Main
- Allergic rhinitis — inflammation of the nasal mucosa due to the immune system's reaction to pollen, dust, animal fur and mould.
- Symptoms persist as long as contact with the allergen continues: congestion, clear discharge, sneezing, itching in the nose and eyes.
- Examination begins with history-taking and examination of the nose, then skin allergy tests and a blood test for antibodies may be possible.
- The condition is managed by an allergist-immunologist and an ENT doctor; if no specialist is available, one can start with a general practitioner.
- Prevention relies on limiting contact with the allergen, wet cleaning, air purifiers and avoiding tobacco smoke.
What is allergic rhinitis
Allergic rhinitis is an inflammation of the nasal mucosa that occurs as a reaction of the immune system to contact with allergens. Below we look at exactly what happens in the body, which substances and circumstances trigger the reaction, and who experiences it more often.
What happens in the body
The nasal mucosa is the first to meet the inhaled air along with particles of pollen, dust and animal fur. In a predisposed person, the immune system takes these harmless particles for a threat and begins to react to them as if they were dangerous. On repeated contact with such a substance, special compounds are released in the mucosa that trigger inflammation. Because of this, small vessels dilate, the tissue swells, and the nasal passages narrow and let air through less well. At the same time, nerve endings are irritated, so the person sneezes and feels itching in the nose. The discharge becomes profuse and clear, and the sense of smell is temporarily dulled. If contact with the irritant is repeated often, the mucosa stays inflamed longer and reacts even to weak influences.
What causes it to develop
- Plant pollen: small particles of flowering grasses, trees and shrubs rise into the air and enter the nose during breathing.
- House dust and mites: mites invisible to the eye live in beds, upholstered furniture and carpets, and their particles are constantly present in the air of a home.
- Animal fur and dander: the reaction is caused not so much by the hairs as by the tiniest flakes of skin and proteins in the saliva of pets.
- Mould and fungal spores: they multiply in damp rooms, bathrooms and on walls, and the spores are easily carried through the air.
- Some food products: in some people the nose reacts to certain types of food, although a food reaction and a runny nose are not always linked.
- Strong odours and tobacco smoke: they are not allergens themselves, but they irritate the already inflamed mucosa and intensify its reaction.
Who experiences it more often
More often than others, such a reaction to inhaled substances is experienced by people with a hereditary predisposition to allergy. If the parents had increased sensitivity to pollen or dust, the likelihood of a similar reaction in a child is noticeably higher. It usually manifests in childhood or young age, but the first episodes may also occur later. In residents of large cities the condition occurs more often than in rural residents, because of polluted air and an abundance of irritants. Seasonality also matters: with a reaction to pollen, symptoms recur during the flowering period of plants. In people who are constantly near animals or in damp rooms, exacerbations occur all year round. Therefore, with a recurring runny nose and sneezing, it is worth writing down on which days and where they occur — these notes will help the doctor understand the causes.
What symptoms can occur?
Allergic rhinitis manifests immediately after contact with the allergen and persists as long as this contact continues. Besides a runny nose, it is often accompanied by itching in the nose and eyes and general discomfort.
How it is noticed at the very beginning
Allergic rhinitis begins with itching in the nose and frequent sneezing, which are easily put down to fatigue or a cold. A person notices that the nose is blocked and clear discharge appears from it. The eyes redden and water, itching joins in, and this is already difficult to explain by ordinary overwork. The symptoms last exactly as long as contact with the allergen continues and do not go away after rest. Because of nasal congestion, the sense of smell decreases, and breathing becomes inadequate. Constant discomfort interferes with sleep and work, although the temperature remains normal. If such signs recur under the same circumstances, it is worth booking a routine appointment with an allergist-immunologist or an ENT doctor.
Signs that occur most often
- Nasal congestion: nasal breathing is difficult, and this interferes with sleeping, talking and working during the day.
- Clear nasal discharge: the discharge is liquid and watery, and it increases on contact with the allergen.
- Frequent sneezing: attacks occur in succession, usually immediately after contact with the irritant and without signs of a cold.
- Itching in the nose and eyes: burning and the urge to rub the eyes and nose increase irritation and add discomfort.
- Reduced sense of smell: smells are perceived more weakly because of swelling of the mucosa, and this makes it difficult to assess food and air.
- Watering and redness of the eyes: the eyes look inflamed, and tears flow constantly, which interferes with reading and working.
When to seek help urgently
Examinations and tests
Examination for allergic rhinitis is built up step by step: from history-taking and physical examination to laboratory tests. Below is a breakdown of what exactly is prescribed, what each investigation shows and how to prepare for the appointment.
How the examination begins
Examination for suspected allergic rhinitis begins with asking the patient about the symptoms and their connection with possible allergens. The doctor clarifies when nasal congestion, itching, sneezing and profuse discharge appear, and in which seasons or rooms this recurs. Separately, it is established whether there is a reaction to dust, animal fur, plant pollen, mould or strong odours. Then an examination of the nose is carried out, during which the condition of the mucous membrane, its colour, swelling and the nature of the discharge are assessed. Such an examination helps to distinguish an allergic reaction from other causes of a runny nose and to see the changes typical of it. If the picture remains unclear, the doctor may prescribe additional tests to confirm the allergy. Before the appointment, it is worth writing down in advance in which situations the symptoms worsen, to make the conversation easier.
What is prescribed and what it shows
What is worth preparing for the appointment
- Symptom diary: notes about when and where the runny nose appears help the doctor to see the connection with allergens.
- List of allergens: list the suspected triggers to narrow down the possible causes of the reaction.
- Previous results: existing tests and reports show the dynamics and save you from repeat investigations.
- Doctors' notes: records from other clinics give a full picture of the condition over the past time.
- List of what you are taking: indicate everything you are taking now, so that the doctor takes it into account during the examination.
- Questions for the doctor: formulate in advance what you want to clarify, so as not to forget anything important at the appointment.
Which doctor should I see?
The section explains which specialist to consult for allergic rhinitis, what happens at the first appointment and what areas of care the treatment consists of. It also separately examines which part of the result depends on the regularity of follow-up with the doctor.
Which specialist manages this condition
Allergic rhinitis is managed by an allergist-immunologist, and if there are pronounced nasal symptoms, an ENT doctor joins the follow-up. The allergist-immunologist assesses the general condition, clarifies which specific irritants trigger the reaction, and determines the further approach to care. The ENT doctor examines the nasal cavity and paranasal sinuses to rule out other causes of difficulty breathing and discharge. If there is no specialist nearby, you can start with an appointment with a general practitioner, who will refer you to the right doctor. At the first appointment, the doctor asks in detail about when and under what circumstances the symptoms appear, how long they last and what relieves them. Then they examine the nose, paying attention to swelling of the mucosa, the nature of the discharge and the state of nasal breathing. Based on the examination and the conversation, the doctor selects an individual approach and decides whether additional examination by related specialists is needed. If symptoms recur season after season, it is reasonable not to postpone the visit, but to discuss a follow-up plan with the doctor straight away.
What the treatment consists of
- Selection of therapy by the doctor: the specialist determines the areas of care taking into account the form of rhinitis, the severity of symptoms and the patient's general condition.
- Follow-up with the specialist: regular visits allow changes in the course of the condition to be noticed in time and the chosen approach to be adjusted.
- Allergen-specific immunotherapy: a method in which the body is gradually accustomed to the causative allergen, which reduces sensitivity to it.
- Nasal irrigation with saline solutions: a simple procedure that helps cleanse the mucosa of irritants and reduce congestion.
- Physiotherapy procedures: additional methods of treatment that the doctor may recommend in addition to the main areas of care.
What depends on the patient themselves
The regularity of follow-up with the specialist largely determines how stable the improvement in the condition will be with allergic rhinitis. If visits to the doctor happen only occasionally, the specialist does not see the full picture and cannot notice in time that the chosen approach has stopped working. A patient who comes to appointments at the appointed times helps the doctor track the dynamics and, if necessary, change the approach. It is equally important to honestly talk about how the symptoms manifest at home and at work, what makes them worse and what brings relief. Notes about when and under what circumstances things get worse give the doctor more than general words about how you feel. Following the recommendations agreed with the specialist and refraining from making decisions on your own support the result achieved at the appointment. If something in the prescribed approach does not suit you or raises questions, this should be told to the doctor rather than changing everything yourself. Calm and consistent following of the plan drawn up together with the doctor is usually easier to cope with than trying to figure things out alone.
What helps prevent an exacerbation?
Prevention of allergic rhinitis largely depends on a person's everyday decisions. Below are habits, monitoring and regular visits to the doctor that reduce the risk of exacerbation.
What to change in habits
Limiting contact with known allergens remains the mainstay of preventing allergic rhinitis. If the cause of the reaction has been identified, it is sensible to remove it from the home and, where possible, avoid it elsewhere. During the pollen season, wearing a protective mask outdoors and keeping windows closed during the hours of active flowering help. Wet cleaning of rooms reduces settled dust and prevents it from rising into the air when people move about. Air purifiers reduce the concentration of fine particles in a room, especially in the bedroom, where a person spends the night. Giving up smoking and avoiding tobacco smoke noticeably reduce irritation of the nasal mucosa. Timely treatment of concomitant diseases of the nose and paranasal sinuses also reduces the frequency of exacerbations, so they are worth mentioning to the doctor.
What to keep under control
- Contact with the allergen: note where and when symptoms appear so that you understand what to avoid in everyday life.
- Air quality at home: a purifier and wet cleaning help keep dust under control all year round.
- Pollen season: follow the flowering calendar of plants in your area and change your routine in advance.
- Tobacco smoke: giving up smoking and banning smoke in the flat reduce constant irritation of the nose.
- Diseases of the nose and sinuses: their exacerbations should be treated in time, not put off until the condition becomes severe.
- Observation diary: short notes about how you feel help the doctor see patterns and adjust recommendations.
How often to see the doctor
Regular monitoring is needed even when you feel well and symptoms hardly bother you. Allergic rhinitis follows a wave-like course, and a calm period does not cancel follow-up with a specialist. The doctor assesses how well the usual measures are working and notices changes earlier than the person themselves. Seasonality differs between allergens, so it is sensible to tie the schedule of visits to the period of exacerbations. If new symptoms appear or old ones worsen, it is not worth putting off a conversation with the doctor. Concomitant diseases of the nose and paranasal sinuses also require attention, otherwise they maintain inflammation. The practical conclusion is simple: agree on a clear schedule of visits in advance and stick to it, not only when things get worse.
What is worth remembering
Allergic rhinitis is a condition that requires not a one-off visit, but observation and an understanding of your own triggers. Below is the main thing worth keeping in mind after getting to know the topic.
Key takeaways
Allergic rhinitis is not cured by a single effort and does not go away with a change in the weather, so the main mistake is to expect that congestion and itching will disappear on their own. Allergic rhinitis is often confused with a cold, and a person takes remedies for a runny nose for weeks without understanding why there is no improvement. Allergic rhinitis worsens on contact with pollen, dust, animal fur and mould, and these circumstances can be tracked and recorded. Allergic rhinitis noticeably reduces quality of life: it interferes with sleep, work, sport and relaxing outdoors. Allergic rhinitis in children and adults manifests similarly, but in children it more often affects sleep and attention. Allergic rhinitis does not directly threaten life, however, without attention to it, breathing and general wellbeing worsen. Allergic rhinitis is worth discussing with a doctor, rather than choosing remedies on your own on the advice of acquaintances.
