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Allergic Rhinitis

Allergic rhinitis is an inflammation of the nasal passages, usually associated with watery nasal discharge and itching of the nose and eyes.

Allergic rhinitis affects about 20 percent of the American population and ranks as one of the most common illnesses in the U.S. The symptoms occur in the nose and eyes and usually occur after exposure to dust, dander, or certain seasonal pollens in people that are allergic to these substances. Two-thirds of all patients have symptoms of allergic rhinitis before the age of 30, but onset can occur at any age.

Allergic rhinitis has no sexual predilection, although boys up to the age of 10 are twice as likely to have symptoms as girls. There is strong genetic predisposition to allergic rhinitis. One parent with a history of allergic rhinitis has about a 30 percent chance of producing offspring with the disorder; the risk increases to 50 percent if both parents have a history of allergies.

Patients can be severely restricted in their daily activities, resulting in excessive time away from school or work. Millions of dollars are spent each year on physician services and medication for treatment of this chronic illness.

Characteristic symptoms include repetitive sneezing; rhinorrhea (runny nose); post-nasal drip; nasal congestion; pruritic (itchy) eyes, ears, nose or throat; and generalized fatigue. Symptoms can also include wheezing, eye tearing, sore throat, and impaired smell. A chronic cough may be secondary to postnasal drip, but should not be mistaken for asthma. Sinus headaches and ear plugging are also common.

The goal of treatment is to reduce the allergy symptoms. Avoidance of the allergen or minimization of contact with it is the best treatment, but some relief may be found with over the counter use of aantihistamines. Common older (first generation) antihistamines include diphenhydramine (Benadryl) or chlorpheniramine (Chlotripolon). Although effective, they cause significant sedation, limiting their usefulness as a long term therapeutic option for most patients. Non-sedating (less likely to cause drowsiness) second generation long-acting antihistamines include Claritine/loratidine, Allegra/fexofenadine and Aerius/desloratidine.

Corticosteroid nasal sprays (e.g. Nasonex, Nasacort or Avamys) are the most commonly chosen prescription medications for chronic allergy sufferers.

It is important to remember that improvement may not occur for one to two weeks after starting therapy with steroid nasal sprays. Discuss the symptoms with your doctor – a correct diagnosis is the first step towards improving your quality of life.