What is Allergic Rhinitis?
Does your child have recurrent nasal congestion, nasal discharge and sneezing? He can be suffering from Allergic rhinitis. Allergic rhinitis is a diagnosis that can be established both in infants and in an older child, but its prevalence usually peaks late in childhood
It is estimated that about 20-40% of children suffer from allergic rhinitis, especially those who are living in highly industrialized areas.
Definition of Allergic Rhinitis
Allergic rhinitis is a disease that is manifested as frequent sneezing, watery nasal discharge and nasal congestion. Its symptoms are very similar to an ordinary upper respiratory infection thus; it is often mistakenly diagnosed as such. It is a type of an allergic reaction and is caused by the exposure of the child to an allergen which leads to the infiltration of the nasal mucosa by inflammatory cells. Some children react to an allergen 4 -8 hours after the exposure but some may react right after the exposure. Allergic rhinitis may be seasonal or perennial. Seasonal allergic rhinitis usually follows a well-defined cyclical course whereas perennial causes symptoms that are experienced all throughout the year. Seasonal allergic rhinitis is often attributed to the reaction of the patient to the pollination of trees in spring or during extreme cold temperature during the winter. The fur of cats and dogs are common cause of allergic rhinitis.
What are the signs and symptoms of allergic rhinitis?
Typical complaints and manifestations are the following:
- Intermittent nasal congestion which is usually severe at night and often disturbs sleep
- Clear nasal discharge or rhinorrhea is a common symptom of allergic rhinitis
- Conjunctival irritation or itchiness
- Some may have headache or coughing
- Children often rub their nose with their hand and this is called “the allergic salute”
- The presence of a horizontal crease over the nasal area caused by frequent rubbing
How is Allergic Rhinitis diagnosed?
In the diagnosis of allergic rhinitis, the patient’s history plays a vital role as well as the physical examination and laboratory tests. The diagnosis should be based on the presence of the above signs and symptoms in the absence of any respiratory tract infection or structural anomalies.
Risk factors should be identified and this includes a strong family history of allergy or asthma or infants that are given complementary food or milk formula earlier. Heavy exposure to allergens such as smoking or pets should be taken into consideration.
Epicutaneous skin tests are the best method for the detection of allergen specific immunoglobulin, although it is often times not necessary to perform such test to be able to diagnose allergic rhinitis in a child.. Eosinophils noted in the nasal mucosa also helps in the diagnosis of allergic rhinitis.
How can Allergic Rhinitis be treated?
The goal of the treatment of allergic rhinitis is to prevent recurrence of symptoms in a safe way. The removal of the offending allergen is most important in the management of allergic rhinitis. Linens and pillow cases should be hypoallergenic and it should be washed regularly. Pets should be avoided at all cost.
Oral antihistamines can be given as needed and is suitable for children with mild and intermittent symptoms. It relieves the sneezing and the nasal itch. Second generation anti-histamines such as Citirizine and Loratadine are preferred because they are less sedating. Patients who have more severe manifestations should be given corticosteroids. A consultation with an allergist is recommended for patients who do not respond to treatment. Should you give your child anti histamine? Consult your pediatrician, it is always important to do that first.
Do you have some questions or concerns about allergic rhinitis? Feel free to leave a comment and I will gladly get back at you as soon as I can.
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