What kind of disease is allergic rhinitis? What is its manifestation?
Allergic rhinitis is a rhinitis that occurs when a person with allergies is allergic to a substance. Its clinical manifestations are sudden sneezing, profuse runny nose, nasal blockage, nasal itching and other symptoms. There are three elements in the occurrence of allergic rhinitis: 1) a person with allergy; 2) an allergen in the environment; 3) an allergic person is exposed to an allergen. Allergic rhinitis can only occur if 1 and 2 are present at the same time. As the name implies, perennial allergens are allergens that exist in the environment all year round, such as dust mites, house dust mites, molds, etc. Seasonal allergens are allergens that exist in certain seasons, such as flowers, plants and trees. Occupational allergens such as paints, coatings, etc. People who are allergic to perennial allergens generally have the above symptoms present all year round. People who are allergic to seasonal allergens such as flowers and plants generally develop allergic symptoms when a certain season or month comes. In addition to the above nasal symptoms, some patients have a combination of allergic pharyngitis, which is manifested by persistent and repeated coughing and coughing up sputum, and taking antibiotics is not effective. Other patients have a combination of allergic conjunctivitis, which is characterized by itchy eyes, congestion and edema of the conjunctiva, and blurred vision. Some patients have combined asthma with coughing and breathing difficulties, which can be life-threatening in severe cases.
How is allergic rhinitis diagnosed?
The diagnosis of allergic rhinitis is accomplished through a combination of the following three aspects.
First is the typical medical history. Patients have a long history of recurrent and persistent morning sneezing, runny nose, nasal congestion, breathing difficulties, severe coughing and wheezing. Or the above symptoms occur suddenly at the arrival of a certain season. It is not accompanied by symptoms of upper respiratory tract infection such as fever and general malaise. Some patients only show prolonged nasal dryness and bleeding.
Second, physical examination: swollen turbinates with more watery secretions are seen; or the nasal mucosa is congested and dry, or even eroded. Some of the nasal mucosa is pale, dry and erosive. Some are accompanied by congested and rough skin around the anterior nostril or nasal tip and dark circles under the eyes.
Third, allergen testing. This is the only means to confirm the diagnosis of allergic rhinitis. The common clinical methods of allergen detection are skin prick test and serum specific immunoglobulin E (IgE) detection test. The former is an in vivo test, which is affected by anti-allergic drugs and beta-blocker-type antihypertensive drugs and is best performed 1 week after stopping the drugs. The latter is an in vitro test, which is relatively sensitive and accurate, and is not affected by drugs.
The above three points need to be combined. Without the third, the diagnosis cannot be confirmed by history and signs alone. Without the first and second cannot accurately screen cases for allergen testing and will inevitably cause unnecessary waste to the patient.
How exactly can allergic rhinitis be treated? Can it be cured?
Most allergic rhinitis cannot be cured, but only a small percentage of people can be cured by changing the immune status of the body through specific desensitization therapy, and these people are those who are allergic only to dust mite or house dust mite or mainly to dust mite or house dust mite, combined with allergy to one or two other allergens. The treatment is either sublingual dust mite drops or subcutaneous allergen injections. According to the report of the 2008 International Forum on New Advances in the Treatment of Allergic Diseases, sublingual and subcutaneous injections are equally effective, and because sublingual administration is less painful and more convenient, it is more easily accepted by patients, especially pediatric patients. Hyposensitization therapy requires at least 2-3 years of continuous medication according to the physician’s schedule. Sublingual hyposensitization therapy requires daily dosing for more than 2 years to ensure efficacy. Other than this, other allergic rhinitis relies mainly on medication and physical therapy.
The following is an introduction to medication, which is the most commonly used treatment for allergic rhinitis. The most commonly used medications are antihistamines and glucocorticoids. Antihistamines include oral cetirizine hydrochloride and loratadine. Nasal spray azelastine hydrochloride, lisprostin. The above four drugs are effective and have mild side effects. Common corticosteroids are budesonide nasal spray (Reynocort), beclomethasone propionate nasal spray (Berkner), mometasone furoate nasal spray (Nesuna), and fluticasone propionate nasal spray (Coquelia). It is important to correct a common misconception among patients that they hope that allergic rhinitis will be completely cured after a period of medication, or that the symptoms will not recur. This is not possible. Since allergic rhinitis cannot be cured, as long as allergens are present, people with allergies will have symptoms, therefore, patients with perennial allergens need to use medication year-round, orally or nasally. Patients who are allergic to seasonal allergens need to be medicated throughout the pollen season. Treatment is effective when symptoms can be controlled with antihistamines or moderate doses of corticosteroids.
For patients with combined allergic pharyngitis, oral cetirizine hydrochloride and loratadine can be effective in controlling symptoms.
Here is a reminder that those patients who often have recurrent cough and itchy throat, even without the symptoms of sneezing and runny nose, should consider whether they have allergic pharyngitis and should go to the hospital promptly for treatment, rather than treating themselves according to common pharyngitis.
For patients who do not want to take medication for a long time or take medication that does not work, you can choose physical therapy. The best physical therapy method is ultrasound focus knife nasal mucosa treatment, which is effective and has light side effects, and if the operation is accurate there are almost no side effects and non-invasive. For hospitals without ultrasound focus knife, radiofrequency therapy, microwave therapy, low temperature plasma therapy is also the right choice for those patients whose medication is ineffective, nasal mucosa hypertrophy, and severe nasal congestion.