Running nose? Continuous Sneezing ? Nasal itching ? Nasal blockage ? Are you suffering from these symptoms? It could be Allergic Rhinitis.

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When you are exposed to dust, do you sneeze continuously? Do you have running nose during this time ? Do you feel itching in the nose ? Do you have nasal blockage? Or may be instead of dust, does similar illness happens with something else? Like exposure to cold, Animal dander, Fungal molds, Pungent smell, Pollen, Beg bugs, flies, cockroaches, any particular food.

If your answer is yes, then you could possibly be having what is medically called as ALLERGIC RHINITIS.
Now, don't panic. We can manage it very well.

How does it happen?
Like any other allergy, here also there will be a particular substance (allergen) causing these symptoms. The basic pathology is an over-reaction of body's defence system (immune system) to the allergen. Same allergen may not cause the above symptoms for everyone. All symptoms may not be present in everyone.
Like I mentioned earlier, pollen, dust, dust mites, animal dander, feathers, saliva(of pets), fungal molds, insects (cockroaches, flies,bed bugs), and food items (milk,egg, certain fruits) are the most common allergens.

What can you do?
When you are suffering these illnes, the primary thing to be done from your side is to IDENTIFY & AVOID THE ALLERGEN as much as possible. On close observation on occurance of the above symptoms, try to identify the allergen. If you are able to find the allergen, then try to avoid it as much as possible. Like if it is dust allergy, try to minimise the exposure to dust, by frequently cleaning the house, using masks while cleaning, keeping the dust attracting furnitures (sofa, cushioned chairs, thick carpets, curtains) clean.
But in many cases you won't be able to find a particular allergen yourselves.

Consult an ENT Doctor
Your doctor will take a thorough history of your illness and do a clinical examination followed by a diagnostic nasal endoscopic examination which will in most cases helps in diagnosis of the condition.

In addition the doctor might take nasal smears for study( to look for eosinophils), do some blood tests( to look for raised eosinophil count).
He might also ask for Dermatology consultation to do Allergen test (Patch test) to identify the particular allergen. Or sometimes tests like ELISA may be done to look for antibody against a particular allergen.
A CT scan may also be required in the later stages of disease depending upon the severity of disease. 

How do we manage ?
With proper treatment, the condition can be well managed.
Initially doctor will give you some oral medicines( antihistamines, decongestants, leukotriene inhibitors ).
He may also advise you to take some topical steroid drugs like nasal drops or nasal sprays ( fluticasone, mometasone, beclomethasone ).
  People generally have a reluctance to use steroid medication once explained. But it is to be noted that steroid nasal drops/sprays do not cause much side effects like you believe. Also these are very effective in controlling your symptoms.

Some other nasal drops like decongestants ( oxymetasoline, xylometasoline ) should only be used temporarily exactly for the duration advised by your doctor. These medications are notorious to cause something called rebound phenomenon( when you stop medication symptoms will aggravate again).

In severe cases ( like if there is nasal polyposis) your doctor might ask you take steroid medication orally as well for a short period of time in tapering doses.

Surgery???
Not every patient with allergic rhinitis need surgery. These are required only in conditions when you do not have significant improvement with medical treatment.
In required cases, an ENDOSCOPIC NASAL SURGERY called as FESS (Functional Endoscopic Sinus Surgery) will be done.
This surgery is done completely through nose with an endoscope. So you don't have to worry about scars. 

Is surgery the ultimate solution ?
No, it is not. Even after surgery, you will have to continue medications and sprays or drops. When you get better symptomatically, your doctor will reduce the number, dosage and frequency of these medications.

If you follow the orders properly things can be very well managed and you can lead a quality life.
Thankyou.
- Dr.Yethin Yedukumar (MBBS, M.S.ENT)



Hi friends. In this blog, you will find some interesting articles related to Ear, nose and throat diseases. Do share if found useful. Thankyou.

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