What is allergic rhinitis?
Allergic rhinitis, also known as: allergic rhinitis, is an immune disease of the nasal mucosa that occurs in patients with allergies after exposure to an allergen. If exposure to allergens is not avoided, allergic rhinitis persists, and even though there are periods when there are no symptoms, the chronic inflammatory state of the nasal mucosa persists in the presence of allergens.
Allergic rhinitis is a global health problem that is common worldwide, with a global prevalence of 10-25%, and the number of sufferers is increasing.
Dangers of allergic rhinitis.
Although allergic rhinitis is not a serious disease, it can significantly affect the patient’s daily life, schooling and work efficiency, often with annoying symptoms that lead to social difficulties, often putting the patient in an “embarrassing” situation and causing a heavy financial burden. In addition, allergic rhinitis affects the patient’s breathing and sleep, has the potential to develop into asthma, and is an independent trigger for the development and aggravation of asthma, as well as other related diseases, such as allergic conjunctivitis, otitis media, sinusitis, adenoid hypertrophy, etc.
What are the causes of the disease?
Exposure to allergens (decoration materials, pollutants, chemicals, dust, latex, smoking environment, animal dander, pollen, dust mites, insect excrement, mold, certain foods, occupation, etc.) With the accelerated industrialization of society and the improvement of people’s living standards, some new allergens continue to appear, such as aromatic hydrocarbon compounds from diesel combustion, latex in medical gloves, etc. have strong allergenicity. In addition, some indoor pollution sources such as cigarettes and formaldehyde released from wooden furniture are also important allergens. All these factors are one of the main reasons for the increasing incidence of allergic rhinitis worldwide year by year.
What are the signs and symptoms of allergic rhinitis?
There are four typical symptoms of allergic rhinitis, namely: itchy nose, sneezing, runny nose and nasal congestion.
Nasal itching: In mild cases, there is an ant-like sensation in the nose, but in severe cases, it is unbearable and the nose is often rubbed from time to time.
Sneezing: continuous sneezing, often up to several or a dozen in a row.
Runny nose: a large amount of clear water-like nasal discharge, and in severe cases, the nasal discharge continues throughout the day.
Nasal congestion: intermittent or persistent, unilateral or bilateral, or alternating blockage on both sides.
Children need to be carefully questioned and observed by parents or physicians because they do not give detailed descriptions of their symptoms.
Allergic rhinitis needs to be differentiated from the common cold!
Allergic rhinitis is often misdiagnosed as a recurrent cold, and the disease can be differentiated according to the following points
1. The onset of a cold is acute and usually lasts only 7-10 days.
2, the cold can start as a watery clear snot, and later as yellow sticky purulent snot.
3, the cold is often accompanied by systemic symptoms, such as: headache, fever, muscle and joint pain, etc.
Treatment of allergic rhinitis.
The basic principle: allergic rhinitis is a disease triggered by contact with allergens, the current treatment means are to reduce or control the symptoms of human allergy to allergens through drugs, rather than eradicating external allergens, only should try to find the cause of allergy, completely avoid before it is possible to completely no longer attack. The treatment of allergic rhinitis by one-time eradication and surgical eradication are fundamentally against the principle. For patients who cannot avoid allergens (e.g., fungus) only continuous medication can be used, so it is important to use medication rationally, avoid long-term systemic medication, and prefer topical medication. The following is the WHO (International Health Organization) recommended treatment plan for allergic rhinitis.
1. Avoid contact with allergens.
Try to avoid or reduce contact with allergens, such as: no indoor carpeting, no suede sofas, frequent removal of house dust and bed dust, do not eat suspected allergy food, try not to use insecticides, air fresheners, etc., avoid contact with cigarette smoke, etc. However, because some allergens are ubiquitous and hidden, it is very difficult to avoid them completely.
2.Specific immunotherapy.
Also known as desensitization therapy, it is one of the only treatments for the cause of allergic rhinitis and asthma. The advantages are: ① significant improvement in allergy symptoms; ② significant reduction in the amount of allopathic medication (hormones and antihistamines, etc.) for patients, and even discontinuation of allopathic medication; ③ continuous control of allergy symptoms during desensitization therapy; ④ efficacy that still exists after the termination of desensitization therapy; ⑤ prevention of the occurrence of new allergies and deterioration of the disease (such as effective prevention of the development of allergic rhinitis into asthma, or effective prevention of the deterioration of asthma, etc.).
3. Drug therapy.
Antihistamine usage (cetirizine, loratadine, imipramine, ibastine ……) is used until the histamine-related symptoms disappear. It should not be taken orally for a long period of time, but only for the initial treatment of attacks and control of histamine-related symptoms (nasal itching, sneezing, runny nose, etc.).
Nasal glucocorticosteroid usage (Norocort, coleus, mometasone furoate) nasal hormone has significant improvement on all four symptoms, especially on nasal congestion which is more effective than antihistamines, and can be used to prevent the onset of allergic rhinitis. In 2008, nasal hormones were recommended by the World Health Organization as the first choice for the treatment of allergic rhinitis because of their ease of use, precise efficacy, low side effects and long duration of use.
Topical decongestants should be used with caution! (Rhinotec spray, ephedrine nasal drops, nasal drops ……) can effectively improve nasal blockage, but are not effective for other symptoms. These drugs, in general, should not be used for more than seven days in a row, long-term use may lead to irreversible drug rhinitis.
Chinese patent medicines (Genotone, Nasal Abyss Tongkou, Nasal Abyss Shu ……) are used as auxiliary medicines to eliminate mucosal edema, improve nasal ventilation and promote the recovery of mucus cilia function.
4.Surgical treatment.
Surgical operation is only used for those who still have nasal blockage and seriously affect life and workers after regular drug or immunotherapy for a few. The purpose of surgical treatment is to improve ventilation, not to treat allergies. Commonly used methods include radiofrequency treatment of the inferior turbinates and correction of poor nasal framework structure to improve nasal ventilation.
Can allergic rhinitis be cured?
The development of allergic rhinitis depends on the patient’s allergic constitution and the allergens in the environment, one without the other. Allergic constitution is genetically related and the current medical level cannot change the allergic constitution from the genetic level, nor is it possible to remove external allergens. . Atopic immunotherapy is the only “curative” treatment in the sense that it induces tolerance to allergens to achieve long-term clinical symptom relief and disappearance.
The correct use of nasal glucocorticoids: 1.
1. Spraying method.
Spray the right nose with the left hand and the left nose with the right hand.
2. Alternate dosing.
Adjustment of the minimum maintenance dose.
After the symptoms are completely controlled, continue to maintain this dose for 1 month, then the dose is reduced to every other day or alternate nasal spray, maintain this dose for 1 month, if the symptoms are still completely controlled, reduce the dose again, such as every other day, every second day, every third day, and so on to maintain the symptoms as the minimum maintenance dose, but do not stop the drug. Discontinuation may be considered for seasonal or intermittent allergic rhinitis. Resistance is usually rare with long-term treatment. The initial treatment regimen may be repeated in case of recurrence.