1.What is allergic rhinitis?
Allergic rhinitis in children is a disease caused by the inhalation of external allergic antigens, with nasal itching, sneezing, runny nose and nasal obstruction as the main symptoms.
2.What are the causes of allergic rhinitis?
(1) Genetics and constitution: According to statistics, the incidence of allergic diseases in children with both parents can be as high as 75%, and the incidence of allergic diseases in single parents can sometimes be as high as 50%, so genetic factors play an important role.
(2) Environment: Allergic rhinitis seasonal attacks are also caused by the stimulation of allergens in the environment, such as pollen, house dust mites, dust mites, animal dander feathers, etc. are allergens that cause allergic rhinitis. With the deepening of atmospheric pollution, it is possible that babies who are not allergic may become allergic because their immune function has not yet been fully formed.
(3) Diet: There are some allergens in the diet that stimulate the nasal mucosa can also trigger allergic rhinitis in babies, but these allergens need to be summarized in the mother’s attention in ordinary life, different babies have different dietary allergies, such as milk, eggs, fish and shrimp, meat, fruits, and even certain vegetables, all of which may become allergens.
(4) Disease: Allergic rhinitis is often accompanied by the onset of a cold, which sometimes leads directly to the onset of allergic rhinitis in babies; in addition, antibiotics and other drugs used by babies in some diseases can also indirectly cause the onset of allergic rhinitis in babies.
3.How is allergic rhinitis clinically classified?
Intermittent allergic rhinitis and persistent allergic rhinitis are classified according to the duration of symptoms.
Intermittent: symptomatic manifestations < 4 d/week, or < 4 consecutive weeks.
Persistent: symptomatology ≥ 4 d/week and ≥ 4 consecutive weeks.
Mild and moderate-severe according to the severity of symptoms and the impact on quality of life.
Mild: mild symptoms with no significant impact on learning, cultural and physical activities and sleep.
Moderate-severe: symptoms are obvious and have an impact on learning, cultural and sports activities and sleep.
5.What are the clinical manifestations of allergic rhinitis?
Performance symptoms.
(1) nasal itching (children often rub their noses), nasal mucus (mostly clear water-like nasal mucus, pus mucus when combined with infection), alternating nasal congestion (dry throat and sore throat due to breathing through the mouth).
(2) Nasal disinflation, ear congestion, dizziness, and headache.
(3) Sneezing (usually sudden and violent)
(4) Red, itchy and watery eyes.
(5) Dark circles under the eyes.
(6) Decreased or absent sense of smell.
(7) Transverse wrinkled allergic folds on the tip and underside of the nose due to frequent rubbing.
(8) Children may develop allergic salutation by rubbing the nose with the palm of the hand upward to relieve nasal itching and to make the nasal passages clear.
6.What are the dangers of allergic rhinitis?
(1) Bronchial asthma: It is the most common complication of allergic rhinitis, and the two often affect each other. Allergic rhinitis and bronchial asthma often coexist, and the former is a risk factor for asthma earlier than the latter. Therefore, the concept of “one airway, one disease” is often proposed.
(2) Allergic sinusitis: the mucous membrane of the sinus opening is edematous, resulting in nasal congestion and poor drainage, and the sinus cavity gradually generates negative pressure, when the patient has headache, if accompanied by infection, there may be allergic sinusitis.
(3) Allergic pharyngitis: Patients may also have itchy throat, cough, or mild hoarseness, and in severe cases, mucous membrane edema of the epiglottis and vocal cords may lead to breathing difficulties.
(4) Nasal polyps: Repeated nasal mucous membrane edema leads to the formation of nasal polyps, which obstruct the nasal cavity and cause obstruction of ventilation and require surgical removal to cure.
(5) Nasal bleeding: Itchy nose leads to excessive pinching, making the nasal mucosa damaged and bleeding.
(6) Olfactory disorder: nasal mucosa edema or nasal infection injures the olfactory nerve.
(7) Insomnia: Long-term nasal congestion makes it more difficult for people to fall asleep, resulting in poor sleep and poor concentration.
7.How to diagnose allergic rhinitis? What diseases should be differentiated from?
The diagnosis of this disease mainly relies on medical history, characteristic clinical manifestations and positive specific tests (skin prick test and serum specific IgE test).
The disease should be differentiated from the following diseases.
(1) Vasomotor rhinitis: children with the disease can sometimes have lightning attacks at the slightest touch of the nose, which are sudden and disappear quickly. The symptoms are similar to those of allergic rhinitis, but there is no itching in the nose and the symptoms can be relieved with oral cold medication. The disease can be triggered by changes in heat or cold, changes in body position (getting up), and emotional stress.
(2) Cold: Patients with allergic rhinitis often think they have a cold, the difference between the two is that the latter is mostly caused by viruses and bacteria invading the body, not related to exposure to allergens and triggering factors, manifested as nasal congestion, fluid, severe cases have fever, cough, muscle aches, fatigue and other systemic symptoms, and can be found in the nasal mucosa redness, mostly self-limiting disease, pay attention to rest, drink more water, about 7-10 days can Heal.
8.How is allergic rhinitis treated? How long does it take to cure?
(1) Avoid contact with allergens
During the susceptible season, outdoor activities should be limited as much as possible, especially to avoid contact with pollen season, flowering plants, willow wool and fruit hairs on phacelia trees, and you can wear a mask when you go out.
(2) Drug treatment
Mainly including antihistamines, nasal glucocorticoids, anti-leukotrienes, chromogranins, decongestants, nasal saline rinses, etc. Now there are also topical preparations used directly in the nasal cavity to make high concentration of drugs effectively reach the target tissues, with fast onset of action, few adverse reactions and easy operation, good cooperation of children and obvious effect, so topical treatment is more and more commonly used.
(3) Specific immunotherapy
It is also called desensitization or hyposensitization therapy, which is given to patients to gradually increase the dose of allergen extract (allergen vaccine) to a certain dose, so as to effectively improve the corresponding symptoms caused by exposure to the allergen. It is mainly indicated for allergic rhinitis over the age of 5 years, which has failed to respond to conventional drug therapy and is mainly caused by dust mite allergy. The diagnosis is clear, the number of combined other allergens is low (1-2), and the child’s parents understand the risks and limitations of treatment.
Persistent allergic rhinitis is generally treated in a stepwise fashion: that is, the regimen is adjusted every 2-4 weeks during treatment according to efficacy, with appropriate increases and decreases in medication and dose, with a moderate to severe course of treatment over 3 months, and nasal hormones at the lowest possible dose for about 2-6 weeks. Rhinitis in children can be cured, and the results are better than those in adults. However, rhinitis is easily recurring like a cold, giving parents the feeling that rhinitis is always incurable, and children with allergies are more likely to relapse than other children.