When you’re sniffling, sneezing, and feeling congested, allergic rhinitis is often the culprit. At London ENT, we understand that gaining comprehensive knowledge about this common condition, its symptoms, and treatment options can significantly improve your quality of life. In the following article, we delve into what allergic rhinitis is, how to identify the common allergens that trigger it, and various treatment modalities including medical therapies and surgical options. Whether you’re new to the world of allergies or looking to gain a deeper insight, this guide aims to offer comprehensive information tailored to the needs of those in Essex.
What is allergic rhinitis?
Allergic rhinitis is a major health problem which affects up to 20% of the general population. It is a condition in which there is inflammation of the inner lining of the nose (‘rhinitis’) which is caused by an allergy. The commonest type of allergy is usually to something that is breathed in. This is particularly prevalent in Essex, where air pollution and pollen can exacerbate symptoms. One of the functions of the nose is to filter unwanted particles from the air, and if you are allergic to one of these particles, this will cause inflammation of the lining of the nose to an extent which is out of proportion to the amount of allergen inhaled.
What are the symptoms of allergic rhinitis?
When inflammation occurs within the nose, this causes a feeling of a blocked nose, sneezing, watery discharge from the nose and itchy eyes. Sometimes the nasal discharge can become thicker and more mucous-like, particularly if there is continued exposure to the allergen or if the sinuses become involved. In addition, some people experience wheezing and shortness of breath, which occurs when the allergen affects the lungs. This can happen in anyone, not only those with asthma. In fact, even if you do not currently have asthma, the risk of developing asthma if you already have allergic rhinitis is 3 times greater than for the general population. This is why at London ENT, based in Essex, we offer comprehensive diagnosis and treatment plans.
What are the most common allergens that cause allergic rhinitis?
The most common airborne allergens triggering allergic rhinitis include pollens, house dust mite, and animal dander from cats and dogs. In regions like London and Essex, pollutants and certain types of pollens can be more prevalent, making the condition more challenging to manage. Other substances like dairy products, alcohol, seafood, and nuts can also cause allergic rhinitis. At London ENT, we offer specialised testing to identify these allergens, helping residents of London and Essex tailor their allergy avoidance strategies.
How do I find out if I am allergic to something?
Most people have an inkling of whether they are allergic to a substance based on past reactions upon exposure. If you suspect an allergy, avoiding the suspected item to see if symptoms diminish is a practical first step. For more conclusive results, London ENT offers tests like skin prick allergy tests and blood tests that can be particularly helpful for those living in London and Essex.
What is the treatment for allergic rhinitis in Essex?
The cornerstone of treatment involves allergen avoidance, which can be particularly challenging given the urban and suburban environments of Essex. At London ENT, we provide comprehensive treatment plans that may include antihistamines to alleviate symptoms like itching and sneezing, and intranasal steroid sprays to reduce inflammation. Avoiding all instances of possible exposure may simply not be practical or possible. For example, a gardener unfortunate enough to have an allergy to tree pollen may never be able to avoid this allergen.
In terms of medical therapies, antihistamines are widely used for allergic rhinitis as they reduce symptoms of itching, sneezing, and watery nasal discharge. Intranasal steroid sprays are also extremely effective as they diminish the inflammation of the lining of the nose, thereby relieving the feeling of nasal blockage. Sometimes, nasal decongestants need to be used for short-term symptom relief. Saltwater douches can also be helpful by clearing mucus from the nose and eliminating irritants and allergens from the nasal cavity, thereby allowing nasal steroid sprays to work more effectively.
Is there a role for surgery in allergic rhinitis?
Most Essex people with allergic rhinitis are successfully managed with allergy avoidance and medical therapies. However, there are certain situations in which surgery may have a role.
Indications for surgery in allergic rhinitis:
- Persistent symptoms resistant to medical treatment
- Anatomically large, swollen intranasal tissue (inferior turbinates)
Surgery in general involves resection or reduction of the inferior turbinates, which are structures within the nose that swell up in response to allergy or infection. Excessive and persistent exposure to an allergen can result in swelling to such a degree that causes a permanent enlargement of these turbinates. This results in nasal block which cannot always be reversed by medications alone.
- Resection: Total resection restores the intranasal airway but can be associated with problems with crusting and bleeding because of the destruction of the highly specialised mucosal lining
- Reduction: This involves the reduction of the mucosal surface only. Improvement in the nasal airway does occur but the benefits are generally short-lived and the procedure often needs to be repeated. Diathermy is the most commonly adopted technique
- Turbinoplasty: In this procedure, the outer part of the inferior turbinate is removed, leaving the inner mucosal lining intact which is crucial in restoring normal nasal physiology.
Advantages of the Turbinoplasty technique include considerably less intra-operative bleeding, reduced likelihood of long-term crusting owing to the preservation of the mucosa, and persistence of benefits in the long term. This lower morbidity operation therefore offers the same advantages of both of the above alternative procedures without the associated disadvantages. London ENT offers various surgical options, including Turbinoplasty, particularly for patients in Essex with persistent symptoms.
What are the other conditions that can be associated with allergic rhinitis?
Allergic rhinitis occurs as part of an immune system-mediated hypersensitivity reaction to a particular substance or allergen. There are other conditions that can occur in the body which are also caused by a similar hypersensitivity of the immune system to certain agents. For example, eczema is a condition of extreme sensitivity of the skin to certain topically applied substances. This results in itching, dryness and redness of the skin in a manner analogous to that of allergic rhinitis.
Asthma is a condition of the lower airways and lungs which is caused, as part of its underlying pathophysiology, by a hypersensitivity of the airways to certain triggers such as pollens, exposure to cold or smoke, or exercise. It is well established that patients with allergic rhinitis are 3 times more likely to develop asthma at some stage in their lives. Furthermore, patients with both asthma and allergic rhinitis find that their asthma symptoms are more severe and require more medications than in patients with asthma alone. What is interesting is that in patients with both conditions, treatment of the allergic rhinitis alone with topical intranasal steroid sprays results in a reduction in their asthma symptoms and a decrease in the amount of medications they need to take for their asthma. Given that asthma can be a life threatening condition, taking a nasal spray is a simple and potentially significant intervention.
Treating allergic rhinitis at London ENT can often alleviate symptoms of these associated conditions, making it a vital part of healthcare especially for those living in Essex.
For more information please contact London ENT on 0203 865 7225