Allergic Rhinitis (“Sinus”)

What is allergic rhinitis
(commonly called “sinus”)?

Allergic rhinitis is a reaction of the lining of the nose to particles in the air.

How does it occur? 

Allergic rhinitis occurs when the nose and usually also the ears, eyes, sinuses, and throat come into contact with allergy-causing substances. The allergy-causing substances are called allergens. The most common allergens are dust, pollens, molds and animal dander. Allergens such as the mites in house dust are present year-round. Temperature and humidity changes
(e.g. air-con) may also aggravate the symptoms.

When the lining tissues of the nose and sinuses come into contact with allergens, a chemical called histamine is released from cells in the nose. Histamine causes the nose lining to swell, itch, and make too much mucus. 

What are the symptoms? 

Common symptoms of allergic rhinitis are 

  • itchy, runny nose 
  • sneezing 
  • nasal and head congestion. 

How is it diagnosed? 

A skin prick test is usually done to confirm the diagnosis. For these tests, tiny amounts of suspected allergens are pricked under your skin to look for reactions. The skin prick test will identify the common allergens causing your symptoms. 

How is it treated? 

  1. Allergen avoidance
  2. Anti-histamines 
  3. Steroid nasal sprays
  4. Sublingual Immunotherapy (SLIT)
  5. Radio-frequency turbinate reduction (RFIT)

The first step is to try to avoid contact with the things you are allergic to. For example, in house dust mite allergy (the commonest), soft toys may need to be put away. Changing and washing bed sheets and pillow cases weekly in hot water will also reduce the amount of dust mites

The second step is treatment with medicine. Antihistamine medicines can help treat and prevent allergy symptoms. The newer anti-histamines do not cause much drowsiness. Some anti-histamines are combined with a decongestant (e.g. Aerius-D)

Steroid nasal sprays are every effective and only act locally in the nose and are not absorbed into the body so they are safe for long term use.

If your symptoms are severe in spite of medicines, you may benefit from a RFIT or sublingual immunotherapy (SLIT). Surgical procedure of radiofrequency reduction of the inferior turbinates (RFIT) is very effective for nasal obstruction. This can be done under LA in the clinic and takes only a few minutes.

For SLIT, a mixture is prepared that contains the allergens identified in your allergy tests. The mixture is placed under your tongue in tiny amounts over the course of 2-3 years. Over time, you will become less sensitive to the allergens. Usually after 4 to 6 months of SLIT, you will begin to have relief from your allergies. Studies have shown that SLIT is about 80% successful in curing allergic rhinitis

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