Allergic Rhinitis
Ear Nose Throat Diseases
Allergy symptoms start when the body's immune system responds to a foreign substance (antigen), sending antibodies to the entry point of the allergen. This results in a battle between the allergen and the antibodies, leading to the release of various chemical substances in the bloodstream. These chemical substances, in turn, cause allergic disease symptoms. Allergic rhinitis, although there has been an increase in its prevalence in Europe in the last 10 years, is rarely considered a serious problem because it is not a life-threatening condition, and temporary relief can often be achieved with over-the-counter medications.
What are the Symptoms of Allergic Rhinitis?
The symptoms of allergic rhinitis include sneezing, itchy eyes, itchy nose, nasal congestion, runny nose, and sometimes headaches. Some patients may experience hearing problems, sore throat, hoarseness, and coughing. Allergy symptoms may persist throughout the year in some individuals, while in others, they may worsen during specific seasons. Seasonal allergic rhinitis, also known as hay fever, occurs in individuals during spring and fall months. The most common allergens causing these symptoms are grass, tree, and weed pollen. Year-round allergic rhinitis is often triggered by allergens such as dust mites, mold spores, and pet dander. On the other hand, studies have also shown that air pollution can exacerbate allergy symptoms. In a study conducted in Istanbul, it was found that areas with high air pollution had more allergy symptoms.
Turkey's Allergen: Grass Pollen
Pollen from grass is the most common allergen in Turkey. Some allergens are always present, such as dust mites, pets, certain foods, and certain chemicals. Allergic symptoms caused by these allergens often worsen when homes are closed during the winter months. Mold spores, like pollen, can trigger allergic reactions and are present both indoors and outdoors. Indoor plants, humid areas, and bathroom mold are common sources of mold exposure. 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 has significant social, clinical, and economic consequences. In many patients, allergic rhinitis symptoms persist for more than 4 months a year, negatively impacting their quality of life. Allergic rhinitis can also lead to workdays lost for adults, school days missed for children, and economic problems due to the cost of diagnosis and treatment. Additionally, allergic rhinitis can coexist with other diseases, including asthma, sinusitis, developmental problems in children's dental and oral structures due to nasal congestion, middle ear diseases, conjunctivitis, and food allergies.
How is Allergic Rhinitis Diagnosed?
The patient's medical history plays a crucial role in diagnosing allergic rhinitis. It is essential to inquire about the patient's age, environments where symptoms worsen, previous medications used, and whether there are other family members with allergies. Since allergies are genetic, a family history of allergies can be very helpful in diagnosis. Additionally, allergic rhinitis is often seen as a disease of children and young adults. Therefore, a detailed ear, nose, and throat examination should be performed. If the patient's history and examination findings suggest allergies, allergy tests are performed. Allergy tests can be done using skin tests or blood tests to examine allergens. In particular, individuals who do not respond to allergy treatment should undergo a detailed examination of their nose, checking for adenoids in children, deviated nasal septum, nasal polyps, or sinusitis in adults. Middle ear infections in children, which can be caused by nasal congestion, should also be investigated. On the other hand, adults with frequent middle ear infections should also be screened for allergies.
Allergic Rhinitis May Be Associated with Sinusitis
The symptoms of allergic rhinitis can often be confused with sinusitis. Some patients with allergic rhinitis may receive antibiotic treatment for years due to a misdiagnosis of sinusitis. Conversely, patients with persistent head and facial pain, greenish nasal discharge, and other symptoms even with intensive treatment for allergic rhinitis should be evaluated for sinusitis. Recent studies have shown a close relationship between rhinitis and sinusitis. Therefore, individuals with recurrent sinusitis complaints should be examined for the presence of allergic rhinitis.
Treatment and Prevention of Allergic Rhinitis
Controlling allergic symptoms involves using a combination of multiple treatment methods. These include avoiding exposure to allergens, medication therapy, and allergen-specific immunotherapy. The first step is to avoid allergens that trigger symptoms. Here are some suggestions for eliminating allergens from your environment:
Change the filters in air conditioners every month
Keep windows and doors closed during pollen seasons.
Remove indoor plants from your home.
Do not keep furry pets in your home.
Use synthetic pillows, duvets, and mattresses instead of down or wool ones.
Do not smoke and do not allow smoking around you.
Medication Therapy for Allergic Rhinitis
Medication therapy is one of the most commonly used treatment options for allergic rhinitis. However, it is important to note that medication will be effective only as long as it is used. When medication therapy is discontinued, allergic symptoms tend to recur quickly. Individuals with allergic rhinitis should start using medication at least two weeks before the allergy season begins. Some medications commonly used in the treatment of allergic rhinitis may cause side effects, so it is essential to consult with a specialist doctor for guidance. Currently, the most commonly used drugs are antihistamines and steroid nasal sprays.
Allergen-Specific Immunotherapy for Allergic Rhinitis
Immunotherapy is defined as a treatment method that targets the cause of the disease. However, before starting immunotherapy, allergy tests should be performed to determine the allergen or allergens responsible for the patient's symptoms. With this treatment method, gradually increasing doses of the allergen causing the allergic symptoms are administered to the patient, with the goal of building immunity against that specific allergen. Immunotherapy involves injections given initially once a week, then once a month after reaching the maintenance dose. Immunotherapy can have long-lasting effects on allergic symptoms, even after it is discontinued. Research has shown that immunotherapy may prevent the development of new allergies and reduce the risk of asthma in children. However, due to the risk of side effects, immunotherapy should be administered by experienced individuals in well-equipped centers. In recent years, immunotherapy has also been administered through oral drops. However, the choice of method should be made in consultation with a doctor.