Allergic rhinitis is irritation and inflammation in the nasal passages after exposure to allergens. Allergens are substances that cause an abnormal response of the immune system. The response can includes swelling of the nasal passage, runny or itchy nose, watery eyes, congestion and congestion pain, and sneezing. It may be:
An allergic reaction occurs when your body's immune system overreacts to an allergen. When you breathe in an allergen, cells in your nasal passages release a chemical called histamine. Histamine causes your nose to feel itchy and creates swelling and mucus production in the nasal passages.
Site of Histamine Production
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Factors that increase your chance of having allergic rhinitis include:
Exposure to the allergen can cause:
You will be asked about your symptoms and medical history. Allergic rhinitis is most often diagnosed based on description of symptoms. A referral to an allergy specialist may also be made.
The following tests may be done:
Minimizing exposure to the allergen is the most effective way to treat allergies. Specific steps will depend on allergen such as:
Dust mite reduction:
Mold exposure reduction:
Animal allergen reduction:
General reduction techniques:
Though reducing allergens can help, it is not possible to completely eliminate all allergens. Other treatments may help reduce the body's reaction to the allergen:
Medications can help to minimize the reaction of the immune system to reduce symptoms like swelling and mucous production. They may be given alone or in combination. Options include:
These medications are most effective when delivered before exposure to allergen and through time of exposure.
Other medications that may be added include:
Decongestants may be recommended for severe congestion. Decongestants are not appropriate for everyone and do not stop symptoms, only temporarily relieve some pressure. Overuse of nasal decongestant sprays can actually make symptoms worse.
Immunotherapy gradually introduces your body to an allergen through injections or pills placed under the tongue. The goal is to make your body's immune system less sensitive to those allergens and reduce or eliminate allergic rhinitis. This therapy requires several treatments over an extended period of time. It may only be recommended for people who have poor management with medication alone.
The therapy is delivered in small amounts over weeks, months, or even years. Immunotherapy is only available for specific allergens but more may become available after appropriate testing.
American Academy of Allergy, Asthma, and Immunology
Asthma and Allergy Foundation of America
Allergy Asthma Information Association
Allergic rhinitis. American College of Allergy, Asthma, & Immunology website. Available at: http://www.acaai.org/allergist/allergies/types/rhinitis/Pages/default.aspx. Accessed September 23, 2015.
Allergic rhinitis. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated June 8, 2015. Accessed September 23, 2015.
Managing Indoor Allergen Culprits. American Academy of Allergy Asthma and Immunology website. Available at: http://www.aaaai.org/Aaaai/media/MediaLibrary/PDF%20Documents/Libraries/EL-indoor-allergies-managing-patient.pdf. Updated February 2011. Accessed September 23, 2015.
Rhinitis. American Academy of Allergy Asthma & Immunology website. Available at: http://www.aaaai.org/conditions-and-treatments/allergies/rhinitis.aspx. Accessed September 23, 2015.
Wheatley L, Togias A. Allergic Rhinitis. N Engl J Med 2015; 372:456-463. Accessed at: http://www.nejm.org/doi/full/10.1056/NEJMcp1412282. Accessed September 23, 2015.
8/11/2006 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Durham SR, Yang WH, Pedersen MR, et al. Sublingual immunotherapy with once-daily grass allergen tablets: a randomized controlled trial in seasonal allergic rhinoconjunctivitis. J Allergy Clin Immunol. 2006;117:802-809.
8/27/2013 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Kim JM, Lin SY, Suarez-Cuervo C, et al. Allergen-specific immunotherapy for pediatric asthma and rhinoconjunctivitis: a systematic review. Pediatrics. 2013 Jun;131(6):1155-67.
Last reviewed September 2015 by Marcin Chwistek, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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