Allergic rhinitis should be well identified from some non-allergic causes including rhinitis medicamentosa, vasomotor rhinitis and other communicable causes. Doing so will seem bit difficult, but not impossible. The time when one gets symptoms can be much identical of what they actually suffer from (to see if it’s seasonal or perennial). E.g. The symptoms of perennial rhinitis will usually flare up in the month of October, caused by dust mite allergy with rising humidity and temperature.
Causes of Rhinitis
- Infectious: Bacteria, viral etc.
- Irritants: Fumes etc.
- NARES: Non-allergic rhinitis with eosinophilia
- Drug-induced: Cocaine abuse
- CSF leak
- Pregnancy: Nasal polyps, tumours, septal deviation etc.
Diagnoses of Allergic Rhinitis
- Nose examinations are performed. Any history showing any relevant irregularities can help in diagnosis too. Rhinoscopy is also conducted to get a better view.
- Increase in Total IgE shows an allergic basis, but it doesn’t mean that it’s excluded in normal IgE tests.
- Elevated Eosinophil count in blood is rare.
- SPTs may indicate the sensitivity to aero-allergens, but clinically will be determined only from the history
- Often, in case of the local allergy when no IgE spill in the bloodstream is identified, the RASTs and SPTs may come negative.
- The nasal secretions test will be helpful for excess eosinophilis.
- Peripheral blood eosinophilia may get variable results as being a weak diagnostic factor.
- An examination of nasal provocation is conducted to identify any suspected allergen too.
Treatments of Allergic Rhinitis and Its Management
- In mild rhinitis, the topical or systemic antihistamines will provide a good relief.
- Whereas the topical steroids or mast-cell blocking agents can work well in rather more severe cases.
- One can use decongestants with doctor’s advices and some cautions.
- In vasomotor rhinitis, the ipratropium bromide will be more useful.
- Oral corticosteroids will act well in the worst cases too.
- Immunotherapy is advised in case of a failure of any drug therapy (with one especially having an allergy with single allergen and no relevant contradictions).
- The sinus involvement may require a surgery and polyps too if one fails topical steroid therapy.
- Avoidance of cold air, spicy foods and alcohol is required for one with vasomotor rhinitis.
- Avoidance of allergens at all possible places is necessary too.
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