What is Allergic Rhinitis? How is it Treated?

Seasonal allergic rhinitis, also known as hay fever, is one of the most common allergic diseases. If you feel unwell at the same time every year, you may be one of the people with seasonal allergies.

Allergic rhinitis, also known as hay fever, is one of the most common allergic diseases. If you feel unwell at the same time every year, you may be one of the people with spring allergies.

Allergy symptoms start when the body's immune system reacts to a foreign substance (antigen). The immune system does this by sending antibodies to the point of entry of the allergen. The battle between the allergen and antibodies leads to the release of various chemical substances into the bloodstream. These chemicals then cause the symptoms of allergic diseases. Although the prevalence of allergic rhinitis has increased in Europe over the last decade, it is rarely considered a serious problem because it is not life-threatening and temporary relief can often be achieved with medications taken on recommendation without the need for a doctor's visit.

What are the Symptoms of Allergic Rhinitis?

The symptoms of allergic rhinitis include sneezing, itching in the eyes and nose, nasal congestion, runny nose, and sometimes headaches. Some patients may also experience hearing problems, sore throat, hoarseness, and cough. Allergy symptoms may persist for an entire year in some individuals, while in others, they may increase during specific seasons. People with seasonal allergic rhinitis, or hay fever, typically experience symptoms in spring and autumn. The most common allergens causing this are grass, tree, and weed pollens. For those with year-round allergic rhinitis, dust mites, mold fungi, and pet dander are the most common allergens. Furthermore, studies indicate that air pollution can worsen allergy symptoms. A study conducted in Istanbul found that allergy symptoms were more common in areas with air pollution.

Turkey’s Allergen: Grass Pollen

Pollens, foods, fungi, dust, pet dander, chemicals, certain medications, and environmental irritants can trigger allergic reactions. Hay fever is caused by pollen. In Turkey, the most common allergen is grass pollen. Some allergens are always present, such as dust mites, pets, foods, and certain chemicals. Symptoms caused by these allergens often worsen in winter when homes are closed. Mold fungi, like pollen, can also cause allergic reactions and can be found both indoors and outdoors. Indoor plants, damp areas, and places where bathroom fungi are often found are common sources. Contrary to popular belief, colorful or fragrant flowers rarely cause allergies.

Can Allergies Be a Serious Disease?

Allergic rhinitis is rarely considered a serious problem. However, it can lead to significant social, clinical, and economic impacts. In many cases, patients experience allergic rhinitis symptoms for more than four months a year, which affects their quality of life. Rhinitis also causes economic problems due to work absenteeism in adults and school absenteeism in children, as well as the costs of diagnosis and treatment. Allergic rhinitis can also coexist with other diseases. Conditions such as asthma, sinusitis, nasal congestion-related dental and oral development issues in children, middle ear diseases, conjunctivitis, and food allergies are commonly seen alongside allergic rhinitis.

How is Allergic Rhinitis Diagnosed?

In diagnosing allergic rhinitis, patient history is crucial. It is important to investigate the patient’s age, the environments where symptoms worsen, previous medications used, and whether anyone else in the family has allergies. Since allergy is a genetic condition, a family history of allergies is very helpful in the diagnosis. Additionally, allergic rhinitis is commonly seen in children and young adults. A detailed ear, nose, and throat examination should follow. If the patient’s history and examination findings suggest allergies, allergy tests are performed. Allergy tests can be done through skin tests or by examining allergens in the blood. In particular, for individuals who do not respond to allergy treatment, a detailed nasal examination is performed. In children, adenoids, and in adults, issues like cartilage curvature, nasal polyps, and sinusitis are checked. In children, the possibility of accompanying middle ear infections is also investigated. Additionally, children who frequently experience middle ear infections are also questioned about potential allergies.

Allergic Rhinitis May Be Related to Sinusitis

The symptoms of allergic rhinitis are often confused with those of sinusitis. Some allergic rhinitis patients may undergo years of antibiotic treatment due to a misdiagnosis of sinusitis. On the other hand, for patients who do not respond to treatment but have persistent symptoms like headaches, facial pain, or greenish nasal discharge, it is important to investigate whether sinusitis is present. Recent studies have shown a close relationship between rhinitis and sinusitis. Therefore, it is beneficial to investigate whether individuals with recurrent sinusitis have allergic rhinitis.

Treatment and Prevention of Allergic Rhinitis

Controlling allergic symptoms typically requires the use of multiple treatment methods. These include avoiding allergens, medication, and immunotherapy (allergy shots). The first step is to avoid exposure to the allergens that trigger symptoms. Here are some suggestions to remove allergens from your environment:

• Change air conditioner filters every month
• Keep windows and doors closed during pollen season
• Remove indoor plants
• Avoid having pets with fur at home
• Use synthetic pillows, duvets, and mattresses instead of down or wool
• Do not smoke and avoid exposure to secondhand smoke

Medication for Allergic Rhinitis

Another common treatment for allergic rhinitis is medication. However, it is important to remember that medications are only effective while being used. Once medication is stopped, allergy symptoms often return quickly. People with allergic rhinitis should start using medication at least two weeks before the allergy season begins. Some medications used in allergic rhinitis treatment may have side effects, so it is essential to consult a specialist doctor. The most commonly used medications today are antihistamines and steroid sprays.

Immunotherapy for Allergic Rhinitis

Immunotherapy is a treatment aimed at addressing the root cause of allergies. However, before starting immunotherapy, allergy tests must be performed to identify the allergens that are causing symptoms. In this treatment, allergens are gradually administered in increasing doses to help the individual build immunity against them. Immunotherapy injections are initially given weekly, and after reaching the maintenance dose, they are administered monthly. This treatment has long-term effects on allergy symptoms and can even remain effective after it is stopped. Research has shown that immunotherapy can prevent the development of new allergies and reduce the risk of asthma in children. However, because of the risk of side effects, immunotherapy should only be performed by experienced professionals in well-equipped centers. In recent years, immunotherapy has also been administered through oral drops, but the method should be chosen in consultation between the patient and the doctor.