How to diagnose and treat allergic rhinitis

  Allergic rhinitis-asthma syndrome is an allergic condition in which both upper respiratory tract allergy (allergic rhinitis) and lower respiratory tract allergy (asthma) occur simultaneously.  Since the inflammatory conditions of allergic rhinitis and asthma are very similar in terms of pathogenic triggers, genetic alterations, local pathological changes, abnormalities in the immune function of the body and pathogenesis, they often coexist and are very closely related. Epidemiological surveys have confirmed that the incidence of asthma is 4-20 times higher in patients with allergic rhinitis than in normal subjects, and it is even believed that 60% of allergic rhinitis may develop into asthma or be accompanied by lower respiratory tract symptoms. If asthma patients with combined allergic rhinitis are treated for asthma alone, their asthma symptoms are often not effectively controlled, and patients often suspect that the treatment is ineffective, not knowing that the asthma treatment may be ineffective because the rhinitis is not well controlled.  The diagnosis of allergic rhinitis-asthma syndrome includes a typical history of allergy, clinical symptoms and laboratory tests.  A typical allergic history includes a history of eczema during one’s infancy, a history of asthma, and a family history of allergic disease. Clinical symptoms include itchy nose, frequent sneezing, runny nose, nasal congestion, cough and wheezing. Some patients often also have symptoms of allergic conjunctivitis such as itchy eyes and tearing. Once the above symptoms and medical history are present, allergen skin prick test, serum allergen-specific IgE assay, pulmonary function test and rhinoscopy should be done as soon as possible to clarify the diagnosis.  Once the diagnosis of allergic rhinitis-asthma syndrome is confirmed, combined treatment should be given. In addition to oral inhaled glucocorticoid medication to control asthma symptoms, treatment should be given for allergic rhinitis, including nasal cleansing, intranasal hormone and anti-allergy medication. It has been found that for asthma patients with allergic rhinitis, aggressive treatment of rhinitis can significantly reduce the number of emergency room visits and hospitalizations for asthma patients.