Allergic Rhinitis

Allergic rhinitis or hay fever is a disease characterized by runny nose, sneezing, nasal congestion, and itchy nose and throat in individuals sensitive to airborne allergens. Allergy is a genetically inherited disease, and if both parents are allergic, there is a 50% probability of allergy in their children. When allergens encounter the body defense system in allergic bodies, a special antibody called IgE is produced against them. The recombination of these antibodies with allergens causes the secretion of chemical substances that cause an allergic reaction from the cells in the nasal mucosa (the membrane lining the nose). pollen, animal epithelium and hair, fungal spores, and house dust mites.

Diagnosis and treatment of allergic rhinitis is important because it causes acute and chronic sinusitis and affects the quality of life of the patient. Allergic rhinitis can occur in spring and summer, or it can last all year. Allergic rhinitis can be seen especially in children with asthma, middle ear diseases and food allergies.

Diagnosis is made by a clinic compatible with allergy, otolaryngological examination and endoscopy, and skin prick test or blood tests. The Skin Prick test is applied to the uppermost layer of the skin with a solution applicator containing allergens on the patient’s forearm and waited for 20 minutes. If the patient has allergen sensitivity, there will be swelling and redness in that area. The physician evaluates this redness and swelling and determines whether the patient is sensitive and, if so, to which allergen.

Its treatment consists of prevention, drug therapy and vaccine therapy, which we call immunotherapy. Drugs used in drug therapy; oral or topical antihistamines, oral or topical decongestants, topical cromones, leukotriene antagonists, topical and rarely systemic glucocorticosteroids. The oldest drugs used in the treatment of allergic rhinitis are oral antihistamines. If used in treatment, new generation antihistamines should be preferred as the first choice. Oral antihistamines prevent nasal itching, discharge, and sneezing, but their effectiveness in the symptom of nasal congestion is minimal. They are used once a day. Topical antihistamines are also effective in relieving nasal itching, sneezing, runny nose, and congestion. They need to be applied twice a day. They are equally effective with oral antihistamines. Topical corticosteroids are the most powerful weapons we have in controlling all the symptoms of allergic rhinitis.

They are also effective on eye symptoms. Their activity begins between 4-7 hours, but they reach maximum effectiveness in two weeks. They can also be used for prophylactic purposes. They can be applied continuously or when needed, depending on the patient’s symptoms. Since their systemic absorption is low, their side effects are minimal. Therefore, they can be used safely for long periods of time. Leukotriene antagonists are effective in all rhinitis symptoms. They reduce nasal edema. Their effectiveness is equal to antihistamines. They can be combined with antihistamines. Vaccine therapy, that is, immunotherapy, is performed in patients with appropriate indications for whom drug treatment is not sufficient. The only treatment that can change the course of allergy is vaccination.

Protection is often insufficient. It is recommended for patients with pollen allergy to stay indoors between the hours of 10-16, when the intensity is highest in the season, to keep the car windows closed, to take a shower at night, to use glasses and not to go out in windy weather. It is known that indoor allergens play an important role in the etiology of year-round rhinitis and asthma. The most important indoor allergen is house dust mites. The mites perish when the humidity is less than 50% and at temperatures above 60°C. Body proteins and feces of mites are allergenic. Quilts, pillows, carpets, rugs, and curtains in bedrooms are the main sources of house mites. To be protected from mites, places should be kept as empty as possible and should be cleaned frequently with anti-allergic HEPA filtered vacuum cleaners. Air conditioning and central heating should be avoided, the heat and humidity of the house should be reduced. Those with mite allergies can use anti-allergic bedding. Laundry should be washed at 60°C at least once a week. Items such as sofas, books, carpets that collect dust should be removed from the bedroom. It is an important source of mites in stuffed toys. These toys can be kept in the refrigerator at night to reduce the number of mites. Patients with fungal allergies should prefer houses that are exposed to the sun as much as possible and have good ventilation. The indoor humidity should be kept below 35% if possible. Air conditioners with HEPA filters can be used to reduce humidity.

It would be appropriate for them to choose parquet instead of carpet, and paint instead of paper on the wall. Places such as bathrooms, cellars and kitchens should be well ventilated. Moldy food should not be kept in refrigerators.