Allergic rhinitis, also known as allergic rhinitis, is an allergic disease of the nasal mucosa and can cause a variety of complications. There is another type of allergic rhinitis that is induced by non-specific stimuli, without the participation of specific allergens, and is not an immune reaction process, but has clinical manifestations similar to those of allergic rhinitis, called vasomotor rhinitis or neuroreflex rhinitis.
Allergic constitution is genetically related and is usually genetic in origin. Most patients with allergic rhinitis have a family history of allergy, but in recent years, due to accelerated industrialization and increased atmospheric pollution, some people who were originally non-allergic have evolved into allergic. In addition, children who are partial eaters are also susceptible to this disease.
The disease can be triggered when an allergic person comes into contact with an allergen. The allergens that cause the disease are divided into two categories: inhalant and food based on the way they enter the body.
1, inhalation allergens
(1) Pollen is not all plant pollen can cause the disease. Only those pollen with high pollen volume, wide vegetation area, strong allergens and spread by wind are most likely to become allergens. Due to the differences in vegetation species, pollen with allergic potential varies from region to region. China is a vast country, and allergenic pollen is not uniform from region to region, with wild artemisia pollen dominating in the northern region. In recent years, it is believed that with the continuous development of industrialization, the concentration of sulfur dioxide and other harmful substances in the air has increased, which can cause the protein structure of pollen suspended in the air to mutate, so that pollen that originally does not have allergic origin also has a strong allergic origin. This may be one of the main reasons for the significant increase in incidence. There is significant seasonality in both the types and levels of pollen in the air, with spring and summer/autumn being the peaks of pollen dispersal.
(2) The fungus is extremely widespread in nature and is mainly found in soil and decaying organic matter. Its mycelial spores can be widely spread by wind, and the number in the air is sometimes higher than pollen, and higher in rural than urban areas. Indoor high temperature and dark and humid is conducive to fungal growth. Indoor ornamental flower pots in the soil also often become a good place for fungal growth.
(3) House dust mites are spiders of the phylum Arthropoda. They are mainly found in all corners of the house, with the most dust in mattresses, pillows, sofa cushions and other places. The excrement, eggs, debris and disintegrated limbs of mites can be allergens.
(4) Animal dander Animal dander is one of the strongest allergens. Susceptible individuals can be sensitized if they have long-term contact with the animal in question. After sensitization, even a small amount of dander can trigger nasal symptoms. Animal dander that causes respiratory allergic reactions mainly comes from animals in close contact with people, such as domestic pets (ornamental dogs, cats), domestic dogs, cattle, horses and sheep.
(5) feathers poultry or bedding, pillows and clothing in the feathers, domestic ornamental birds shed feathers, all can be allergens.
(6) Indoor dust is one of the common allergens that cause perennial rhinitis. Its composition is quite complex and is a hodgepodge of various substances, including animal, plant and chemical substances.
2. Ingestion allergy
Allergic substances that enter the body from the digestive tract and cause nasal symptoms. The way it acts on the nasal mucosa is very complex and still not very clear. Milk, eggs, fish and shrimp, meat, fruits, and even certain vegetables can be allergens.
The dangers of allergic rhinitis
Allergic rhinitis is a disease that seriously affects the quality of life, but is often not taken seriously. Allergic rhinitis makes work and study much less efficient, and some patients cannot even go to work or school normally at all, and interpersonal interactions are severely limited. Therefore, the danger of allergic rhinitis should not be underestimated.
There is no greater danger than the series of complications caused by allergic rhinitis, which seriously endanger people’s health.
(1) Asthma
The risk of asthma is 8-20 times higher in patients with allergic rhinitis than in normal people. A significant number of asthma patients have allergic rhinitis symptoms before an asthma attack. Asthma is usually present after the onset of nasal and ocular symptoms. In some patients, asthma can appear at the same time as nasal and ocular symptoms, or some have asthma first and nasal symptoms several years later. Asthma attacks are mainly expiratory dyspnea with croup; severe cases are accompanied by chest tightness, breath-holding, and inability to lie down, often in a sitting or semi-sitting position to help breathing. Long-term attacks of asthma can be complicated by emphysema and pulmonary heart disease, seriously affecting the health and quality of life of patients.
(2) Otitis media
As the swollen or edematous nasal mucosa is continuous with the mucosa of the eustachian tube, the same lesion can occur in the mucosa of the eustachian tube. When the swollen and edematous mucosa of the eustachian tube reaches a certain level, it can lead to obstruction of the eustachian tube, fluid accumulation in the middle ear cavity, and conductive deafness, which is called allergic otitis media.
(3) Sinusitis
It is caused by swollen or edematous nasal mucosa blocking the sinus openings in the middle and upper nasal passages. Almost all patients with allergic rhinitis have varying degrees of allergic sinusitis, and the invaded sinuses are often bilateral or total.
(4) Other
Some children with allergic rhinitis often breathe through their mouths due to long-term nasal congestion, which can lead to maxillary dysplasia, inconspicuous zygomatic arches, and a dull face that becomes adenoidal. Pediatric patients often push the tip of their noses upward by hand due to nasal congestion, forming a horizontal fold in the back of the nose. Some patients with allergic rhinitis, including adults and children, may have blue spots under the lower lids or dark circles under the eyes, called allergic “coloring”, which is caused by long-term swelling or edema of the mucous membranes of the nasal cavity and sinuses, which compresses the veins and leads to obstruction of venous return. Some patients with allergic rhinitis may develop nasal polyps in combination.
Treatment
For the prevention and treatment of allergic rhinitis, one is to avoid allergens as much as possible, the second is to take oral anti-allergy drugs, and the third is desensitization treatment. At present, the Department of Otorhinolaryngology of our hospital adopts sublingual desensitizing drugs to treat allergic rhinitis with good efficacy and has accumulated certain experience. Sublingual medication is more easily accepted by patients, especially children, than subcutaneous injection for desensitization treatment.
Misconceptions
It doesn’t matter whether to treat or not
Many people think that allergic rhinitis is just a little painful when it strikes, and afterwards it remains the same as a healthy person, so it does not matter whether it is treated or not. In fact, if allergic rhinitis is not treated in time, it may lead to sinusitis and nasal polyps, and long-term improper treatment may also lead to otitis media, loss of sense of smell and even asthma.
Treating allergic rhinitis as a cold
Some people have symptoms such as itchy nose, sneezing, runny nose and nasal congestion in spring and autumn, mistaking them for “stubborn cold” or “heat stroke” caused by improper dressing and diet in the new season, and fearing that going to the hospital will take time and money, they simply take cold medication on their own. As a result, the course of the disease is prolonged, and eventually it can be a continuous state of nasal congestion and runny nose all year round.
Abuse of decongestants
Some patients, because of long-term nasal congestion, simply apply local decongestants for treatment, and the application is more arbitrary, the accumulation of up to 5-10 times a day. Since these nasal drops usually have strong vasodilatory rebound effect, which is the most common cause of drug rhinitis, the course of treatment should not exceed three days, and the number of daily nasal drops should not exceed three times.
Premature discontinuation of medication
Many patients use medication only when they are ill and stop taking it as soon as their symptoms are relieved, resulting in allergic rhinitis that is sometimes good and sometimes bad, or even getting worse. We suggest that for perennial allergic rhinitis, treatment should be continued for 1 to 2 months for each attack, and some patients even need to be treated for half a year; while for seasonal allergic rhinitis, medication should be used 2 to 3 weeks in advance, and after the season, medication should not be stopped immediately, but continued for about two weeks.
Many people think that allergic rhinitis is better with some nasal drops. As a result, over time, not only is the disease not cured, but also because of the use of nasal drops for too long, resulting in drug rhinitis attacks. It is: the old disease has not been removed, the new disease has started again, adding to the problem.
Daily care
The daily care of allergic rhinitis includes the following aspects.
● Avoid contact with allergens;
Avoid eating cold, raw, cold and other stimulating foods; be cautious of eating fish, shrimp, crab and other seafood; eat foods that benefit lung energy;
Quit smoking and avoid second-hand smoke, and avoid places with dirty air;
Avoid smoking and second-hand smoke.
Use proper nasal rubbing methods;
It is not advisable to use too many vasoconstrictive nasal drops.