications are unusual but may include sinusitis (inflammation of the nasal sinuses), bacterial infections, or infections of the middle ear. Allergic rhinitis can usually be treated very effectively. Bacterial causes of rhinitis can usually be resolved fairly quickly with the use of antibiotics.

Prevention

There is no known way to successfully prevent allergic rhinitis. The only way to prevent viral and bacterial nonallergic rhinitis is to take the steps which prevent transmission of the common cold. These include:

  • washing hands often, especially before touching the face
  • minimizing contact with people already infected
  • not sharing hand towels, eating utensils, or water glasses

Parental Concerns

Rhinitis causes symptoms such as runny nose, itching, and sneezing that may be uncomfortable for the child. Nonallergic rhinitis is not thought to have any significant long-term consequences. Children who have allergic rhinitis may be at increased risk for developing asthma.

See also Allergic rhinitis; Allergies; Common cold.

Resources

Books

Busse, William W., and Holgate, Stephan T. eds. Asthma and Rhinitis. Malden, MA: Blackwell Science, 2000.

Long, Aidan, et al. Management of Allergic and Nonallergic Rhinitis. Rockville, MD: U.S. Dept. of Health and Human Services, Public Health Service, Agency for Healthcare Research and Quality, 2002.

Periodicals

Hopkinson, Kate, and Pauline Powell. "Management of Allergic Rhinitis." Primary Health Care 14, n0. 4 (May 2004): 43.

Wachter, Kerri. "Allergy Is Not Always Behind Rhinitis Symptoms: Separating Allergic from Nonallergic." Family Practice News 33, i.23 (December 1, 2003): 20.

Organizations

American Academy of Allergy, Asthma, Immunology. 555 East Wells Street, Suite 1100, Milwaukee, WI 53202-3823. Web site: www.aaaai.org.

[Article by: Tish Davidson, A.M. Rebecca J. Frey, PhD]


Sports Science and Medicine: rhinitis
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Inflammation of the nose, Acute rhinitis is a symptom of a common cold and hay fever. Rhinitis usually results in blockage of the nose, but this rarely limits aerobic performance because breathing switches from the nose to mouth when the minute ventilation volume rises above 25 l. Rhinitis has assumed far greater importance in sports medicine than it really deserves, because many of the drugs used to treat the condition contain banned substances (e.g. codeine). Several elite athletes have been disqualified from competitions because they have used these substances.

Veterinary Dictionary: rhinitis
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Inflammation of the mucous membrane of the nose. It may be mild and chronic, or acute. There are signs of wheezing, sneezing and respiratory stertor at all levels. There is a strong nasal discharge which may be serous to purulent.

  • allergic r., anaphylactic r. — any allergic reaction of the nasal mucosa, occurring perennially (nonseasonal allergic rhinitis) or seasonally.
  • atrophic r. — see atrophic rhinitis.
  • bovine atopic r. — see enzootic nasal granuloma.
  • catarrhal r. — the common form of rhinitis with a transitory catarrhal discharge.
  • familial allergic r. — a rarely recorded disease of cattle.
  • fibrinous r. — rhinitis with development of a false membrane.
  • hypertrophic r. — that with thickening and swelling of the mucous membrane.
  • inclusion body r. — see inclusion body rhinitis.
  • membranous r. — chronic rhinitis with a membranous exudate.
  • necrotic r. — see necrotic rhinitis.
  • parasitic r. — see pneumonyssus caninum.
  • polypous r. — chronic rhinitis associated with polyps in the nasal cavity.
  • pseudomembranous r. — coagulated discharge clings to the mucosa like a membrane but can be peeled off without leaving a mucosal lesion.
  • purulent r. — chronic rhinitis with formation of pus.
  • vasomotor r. — 1. nonallergic rhinitis in which transient changes in vascular tone and permeability (with the same symptoms of allergic rhinitis).
    • — 2. any condition of allergic or nonallergic rhinitis, as opposed to infectious rhinitis.
Wikipedia: Rhinitis
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Rhinitis
Classification and external resources
ICD-10 J00., J30., J31.0
ICD-9 472.0, 477
OMIM 607154
DiseasesDB 26380
MedlinePlus 000813
eMedicine ent/194 med/104, ped/2560
MeSH D012220

Rhinitis (pronounced /raɪˈnaɪtɪs/), commonly known as a runny nose, is the medical term describing irritation and inflammation of some internal areas of the nose. The primary symptom of rhinitis is nasal dripping. It is caused by chronic or acute inflammation of the mucous membrane of the nose due to viruses, bacteria or irritants. The inflammation results in the generating of excessive amounts of mucus, commonly producing the aforementioned runny nose, as well as nasal congestion and post-nasal drip. According to recent studies completed in the United States, more than 50 million Americans are current sufferers.[clarification needed] Rhinitis has also been found to adversely affect more than just the nose, throat, and eyes. It has been associated with sleeping problems, ear conditions, and even learning problems.[1] Rhinitis is caused by an increase in histamine. This increase is most often caused by airborne allergens. These allergens may affect an individual's nose, throat, or eyes and cause an increase in fluid production within these areas.

Contents

Types

Rhinitis is categorized into three types: infective rhinitis includes acute and chronic bacterial infections; nonallergic (vasomotor) rhinitis includes autonomic, hormonal, drug-induced, atrophic, and gustatory rhinitis, as well as rhinitis medicamentosa; allergic rhinitis, the mic reaction triggered by pollen, mold, animal dander, dust and other similar inhaled allergens.[2]

Vasomotor rhinitis

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Vasomotor rhinitis is also known as non-allergenic rhinitis, because it often has the same symptoms as allergies, but has different causes. Whereas allergenic rhinitis conditions (such as hayfever) are the result of the immune system overreacting to environmental irritants (pollen, etc), vasomotor rhinitis is believed to be caused by oversensitive or excessive blood vessels in the nasal membrane. These blood vessels (which are controlled in turn by the autonomic nervous system) contract or dilate in order to regulate mucus flow and congestion. But in the vasomotor rhinitis sufferer, oversensitive or excessive blood vessel dilation or contraction causes an overreaction to such stimuli as changes in weather, temperature, or barometric pressure, chemical irritants such as smoke, ozone, pollution, perfumes, and aerosol sprays, psychological stress and emotional shocks, certain types of medications, alcohol, and even spicy food. Thus, while a normal individual's nose may run on a very cold day, a vasomotor rhinitis sufferer's nose may start running (or go completely dry) simply by walking into a slightly colder (or slightly warmer) room, or from eating food that is slightly warmer or cooler than room temperature. While a normal individual may tolerate a certain degree of cigarette smoke, the vasomotor rhinitis sufferer may experience significant discomfort from the same level of smoke, etc.

The pathology of vasomotor rhinitis is in fact not very well-understood and more research is needed. Vasomotor rhinitis appears to be significantly more common in women than men, leading some researchers to believe hormones to play a role. In general, age of onset occurs after 20 years of age, in contrast to allergic rhinitis which generally appears before age 20. Individuals suffering from vasomotor rhinitis typically experience symptoms year-round, though symptoms may exacerbate in the spring and fall when rapid weather changes are more common.

Many patients can be subject to vasomotor rhinitis and allergic rhinitis simultaneously. Vasomotor rhinitis is a common condition that often goes unrecognized/underrecognized, especially in women. Vasomotor Rhinitis is a diagnosis of exclusion reached after other conditions have been ruled out.[3] An estimated 17 million United States citizens have vasomotor rhinitis.

Allergic rhinitis

See also: Allergy

When an allergen such as pollen or dust is inhaled by an individual with a sensitized immune system, it triggers antibody production. These antibodies mostly bind to mast cells, which contain histamine. When the mast cells are stimulated by pollen and dust, histamine (and other chemicals) are released. This causes itching, swelling, and mucus production. Symptoms vary in severity between individuals. Very sensitive individuals can experience hives or other rashes. Particulate matter in polluted air and chemicals such as chlorine and detergents, which can normally be tolerated, can greatly aggravate the condition.

Sufferers might also find that cross-reactivity occurs.[4] For example, someone allergic to birch pollen may also find that they have an allergic reaction to the skin of apples or potatoes.[5] A clear sign of this is the occurrence of an itchy throat after eating an apple or sneezing when peeling potatoes or apples. This occurs because of similarities in the proteins of the pollen and the food.[6] There are many cross-reacting substances.

Some disorders may be associated with allergies: Comorbidities include eczema, asthma, depression and migraine.[7]

Allergies are common. Heredity and environmental exposures may contribute to a predisposition to allergies. It is roughly estimated that one in three people have an active allergy at any given time and at least three in four people develop an allergic reaction at least once in their lives. The two categories of allergic rhinitis include:

  • Seasonal – occurs particularly during pollen seasons. Seasonal allergic rhinitis does not usually develop until after 6 years of age.
  • Perennial – occurs throughout the year. This type of allergic rhinitis is commonly seen in younger children.[8]

Allergy testing may reveal the specific allergens an individual is sensitive to. Skin testing is the most common method of allergy testing. This may include intradermal, scratch, patch, or other tests. Less commonly, the suspected allergen is dissolved and dropped onto the lower eyelid as a means of testing for allergies. (This test should only be done by a physician, never the patient, since it can be harmful if done improperly). In some individuals who cannot undergo skin testing (as determined by the doctor), the RAST blood test may be helpful in determining specific allergen sensitivity.

Hay fever

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For the play, see Hay Fever.
Pollen grains from a variety of common plants can cause hay fever.

Allergic rhinitis triggered by the pollens of specific seasonal plants is commonly known as "hay fever", because it is most prevalent during haying season. However, it is possible to suffer from hay fever throughout the year. The pollen which causes hay fever varies between individuals and from region to region; generally speaking, the tiny, hardly visible pollens of wind-pollinated plants are the predominant cause. Pollens of insect-pollinated plants are too large to remain airborne and pose no risk. Examples of plants commonly responsible for hay fever include:

In addition to individual sensitivity and geographic differences in local plant populations, the amount of pollen in the air can be a factor in whether hay fever symptoms develop. Hot, dry, windy days are more likely to have increased amounts of pollen in the air than cool, damp, rainy days when most pollen is washed to the ground.

The time of year at which hay fever symptoms manifest themselves varies greatly depending on the types of pollen to which an allergic reaction is produced. The pollen count, in general, is highest from mid-spring to early summer. As most pollens are produced at fixed periods in the year, a long-term hay fever sufferer may also be able to anticipate when the symptoms are most likely to begin and end, although this may be complicated by an allergy to dust particles.

Prevention and treatment

The goal of rhinitis treatment is to reduce the symptoms caused by the inflammation of affected tissues. In cases of allergic rhinitis, the most effective way to decrease allergic symptoms is to completely avoid the allergen.[9][10] Vasomotor rhinitis can be brought under a measure of control through avoidance of irritants, though many irritants, such as weather changes, are uncontrollable.

Allergic treatment

Main article: Allergy treatment

Allergic rhinitis can typically be treated much like any other allergic condition.

Eliminating exposure to allergens is the most effective preventive measure, but requires consistent effort.

Many people with pollen allergies reduce their exposure by remaining indoors during hay fever season, particularly in the morning and evening, when outdoor pollen levels are at their highest. Closing all the windows and doors prevents wind-borne pollen from entering the home or office. When traveling in a vehicle, closing all the windows reduces exposure. Air conditioners are reasonably effective filters, and special pollen filters can be fitted to both home and vehicle air conditioning systems.[11]

Because many allergens cling to clothing, skin, and hair, regular cleaning reduces exposure and therefore symptoms. Many people bathe before sleeping, to minimize their exposure to potential allergens that could have stuck to their bodies during the day. Some people use nasal irrigation to physically remove contaminants from their noses.

Frequently cleaning floors and washing bedding can significantly reduce local irritants such as dust, as well as those tracked in by family, pets and visitors.

Several antagonistic drugs are used to block the action of allergic mediators, or to prevent activation of cells and degranulation processes. These include antihistamines, cortisone, dexamethasone, hydrocortisone, epinephrine (adrenaline), theophylline and cromolyn sodium. Anti-leukotrienes, such as Montelukast (Singulair) or Zafirlukast (Accolate), are FDA approved for treatment of allergic diseases.[12] One antihistamine, Azelastine (Astelin), is available as a nasal spray.

More severe cases of allergic rhinitis require immunotherapy (allergy shots) or removal of tissue in the nose (e.g., nasal polyps) or sinuses.

Many allergy medications can have unpleasant side-effects, most notably drowsiness; more serious side-effects such as asthma, sinusitis, and even nasal polyps have also been reported however.

A case-control study found "symptomatic allergic rhinitis and rhinitis medication use are associated with a significantly increased risk of unexpectedly dropping a grade in summer examinations".[13]

Nasal treatments

See also: Anti-inflammatory use of glucocorticoids

Systemic Glucocorticoids such as Triamcinolone or Prednisone are effective at reducing nasal inflammation, but their use is limited by their short duration of effect and the side effects of prolonged steroid therapy. Steroid nasal sprays are effective and safe, and may be effective without oral antihistamines. These medications include, in order of potency: beclomethasone (Beconase), budesonide (Rhinocort, Noex), flunisolide (Syntaris), mometasone (Nasonex), fluticasone (Flonase, Flixonase), triamcinolone (Nasacort AQ). They take several days to act and so need be taken continually for several weeks as their therapeutic effect builds up with time.

Topical decongestants: may also be helpful in reducing symptoms such as nasal congestion, but should not be used for long periods as stopping them after protracted use can lead to a rebound nasal congestion (Rhinitis medicamentosa).

Saltwater sprays, rinses or steam: this removes dust, secretions and allergenic molecules from the mucosa, as they are all instant water soluble.

For some patients, especially those with severe non-allergenic rhinitis which at times can produce large amounts of thick mucous, rinsing is the preferred treatment. The nasal passages and sinuses are flooded with warm salty water. The solution should be pH balanced. It should contain Sodium Chloride and Sodium Bicarbonate. There are commercially available preparations which speed the rinsing process as patients may need to repeate the rinse many times during a day.

Rinsing is very often recommend as part of the healing process after sinus or nasal surgery. For this rinse, boiled or distilled water is only necessary during recovery from surgery, as the entire contents of the bottle is used..[14]

Alternative treatments

A large number of over-the-counter treatments are sold, including herbs like eyebright (Euphrasia officinalis), nettle (Urtica dioica), and bayberry (Myrica cerifera), which have not been shown to reduce the symptoms of nasal-pharynx congestion. In addition, feverfew (Tanacetum parthenium) and turmeric (Curcuma longa) has been shown to inhibit phospholipase A2, the enzyme which releases the inflammatory precursor arachidonic acid from the bi-layer membrane of mast cells (the main cells which respond to respiratory allergens and lead to inflammation) but this is only in test tubes and it is not established as anti-inflammatory in humans.

It has been claimed that homeopathy provides relief free of side-effects. However, this is strongly disputed by the medical profession on the grounds that there is no valid evidence to support this claim.[15]

Therapeutic efficacy of complementary-alternative treatments for rhinitis and asthma is not supported by currently available evidence.[16][17]

Nevertheless, there have been some attempts with controlled trials[18] to show that acupuncture is more effective than antihistamine drugs in treatment of hay fever. Complementary-alternative medicines such as acupuncture are extensively offered in the treatment of allergic rhinitis by non-physicians but evidence-based recommendations are lacking. The methodology of clinical trials with complementary-alternative medicine is frequently inadequate.[citation needed] Meta-analyses provides no clear evidence for the efficacy of acupuncture in rhinitis (or asthma).[citation needed] Currently, evidence-based recommendations for acupuncture or homeopathy cannot be made in the treatment of allergic rhinitis.[citation needed]

Eating locally produced unfiltered honey is believed by many to be a treatment for hayfever, supposedly by introducing manageable amounts of pollen to the body. Clinical studies have not provided any evidence for this belief.[19] However, the 2002 study, widely cited as evidence against the efficacy of honey treated patients, was conducted strictly during the pollen season while advocates of honey recommend beginning treatment well before the season begins, or even year round. [20]

See also

References

  1. ^ "Rhinitis and quality of life". http://www.stallergenes.com/en/sciences-innovation/the-respiratory-allergens/rhinitis-asthma-and-quality-of-life.html. 
  2. ^ Allergic
  3. ^ Patricia W. Wheeler, M.D. and Stephen F. Wheeler, M.D.. ""Vasomotor Rhinitis" American Family Physician". http://www.aafp.org/afp/20050915/1057.html. Retrieved 2009-03-10. 
  4. ^ Czaja-Bulsa G, Bachórska J (1998). "[Food allergy in children with pollinosis in the Western sea coast region]". Pol Merkur Lekarski 5 (30): 338–40. PMID 10101519. 
  5. ^ Yamamoto T, Asakura K, Shirasaki H, Himi T, Ogasawara H, Narita S, Kataura A (2005). "[Relationship between pollen allergy and oral allergy syndrome]". Nippon Jibiinkoka Gakkai Kaiho 108 (10): 971–9. PMID 16285612. 
  6. ^ Malandain H (2003). "[Allergies associated with both food and pollen]". Allerg Immunol (Paris) 35 (7): 253–6. PMID 14626714. 
  7. ^ "Allergists Explore Rising Prevalence and Unmet Needs Attributed to Allergic Rhinitis". ACAAI. November 12, 2006. http://www.acaai.org/public/linkpages/NR+Rising+Prevalence+and+Unmet+Needs+of+Allergic+Rhinitis.htm. Retrieved 2008-10-01. 
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Inflammation
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v • d • e
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Respiratory system
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Translations: Rhinitis
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Dansk (Danish)
n. - [med.] rhinitis, snue

Nederlands (Dutch)
neusontsteking

Français (French)
n. - rhinite

Deutsch (German)
n. - (Med.) Rhinitis, Nasenschleimhautentzündung

Ελληνική (Greek)
n. - (παθολ.) ρινίτιδα

Italiano (Italian)
rinite

Português (Portuguese)
n. - rinite (f) (Med.)

Русский (Russian)
воспаление слизистой оболочки носа

Español (Spanish)
n. - rinitis

Svenska (Swedish)
n. - inflammation i näsan

中文（简体）(Chinese (Simplified))
鼻炎, 鼻粘膜炎

中文（繁體）(Chinese (Traditional))
n. - 鼻炎, 鼻粘膜炎

한국어 (Korean)
n. - 비염, 코카타르

日本語 (Japanese)
n. - 鼻炎

العربيه (Arabic)
‏(الاسم) إلتهاب الانف‏

עברית (Hebrew)
n. - ‮דלקת האף‬

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