Allergic rhinitis: causes, symptoms and treatment in adults

Rhinitis, or runny nose, is an inflammation of the nasal mucosa. It can be caused by various reasons: viral or bacterial infection, allergic reaction.

Usually, rhinitis is accompanied by swelling of the inner surface of the nasal passages, sneezing, itching, and an increase in the number. Allergic rhinitis is an immune disease.

In this article we will consider all the features, symptoms, causes of this particular form of the disease. Here you will find information on what to do and how to get rid of an allergic rhinitis.

What is allergic rhinitis?

Allergic rhinitis is an immediate type of allergic reaction (type I allergy).

When pollen comes in contact with the mucous membranes of the nose, eyes or respiratory tract, the body reacts immediately and develops corresponding allergic symptoms (difficulty breathing, sneezing, etc.).

Causes of allergic rhinitis

In the case of allergic rhinitis, or as it is also called, the reason lies in the inadequate response of the human immune system to the ingress of particles of an external substance (allergen) into the body. Hypersensitivity (increased sensitivity of the body to a substance) can manifest itself to the same substances that do not cause any reaction in other people.

The irritants can be:

• pollen of plants;
• wool and skin particles of some animals (cats, dogs, etc.);
• mold spores;
• waste products of microscopic mites contained in house dust (often causing allergy symptoms).

There is also an increased reaction of the mucous membranes to, in which case, an allergic rhinitis may also appear, among other painful manifestations.

Factors provoking the onset of allergic rhinitis

The predisposition to the occurrence of allergic rhinitis or increases if a person has chronic inflammatory diseases in the ear, throat and nose. Those who are prone to lingering colds and frequent viral infections are also at increased risk. Environmental factors:

• severe air pollution;
• tobacco smoke;
• an abundance of dust in the premises;
• constant presence of animals.

The likelihood of allergic rhinitis increases if there is a hereditary predisposition (one of the parents or both are prone to allergic reactions).

Symptoms of allergic rhinitis

The appearance of an allergic rhinitis is characterized by certain symptoms. Some of them can appear almost immediately, within 4 - 8 hours, while others after 2 days or even weeks from the onset of the disease.

According to allergists, when a person first meets an irritating substance, a noticeable allergic reaction may not occur, however, during the next contact with the allergen, it will become more pronounced.

In most cases, the symptoms of allergic rhinitis are as follows:

• repeated sneezing. Usually it immediately occurs when an allergen enters the nasal mucosa;
• itching in the nose, tickling in the nasopharynx. These manifestations are also very pronounced, and precisely at the very beginning of the disease;
• increased secretion of mucus from the nose. In the beginning it is a very thin, watery discharge. In the future, the mucous discharge becomes thicker;
• lacrimation, itching and;
• nasal congestion, inability to breathe through the nose, deterioration of smell;
• hypersensitivity to pungent odors: household and construction chemicals, perfumes, tobacco smoke;
• dry cough that joins later;
• weakness, drowsiness, chills and high fatigue (the phenomena are characteristic in the later stages of the disease). This is how the general allergic reaction of the body manifests itself;
• ear congestion, hearing impairment are also characteristic of chronic allergic rhinitis.

Forms and stages of allergic rhinitis

For a disease such as allergic rhinitis, there are two main forms:

• periodic (seasonal);
• permanent (year-round).

The difference between them is that in the seasonal form, the allergen is of plant origin and is released during the flowering of certain types of flowers or trees. In the chronic form, the irritant is present in human life (dust mites, mold, animals) and the disease may not stop all year round.

There is also a mixed form, in which chronic rhinitis is expressed year-round in an erased form and is amenable to drug control, and in the summer season it worsens.

There are the following stages of the disease:

• acute - allergic rhinitis lasts up to 4 weeks;
• chronic - the manifestations of the disease last longer than 4 weeks in a row. They do not stop at all or there is an unstable remission, and then a recurrence.

An annual recurrence of symptoms of allergic rhinitis for more than 4 weeks is also considered a chronic course of the disease.

Diagnosis of allergic rhinitis

At the very beginning, to establish a diagnosis, the doctor conducts a detailed survey of the patient. This is how the anamnesis is collected about the course of the disease and all the factors accompanying its development, the individual characteristics of the reaction to various substances, as well as to the methods of treatment previously undertaken at home.

The hereditary factor is also being investigated, which is very important in the diagnosis of any allergic diseases.

In the diagnosis of allergic rhinitis, it is of great importance to identify exactly those irritating substances that trigger a negative reaction of the immune system. Thus, a possible range of cross-allergens (similar products and substances that can also negatively affect a person) is established. Allergic rhinitis should be treated only after an accurate diagnosis has been established.

Proven diagnostic methods, the most popular at the moment:

• Skin test(). This simple method is often used, but its error is quite large. The bottom line is that with the help of a special tool, a small scratch is made on the human skin, into which a substance is introduced - an allergen. After 15 minutes, you can evaluate the result. In case of a positive reaction, the test site will turn red, there will be slight swelling and itching.
• Immunoblotting... This is an analysis of the reaction of human antibodies to molecules of an irritating substance. Carried out in laboratory conditions. A fairly accurate diagnostic method.
• Microscopic examination of smears... For this analysis, smears of mucous secretions taken from a patient during an exacerbation of allergic rhinitis are stained with special preparations and examined under a microscope.
• Allergen-specific immunoglobulin (IgE) test... A blood test for an increase in the level of immunoglobulins of class E when exposed to various suspected allergenic substances.
• Provocative analysis method(rarely used). The patient is injected with a small amount of a substance that could potentially cause an allergic reaction. If the result is negative, the dose is gradually increased. Such a study is used only in stationary conditions.

Complications

If the disease is left untreated, allergic rhinitis usually goes through a phase of change, over time, the allergy moves from the nose and eyes to the lower respiratory tract, leading to allergic. As a result, allergic pollen will be triggered.

In addition, many other complications can occur with hay fever, such as:

• asthma;
• itching of the oral mucosa, throat, ear;
• cough;
• allergic skin reactions (eg, redness, swelling);
• trouble concentrating;
• sleep disorders;
• and hearing;
• general apathetic state.

The main complication of this disease is asthma (asthma attacks)... Sufferers have a significantly higher risk of developing asthma than non-allergic people: in 80% of cases, asthma is preceded by an allergy... However, early treatment of allergic rhinitis reduces the risk of developing asthma.

How is allergic rhinitis treated in adults?

To cure allergic rhinitis, first of all, it is necessary to establish and confirm an accurate diagnosis, as well as to identify a list of obvious and potential irritating substances - allergens. In the future, treatment is carried out aimed at solving three problems:

• removal of allergic inflammation and swelling of the nasal mucosa;
• elimination of the reaction to the influence of allergens (allergen-specific therapy);
• organization of a hypoallergenic life, minimization of contact with an irritant.

Nutrition and lifestyle

If the question of treating allergic rhinitis has already arisen, the first step is to change the usual way of life. Of great importance for any allergic disease is the issue of reducing contact with irritants:

• when detecting signs of a negative reaction to food, it is necessary to strictly follow a diet and completely exclude those products that are allergic;
• in the event of a reaction to plant pollen, it is recommended avoid any contact with the allergen during the flowering season(nature walks, trips out of town). During an exacerbation, coming home from the street, you need to immediately change clothes, take a shower, rinse your nose with isotonic solution. This is done in order to reduce the duration of contact with pollen that could be brought into the house on a person's clothes, body and hair;
• if an allergic reaction to house dust is established, it is necessary to regularly carry out wet cleaning indoors... It is also recommended to organize a hypoallergenic life: the absence of carpets, heavy fabric curtains and down pillows, the removal of all kinds of dust collectors. It is necessary to use special covers for upholstered furniture and bedding, acaricidal (anti-mite) cleaning agents;
• using household air purifiers is useful for both pollen allergies and house dust reactions.

The listed methods are especially relevant in cases where it becomes necessary to treat allergic rhinitis during pregnancy. In this case, you need to take all possible measures to organize a healthy lifestyle, proper nutrition and a hypoallergenic life.

This set of measures will reduce the need for the use of chemical drugs.

Drug therapy

Medicines designed to treat allergic rhinitis are designed primarily to relieve an allergic reaction and remove severe symptoms of the disease. Most often these are antihistamines of general action, produced in tablets or drops.

They are taken as prescribed by a doctor, usually once a day, for a long period (from 1 month). Among such agents, second-generation drugs have proven themselves well:

• Cetirizine;
• Claritin;
• Zodak.
• and the third (Erius, Zyrtec).

They have a minimum of side effects compared to the first generation (Suprastin). With a rather mild form of the disease, it happens one drug from this list is enough to completely eliminate symptoms .

When treating allergic rhinitis in patients with a more serious stage of the disease, at the same time with the use of tablets, doctors prescribe local anti-inflammatory drugs.

Usually they are a nasal spray and differ in the composition and principle of action of the active substance. Agents based on sodium derivatives cromoglycate are widely known. These are drugs such as:

• Cromohexal
• Kromosol.

Such medicines are used only as directed by a doctor. They are usually prescribed for mild to moderate severity of the disease.

Allergic rhinitis in adults is sometimes preferable to treat with local agents of this particular group, so that systemic effects from a general antihistamine drug do not develop.

For severe symptoms of allergic rhinitis, more serious hormonal drugs are used to suppress the inflammatory response: nasal corticosteroids, which are also available in the form of sprays. These include drugs such as:

• Nazonex;
• Tafen;
• Benarin.

Although topical corticosteroids are generally well tolerated and have few side effects, they should never be taken without a doctor's prescription. Only treatment in adults is permissible; in young children, these drugs are rarely prescribed.

Preparations based on isotonic solution or sea water:

• Salin;
• Aquamaris.

They are completely harmless and are designed to gently rinse and cleanse the nasal passages from allergens and mucus accumulations that have got there.

Attention!!! It is strongly not recommended to use popular vasoconstrictor drugs for a long time in the treatment of allergic rhinitis - Naphtizin, Xymelin... They do not solve the problem in any way, but instead dry out the inflamed nasal mucosa and, with regular use, cause the development of medication rhinitis.

Before treating an allergic rhinitis, it is worth trying prophylaxis, for example, Nazaval and Prevalin... These are protective sprays based on cellulose or oils and clay, which have an enveloping effect. They help isolate the nasal mucosa from the irritant, that is, prevent the allergen from entering it.

The use of such funds is advisable only in a state without exacerbation - it makes no sense to apply them to the irritated mucous membrane during an allergy attack.

Allergen specific immunotherapy (ASIT)

A separate group of medicines is designed to prevent the development of a negative reaction to an allergen.

Allergen-specific immunotherapy (ASIT) is a relatively new treatment. The method is based on a gradual decrease in the body's sensitivity to an allergen by means of gradual “habituation”. This long and difficult therapy, carried out during the period of remission, allows you to prepare for the season of exacerbation of hay fever and achieve a decrease or complete absence of response to stimuli.

To achieve a stable remission, 3-4 courses of therapy may be required.

Treatment of allergic rhinitis with folk remedies

Trying to treat an allergic rhinitis with alternative medicine is permissible only if the disease is mild and has not turned into a chronic stage.

Care should be taken to remember that many plants themselves can be quite strong allergens.

To find out how the body reacts to a particular herbal remedy, you must try to apply it for several days in a minimal amount.

If the body's reaction is normal, treatment with folk remedies can be carried out in long courses. Here are some popular recipes:

• A decoction of raspberry roots. Pour 100 grams of dry raw materials with 1 liter of water, boil for half an hour, cool and strain. Take such a broth in a quarter of a glass three times a day, before meals. The course of treatment is 14 days.
• Elecampane broth. 2 teaspoons of dry, crushed roots of elecampane pour 200 ml of water, boil for 10 minutes. Strain, take half a glass 2 times a day. The course of taking a decoction is 14 days.
• Aloe juice nose drops. Squeeze juice from a fresh aloe leaf, instill 2 drops in each nostril 2 times a day. The juice can be stored in a tightly sealed container in the refrigerator for 1 week.
• A mixture of lemon and horseradish. Mix the crushed components in equal parts. If desired, you can add a little honey (if you are sure there is no allergic reaction). Take 1 teaspoon twice a day, half an hour before meals.

The symptoms of an allergic rhinitis are very unpleasant, and it can be quite difficult to completely cure this disease. Doctors recommend people at risk to adhere to the following rules to prevent manifestations of allergies:

• use filters and indoor air purifiers;
• regularly carry out wet cleaning, get rid of house dust accumulators (carpets, large soft toys, down and feather pillows);
• avoid long-term exposure to aggressive air (tobacco smoke, strong chemical odors, dust and soot);
• during the flowering season of allergenic plants, stay indoors as much as possible or move to another climatic zone;
• follow the principles of proper nutrition and a hypoallergenic diet;
• at the slightest tendency to allergies, it is worth refusing to keep any animals in the house.

The topic of prevention of such a disease as allergic rhinitis during pregnancy is becoming especially relevant. After all, there is a risk of developing the disease not only for the mother, but also for the unborn child. The use of drugs such as Prevalin or Nazaval- a safe way to prevent the development of the disease.

Forecast

The long-term prognosis of allergic rhinitis is positive because it is often managed successfully by minimizing exposure to allergens and treating with one or more drugs.

However, when people with allergic rhinitis have other coexisting disorders, for example, it is of much greater severity, as in rare cases it has been fatal.

Although the condition is not considered serious (if there is no asthma), it causes a lot of discomfort and interferes with the patient's normal daily life.

Conclusion

There is no simple and quick way to treat allergic rhinitis in allergy-prone people. Only a qualified doctor will tell you what to do in each specific case.

To completely get rid of the disease, you will have to undergo complex diagnostics and a long course of treatment. In the future, it will be necessary to avoid contact with allergens and adhere to a whole set of rules.

Sometimes moving to another climatic zone helps to solve this problem.

Interesting

How to cure allergic rhinitis? This extremely topical issue worries more than a quarter of the population of our country from the first days of spring to the end of summer, when the disease intensifies, turning life into a real nightmare.

Both adults and children suffer from allergic rhinitis. The disease is characterized by regular nasal congestion, frequent sneezing, irritating itching, frequent lacrimation - even one symptom is more than enough to make you want to be cured forever and forget about it like a nightmare.

And today it is possible to do this: in contrast to the unfortunate patients of past centuries, when the disease was considered a mental disorder and treated the soul, and not the body of victims of "hay fever" (another well-established name for allergic rhinitis).

In this article, we will consider the causes and types of the disease, methods and methods of treatment (getting rid of forever), as well as options for diagnosing and identifying an allergen.

Symptoms of allergic rhinitis

Symptoms of allergic rhinitis are very similar to those of a common rhinitis. This is stuffiness and flow from the nose. Most patients immediately grab the vasoconstrictor drops, which almost instantly relieve congestion, and do not rush to the otolaryngologist for diagnosis and treatment. And why, if the drops work effectively?

Symptoms are similar to a simple runny nose. But if conventional remedies do not help, then you need to contact an ENT doctor.

However, this is the main danger of allergic rhinitis - ordinary sprays only relieve congestion, while the main enemy - the allergen - continues to affect the body, cause unpleasant symptoms and prevent it from being cured. Therefore, a runny nose that reacts to the allergic nature of any substance in everyday life or a product in a constant diet will not just go away.

How to distinguish a common rhinitis from allergic rhinitis?

First of all, you need to pay attention to additional symptoms:

• Severe itching in the nose and eyes;
• redness of the eyes and watery eyes;
• sharp and repeated sneezing;
• increased nasal congestion immediately after sneezing;
• the appearance of puffiness of the face;
• the appearance of dark circles under the eyes;
• almost complete absence of nasal breathing during congestion;
• sleep disturbance;
• irritability and fatigue;
• headache.

If at least some of the symptoms match the list, there is a high probability that it is allergic rhinitis. In this case, it is necessary to urgently consult an ENT doctor who will conduct an examination, make an accurate diagnosis and help to recover. Based on it, an effective therapy will be prescribed, which will relieve symptoms and help to permanently recover from a painful disease.

However, it should be borne in mind that in some cases the symptoms may be mild - this is typical for a mild form of the disease. But this does not mean that you can simply get rid of congestion with drugs on your own, not go to the doctor and hope that "everything will heal by itself." On the contrary, if you start the process, then sooner or later the allergic reaction will worsen and lead to a more severe form of the disease, which will be much more difficult to cure.

It is worth remembering that with prolonged contact with the allergen, the symptoms may worsen. Sometimes monitoring your condition allows you to isolate a substance, after contact (ingestion, use, inhalation) with which the runny nose is more pronounced. In this case, it will be easier to select a group of allergens for a special test in order to make sure of their detrimental effect on the body.

Of course, you should not gradually sniff each flower, listening to your feelings, or immediately get rid of your pet. It will be enough for the doctor that a runny nose appears, for example, during the flowering period of plants or after playing with the dog. In this case, samples will be made on the most common flowering plants or on the wool and secretions of animals.

The most important thing in assessing symptoms is an attentive attitude to one's well-being and a reliable story about it to the attending physician when collecting an anamnesis of the disease. This will help identify and heal rhinitis much faster.

Treatment methods

Allergic rhinitis treatment is a complex undertaking.

Before the appointment of therapy, the otolaryngologist conducts diagnostics using sinus scanning, as well as endoscopy and video endoscopy of the nasal cavity.

It is also necessary to conduct allergic tests in order to select antiallergic therapy (antihistamines). Without this item, the treatment will not be effective enough, since by and large it comes down to eliminating the symptoms, and not the cause that causes it. In difficult cases, the ENT can invite an allergist to heal the patient faster.

What can an otorhinolaryngologist prescribe?

To relieve mucosal edema, the doctor prescribes washing and irrigation with anti-inflammatory and moisturizing agents. To suppress the allergen in the body, it is necessary to take antihistamines - in the form of tablets and / or nasal sprays. With severe congestion, it is necessary to use vasoconstrictor drops, which should not be abused - it is necessary to strictly follow medical prescriptions so as not to additionally acquire drug dependence.

Remember that vasoconstrictor drops and sprays provide temporary relief, but can lead to drug dependence if used for more than 7 days in a row! These sprays do not help cure rhinitis!

If the allergen has a strong effect on the body, then a set of measures must be taken to rid the body of the allergen. To do this, it is necessary to carry out a systemic cleaning of the body, for this the so-called folk method is suitable, namely: drinking more liquid. Perhaps the use of diuretic products - watermelon and strawberries (if they are not allergic). Thus, you can gradually get rid of the allergen with the help of the body's excretory system.

If the intoxication is strong, then you can resort to drugs. Such as "Enterosgel", "Polyphepan", "Filtrum" and other sorbents that will help remove the allergen from the body. In extreme cases, your doctor may prescribe IVs or injections to speed up the cleaning process. But getting rid of the allergen is imperative to cure rhinitis.

As soon as the concentration of the allergen decreases, the procedures will become more effective.

With an allergic form, the following ENT manipulations are possible:

• Irrigation of the nasal cavity;
• infrared therapy;
• vibroacoustic therapy;
• ultraviolet irradiation;
• contraction of the nasal mucosa;
• vacuum sanitation;
• laser photodynamic therapy of the nasal cavity and nasopharynx;
• lubricating the nasal cavity with ointments or placing the ointment in the nasal cavity;
• magnetotherapy;
• transcutaneous infrared laser exposure.

In general, everything that can be used to treat a disease in an ENT doctor's office.

If you fulfill all the appointments, go through all the prescribed procedures, identify the allergen that led to the disease, and get rid of it in everyday life, then the prognosis will be extremely positive - allergic rhinitis can be cured forever.

Allergic rhinitis during pregnancy

During pregnancy, any disease can be extremely dangerous for both the expectant mother and the unborn child (which is why doctors recommend curing or at least bringing all chronic diseases to the stage of remission even before conception). Allergic rhinitis is no exception.

The main danger of allergic rhinitis is that the fetus is extremely negatively affected by what can be used to treat the disease. Namely:

• Antihistamines;
• vasoconstrictor drugs;
• glucocorticosteroids.

They can depress the central nervous system of the unborn baby, cause bradycardia and cause the development of various pathologies (for example, cleft palate). In addition, drugs can affect the development of anxiety and hyperexcitability in the infant.

Friends! Timely and correct treatment will provide you with a speedy recovery!

Allergic rhinitis is especially dangerous in the first trimester of pregnancy - at this time, the mother's body and the fetus itself are extremely vulnerable. And although the future child is reliably protected from allergic reactions of the expectant mother by the placenta, it will not work to get rid of the influence of drugs that are trying to cure the disease.

What if, even before pregnancy, there was a problem with allergic rhinitis and allergies in general? How to get rid of the possibility of its manifestation?

You need to carefully monitor your health. It is necessary in advance (before pregnancy) to undergo an allergy test in order to identify a specific group of substances that cause the disease. During pregnancy, it is advisable to exclude allergenic foods and contact with irritating substances.

How to get rid of allergies during pregnancy?

• Pass allergic tests in advance;
• exclude identified allergens from everyday life and diet;
• do regular wet cleaning;
• use air purifiers and humidifiers;
• change bed linen often.

If you follow all these simple rules, then allergic rhinitis can be avoided during pregnancy.

However, if, nevertheless, the disease manifested itself, then in no case should you self-medicate! This is extremely dangerous, first of all, for the unborn child. Only a doctor can cure!

In case of an allergic form of the common cold, you should definitely contact the ENT clinic, where specialists will prescribe a treatment that is safe for the mother and the unborn child.

In no case should you deviate from the appointments, otherwise it can lead to serious consequences, up to a miscarriage.

How to live with allergic rhinitis

More than a quarter of the entire population of our country lives with allergic rhinitis. Of course, this does not mean that you cannot be cured of it forever. It is possible and even necessary. To do this, you need to find a good ENT doctor who will give individual recommendations and help with treatment. This is the first thing to do.

More than 25% of Russian residents are diagnosed with Allergic rhinitis. The disease can manifest itself in both childhood and adulthood.

The second, no less important condition for a comfortable life with allergic rhinitis, is the ability to take care of yourself and the environment on your own. What does it mean? You need to carefully monitor your diet (give up allergenic foods); wear a respirator mask during flowering plants in spring and summer; rinse your nose when you return home (you can even use ordinary boiled water); do wet cleaning every day (wipe the furniture and the floor), do not accumulate things in the corners of the house, where they collect dust; moderately use deodorant sprays and perfumes; take care of pets in a timely manner (wash and comb so that the wool does not spread throughout the house); regularly change bedding (get rid of pillows, blankets and mattresses, which eventually become a haven for dust mites).

This list is endless, but in the end, banal rules will significantly improve the quality of life, and, possibly, completely help to cure allergic manifestations of rhinitis.

If all of the above only weakened the symptoms, then you will have to get rid of the allergic rhinitis with drugs. Indeed, without this, the joy of life is lost: the taste and smell of food passes by, concentration of attention from constant nasal congestion is significantly reduced, the quality of sleep worsens due to respiratory failure, and a walk in a blooming park can turn into hell.

How can the disease be treated?

• Antihistamines (Zodak, Erius, Claritin, Tavegil, etc.)
• Antihistamine drops and nasal sprays (Vibrocil, Fliksonase, Cromohexal, Nosefrin, etc.)
• Adsorbents (Polyphepan, Enterosgel, Activated carbon, Filtrum, Polysorb, Neosmectin, etc.)

These are the three main drug groups that make life with allergic rhinitis much easier, relieve symptoms and are the mainstay of therapy that can cure forever.

When treating a cold, whether it is common or allergic, it is worth remembering that a cure is possible. The main thing is not to give up and find a good otorhinolaryngologist who will help you recover. And then the state of health will return to normal, the mood will improve, and life will again sparkle with bright colors!

Prophylaxis

Disease prevention is the best method to forget about it forever. Preventive measures are also possible with allergic rhinitis.

Firstly, you should follow a hypoallergenic diet (excluding citrus fruits, red berries and fruits, nuts, packaged juices).

Secondly, to get rid of bad habits (in particular, from active and passive smoking and alcohol consumption).

Third, maintain personal hygiene and keep your home clean.

Fourthly, do not have pets or carefully monitor the hygiene of the existing ones (in severe cases, you may need to get rid of the pet - give it up for overexposure during an exacerbation or give it to good hands for good).

Fifthly, take any medications only as prescribed by a doctor, study their instructions, do not mix medications, for a combination of which allergic reactions are detected (spelled out in the instructions).

Sixth, give preference to clothing and bedding made from natural fabrics.

Seventh, if possible, avoid intense physical activity and stressful situations.

Preventive measures are extremely simple. If you follow them, you can get rid of allergies forever!

All of the above is fairly easy to implement. It is worse when the profession is associated with the production of, for example, chemicals. Sooner or later, a professional allergy will begin at such a job. Of course, it will not work to instantly change the field of activity, but you need to remember that if the allergy has already begun, then it will only worsen. In this case, it will not be possible to be cured forever as long as the allergen is constantly present in life.

In addition to creating special conditions at home and in life, prevention of common respiratory diseases is necessary (avoid hypothermia and overheating, dress for the weather, wash your hands thoroughly, do not drink ice water, get rid of the habit of eating ice cream outside in the cold season, etc.) and immunosuppressive therapy. If you follow these simple rules, the quality of life will improve significantly, and allergic rhinitis will become rare or will disappear forever. These measures are for everyone, not just those looking to get rid of allergies.

Vasomotor rhinitis - is a neuro-reflex disease of a non-inflammatory nature. There are two forms of vasomotor rhinitis: allergic (it also has a seasonal runny nose, or hay fever) and neurovegetative.

The cause of a seasonal rhinitis is hay fever there may be pollen from various plants: poplar, aspen, ragweed, etc. Pollen exposure is only possible during the flowering period. At permanent form allergic rhinitis allergens are very diverse and can affect the patient throughout the year. These allergens include food (strawberries, citrus fruits, honey, crayfish, etc.), medicines, perfumes, house dust, animal hair, daphnia.

Symptoms:all varieties are characterized by three main symptoms - difficulty in nasal breathing, profuse mucous or serous discharge from the nose, and bouts of sneezing.

A hallmark of seasonal allergic rhinitis (hay fever) there is a clear seasonality of exacerbations that occur during the flowering of plants, to the pollen of which there is an increased sensitivity of the patient. During the period of exacerbation, sneezing, itching and burning in the nose and eyes, difficulty in nasal breathing, profuse liquid discharge from the nose, irritation of the skin at the entrance to the nose are noted. In addition, weakness, headache, fatigue, and sleep disturbance are noted. The duration of the exacerbation depends on the duration of the flowering of the herbs, the symptoms of the disease go away on their own after the end of this period, and do not appear until the next year.

At persistent allergic rhinitis seasonality is absent, attacks of a cold are observed throughout the year, periodically increasing and weakening regardless of the season. Exacerbations are manifested in the form of seizures, accompanied by sneezing, profuse liquid nasal discharge and difficulty in breathing of varying severity; there is itching in the ears, eyes, nose.

The diagnosis is established after examination by an ENT doctor and consultation with an allergist. When diagnosing allergic rhinitis, an allergological examination is mandatory: skin tests with allergens, determination of general and allergen-specific JgE, nasal provocative test with allergens.

Treatment:The most drastic way to avoid allergic rhinitis is to eliminate the allergen, but it is not always known what causes the allergy. Therefore, it is very important to take some preventive measures: avoid contact with pets, carry out daily wet cleaning in the apartment, do not spray all kinds of aerosols, and avoid staying in smoky rooms. In the diet, you should limit spices, avoid the use of canned food and smoked meats, limit or completely exclude some sweets (chocolate, cocoa) from the diet, as well as eggs, fish, oranges, nuts, honey. All of these foods are highly allergenic. When prescribing any medication, be careful, you should always consult your doctor.

Treatment of allergic rhinitis is carried out by an ENT doctor together with an allergist-immunologist.

Various groups of drugs are used to treat allergic rhinitis.

The most common group is antihistamines, general and local. Their action is that by blocking the histamine receptors of the nasal mucosa, the drugs eliminate itching, sneezing, and nasal discharge. However, they do not eliminate nasal congestion, therefore, the use of vasoconstrictor drugs (Naphthyzin, Galazolin, Nazol, etc.) is additionally required. Vasoconstrictor drugs should be used no more than 7-10 days.

Previously, antihistamines of the first generation were mainly used (Suprastin, Diphenhydramine, Tavegil, etc.). The main adverse reactions when using these drugs are drowsiness, weakening of attention, weakness, headache, lack of coordination, etc. Recently they have been replaced by modern second generation antihistamines, devoid of these serious disadvantages - Claritin, Loratadin, Clarinase, Zyrtec, Kestin , Telfast. These are drugs of general action, produced in the form of tablets and taken 1-2 times a day. In addition, there are effective topical formulations in the form of aerosols or nasal sprays. Allergodil is a topical antihistamine, the effect occurs within 15 minutes and lasts up to 12 hours, does not cause drowsiness, is used in adults and children from 6 years of age. This group also includes Kromosol, Kromoglin, Histimet.
The most effective treatment for allergic rhinitis is the topical application of corticosteroids, which are topical hormonal drugs in the form of nasal sprays. These are drugs such as Aldecin, Nasobek, Beconase, Fliksonase, Nazacort, Nasonex. These drugs have a high degree of safety, and effectively eliminate all symptoms of an allergic rhinitis, as well as a symptom of nasal congestion, which is practically impossible to eliminate with other drugs.

The most effective treatment is to stop the patient's contact with the allergen. Drug therapy includes two main aspects of exposure: specific immunotherapy with an etiologically significant allergen and the use of antihistamines (both the first generation - diphenhydramine, diazolin, tavegil, pipolfen, etc., and the second generation - histimet (levocabastine), terfenadine, loratadine, cetiresin). Antihistamines of the first generation have a number of side effects (pronounced sedation (hypnotic), atropine-like effect, peripheral vasodilation). Therefore, the use of these drugs should be carried out with caution (a certain group of people - drivers, etc. should refuse them).

Treatment of allergic rhinitis is also carried out in a complex and stepwise manner.

The first stage is elimination, consisting of reducing the contamination of ticks, fungi, epidermis of animals and bacteria, etc., evacuation of secretions due to irrigation therapy using mineral water, black tea decoction, massage of the nasal mucosa, acupressure of the wings of the nose and collar zone; enterosorption (excretion of metabolic products, toxins, immune complexes using coal sorbents and Sums-1 for these purposes (30-40 g 3 times a day for 10 days).

The second stage is drug therapy:
a) local (histimet);
b) systemic (gismanal, zirter, claritin), etc., antihistamines;
c) stabilizers of mast cell membranes (derivatives of sodium chromalicate);
d) mucolytics (sinupret, gelomitrol).
According to indications, antibacterial drugs are used (augmentin and other antibiotics and are resistant to the effects of beta-lactamases).

The third stage is specific and non-specific immunocorrective therapy, which increases the content of class A immunoglobulins, especially secretory immunoglobulins. Ribomunil, bronchovaxon, bronchomunal are used as immunostimulants of bacterial origin.

Specific immunotherapy is carried out with the causative allergen. It may seem strange to treat allergic rhinitis with surgical interventions, but nevertheless it is real. The existing changes in chronic allergic rhinitis, characterized by edema, polyposis changes and hypertrophy of the nasal mucosa and other factors, predetermine surgical correction to improve physiological conditions and further drug therapy.

The stages of surgical therapy (consisting of preoperative preparation, the course of surgical intervention and postoperative therapy) proposed by Piskunov G.Z. (1999) are very effective.

Thus, the treatment of allergic rhinitis should be, first of all, pathogenetically justified, taking into account individual characteristics, etiological factors, the severity of clinical manifestations and carried out in specialized medical institutions to avoid possible complications of both the disease itself and the therapy.

One of the most common types of respiratory allergies, with the same frequency in both adults and children, is allergic rhinitis (AR). This chronic inflammation of the nasal mucosa, accompanied by rhinorrhea (runny nose) and respiratory failure, not only significantly impairs the quality of life, but can also lead to the development of serious complications. Only early detection and effective treatment of allergic rhinitis will be the key to a successful recovery.

Causes of allergic rhinitis

The list of conditioned irritants that can cause allergic rhinitis is quite extensive. It includes:

1. Aeroallergens of the external environment (pollen of flowering plants).
2. Household aeroallergens:
   • dust mites;
   • book dust;
   • feather;
   • dandruff and saliva of pets;
   • mold spores;
   • insects (cockroaches, moths, bugs, lice, pests of indoor flowers);
   • dry food for aquarium fish;
   • some medications;
   • Food;
   • cleaning and detergents.
3. Occupational allergens:
   • flour dust,
   • tobacco dust,
   • latex,
   • formaldehyde, etc.

In some cases, allergic rhinitis is caused by exhaust fumes, cigarette smoke, bright sunlight or cold.

The underlying factor, due to which the inflammatory process develops, is the IgE-dependent immune response (the reaction of the body's immune system). It involves mast cells, macrophages, eosinophils and T-lymphocytes located in the epithelium of the nasal mucosa. During the reaction, the target cells begin to release histamine (the main mediator of inflammation). By acting on histamine receptors, it increases capillary permeability, leads to hypersecretion of nasal mucus, the development of edema, nasal congestion and sneezing.

Classification and stages of the course of allergic rhinitis

Chronic rhinitis, which is based on immune inflammation, is divided into 2 forms:

• seasonal,
• year-round.

Seasonal or, as it is called, intermittent rhinitis, develops during the period of dusting of various plant species (in Russia - from early April to late September). Year-round (or persistent) rhinitis makes itself felt throughout the year. Most often, it is caused by constant contact with household allergens. Food and occupational irritants are much less likely to cause inflammation.

There are 3 degrees of AR severity:

• light (compensated),
• medium (subcompensated),
• severe (decompensated).

Researchers divide the course of rhinitis (runny nose) with allergies into several stages:

1. Paroxysmal (recurrent nasal congestion).
2. Catarrhal (profuse discharge, decreased sense of smell, ear congestion, and lacrimation).
3. Vasodilatory (often occurring swelling and narrowing of the nasal passages).
4. Chronic edema.
5. Polypoid (polyproduction process).
6. Nested hyperplasia (proliferation of the mucous membrane, damage to the sinuses, blood vessels, and sometimes the bony structures of the nose).

Note that allergic rhinitis is one of the most common diseases in the world.

Clinical picture

Symptoms of allergic rhinitis are in direct proportion to the form, severity and stage of development of the disease. The most characteristic signs of intermittent AR include:

• itchy nose;
• congestion;
• frequent paroxysmal sneezing (a phenomenon in which the patient sneezes 10 or more times);
• the release of a large amount of clear nasal mucus;
• decreased sense of smell.

With a mild form of the disease, a person feels normal, leads an active lifestyle and can play sports.

Moderate inflammation leads to decreased performance and daily activity, as well as sleep disorders. A pronounced violation of nasal breathing is accompanied by severe headaches, discomfort and tinnitus, and hearing impairment.

In 70% of patients with allergic rhinitis, lacrimation, itching and swelling of the eyelids are observed. Due to venous congestion and pronounced edema of the nasal mucosa, dark circles appear under the eyes, sometimes nosebleeds develop. The systemic manifestations of seasonal AR include the following symptoms:

• increased irritability,
• weakness,
• fast fatiguability,
• deterioration in appetite,
• discomfort in the abdomen (a consequence of swallowing a large amount of nasal mucus).

However, after cessation of exposure (action) of the allergen or under the influence of treatment of an allergic rhinitis, the symptoms of inflammation can completely regress.

The year-round form is characterized by less pronounced signs of allergic rhinitis in adults and children. Most often, the only complaint is nasal congestion without a runny nose. Due to forced breathing through the mouth, the mucous membrane dries out. This condition entails a pathological change in the timbre of the voice (nasal tone) and leads to the development of snoring. Constant runoff of nasal mucus along the back of the nasopharynx causes a dry, chronic cough. Due to persistent airway obstruction, the sense of smell is significantly or completely lost.

What is the difference between seasonal and perennial rhinitis?

Symptoms of seasonal allergic rhinitis develop within a clear time frame (during the period of dusting). At the same time, manifestations of year-round chronic rhinitis are directly dependent on weather conditions. In this case, inflammation is provoked by allergy-causing substances that are constantly circulating in the air. The severity of pathological signs depends on their concentration.

Many patients with year-round rhinitis develop hypersensitivity to several types of allergens at once. Regardless of the amount of treatment, the symptoms of an allergic rhinitis can change throughout the year. In this case, the disease has a wave-like course with exacerbations and periods of remission varying in duration.

Complications

An uncontrolled course of chronic inflammation of the nasal mucosa can lead to the development of the following complications:

• recurrent otitis media,
• sinusitis,
• the formation of polyps.

Due to a change in the immunological reactivity of the respiratory tract (a decrease in protective functions) and the addition of a secondary bacterial infection, rhinitis with allergies is often accompanied by acute respiratory infections, and also often becomes the cause of bronchial hyperreactivity and bronchial asthma.

Diagnostics

At the first consultation, the doctor finds out how allergic rhinitis manifests itself. In doing so, he pays attention to the following symptoms:

• breathing through the mouth;
• swelling and discoloration of the skin under the lower eyelids;
• redness of the mucous membrane of the eyes;
• transverse folds on the dorsum of the nose (a consequence of the so-called "allergic salute" - constant scratching of the tip of the nose).

The main link in the diagnosis is a thorough history taking aimed at identifying the allergen. It includes the following data:

• disease history,
• the presence of a genetic predisposition,
• information about living conditions,
• information about the suffered injuries and operations,
• information about bad habits.

To confirm the diagnosis, the following studies are carried out:

• general blood test (determination of the level of eosinophils - a marker of allergic reactions);
• rhinoscopy (examination of the nasal cavity using a special optical device);
• rhinocytogram (microscopy of nasal mucus);
• skin allergy tests for a standard set of allergens;
• provocative nasal tests (introduction of a test-control liquid into one nasal passage, and an allergen in a gradually increasing concentration in the other).

The latter testing is carried out strictly according to medical indications and in a specialized office equipped with everything necessary to prevent possible systemic reactions (from headache to anaphylactic shock).

To identify or exclude concomitant pathologies of the ENT organs, differential diagnostics can be prescribed, including computed tomography, endoscopic and morphological studies.

Allergy-related rhinitis treatment

How and how to treat allergic rhinitis (runny nose)? Experts identify 3 possible areas:

1. Complete elimination or minimization of contact with the allergen.
2. Symptomatic drug treatment.
3. Allergen-specific immunotherapy (introduction of gradually increasing doses of a causally significant allergen).

Of great importance are educational programs (allergy schools), which are aimed at optimizing the patient's living conditions in order to reduce possible contact with allergens. Such classes are conducted by qualified allergists.

All medicines for allergic rhinitis are divided into 2 groups:

• oral (to be swallowed),
• intranasal (for administration through the nasal passages).

Today, one of the safest topical preparations is considered. Produced in the form of nasal drops, it contains an active component - oxymetazoline, which has a long-lasting vasoconstrictor effect. Within 10-15 minutes after application, the lumen of the vessels decreases, edema subsides and breathing becomes easier. The duration of the mild therapeutic effect is 6-8 hours.

Unlike many other drugs for allergic rhinitis, Sialor®rino is practically not absorbed into the bloodstream, does not cause systemic reactions and drying out of the mucous membrane. The product is available in four therapeutic dosages:

• for adults (0.05%),
• for children (0.025%),
• for babies from 0 to 1 year old (0.01%).

The mini dropper packaging makes it easy and convenient to use. In addition, this form of release ensures sterility and minimizes the risk of microbial penetration.

Of course, in order to completely eliminate the manifestations of the disease, the treatment of an allergic rhinitis must be comprehensive and versatile. When choosing drugs for a child and an adult, the severity of AR and the presence of concomitant pathologies must be taken into account.

Due to the widespread prevalence and development of complications, early diagnosis and adequate treatment of allergic rhinitis are important tasks of modern practical medicine. In all cases of prolonged or recurrent rhinitis, it is necessary to look for the true causes that provoke the development of the inflammatory process. This constructive approach allows the development of effective treatment methods that improve the current condition and prognosis of the disease in general.