Allergic rhinitis

Question 1

What is it?

Answer 1

Exposure of nasal mucosa to allergens leading to IgE inflammation of the nose

Can be
- seasonal- occurring at same time each year (if pollen associated then hayfever)
-perennial- symptoms persist throughout the year
- Occupational

Question 2

What are the clinical features?

Answer 2

Sneezing
Bilateral nasal obstruction
Nasal itching
Rhinorrhoea- post nasal drip
Clear discharge
May have allergic conjunctivitis- itchy eyes with tearing

Question 3

What is the management of mild to moderate?

Answer 3

Avoid allergen
Either
-PRN intranasal antihistamine (azelastine)
- PRN non sedating oral antihistamine (cetirizine or loratidine)

Question 4

What is the management of moderate- severe symptoms?

Answer 4

Can be used it 1st line treatments failed

Regular intranasal steroids during period of allergen exposure e.g. mometasone or fluticasone
Can consider nasal decongestants but should not use for long time as tolerance develops
Can consider oral steroids for big life events