| Allergic rhinitis is an inflammation of the mucous membrane lining of the nose (nasal mucosa). The inflammation is triggered by an allergic reaction. Individuals with allergic rhinitis either suffer symptoms during certain months and are classified as having "seasonal allergic rhinitis" or suffer symptoms throughout the year and are classified as having "perennial allergic rhinitis."
Seasonal allergic rhinitis is caused by tree, grass, and weed pollens. Since trees, grasses, and weeds have well-defined pollinating periods, their pollens are airborne only during certain seasons. Perennial allergic rhinitis is usually caused by one of four common indoor allergens: animal dander, dust mites, cockroaches, and mold spores. This condition can also be caused by the processed materials or chemicals used in a workplace setting.Risk: Allergic rhinitis often appears in childhood, adolescence and young adults. The average age of onset is 8 to 11 years old, but may occur in people of all ages. In 80% of cases, allergic rhinitis develops by age 20. Men and women get allergic rhinitis at about the same rate and it often runs in families (Sheikh). Incidence and Prevalence: Allergic rhinitis is a very common disease and affects approximately 20% of the population or about 40 million people in the US (Sheikh). The prevalence of allergic rhinitis may vary within and among countries. This may be due to geographic differences in the types and potency of different allergens. |
Source: Medical Disability Advisor
| History: Individuals may report symptoms that occur at a certain time of day or in a certain season. Individuals may report an exposure to a specific substance such as cat dander, ragweed, or dust, or they may be unaware of what precipitated the episode. Symptoms can include sneezing, itching of the nose, eyes, mouth, throat, or skin, runny nose, stuffy nose, tearing eyes, wheezing, coughing, drowsiness, and headache. Physical exam: The exam usually reveals reddened nose, swollen and either pale or red nasal membranes, watery and reddened eyes (occasionally with dark circles underneath), and occasionally nasal polyps. Examination of the throat may reveal redness with postnasal drip. The lungs will be clear on examination. Tests: Tests are not required to diagnose allergic rhinitis. Allergy testing is advised if the individual develops rhinitis on a frequent or chronic basis that does not readily respond to treatment. Allergy skin tests help identify the specific allergens responsible so that exposure can be avoided or kept to a minimum. Intradermal, scratch, patch, or other tests may be performed. |
Source: Medical Disability Advisor
| Treatment of allergic rhinitis begins with the identification of the agent(s) causing the allergic reaction. The four steps in treating allergic rhinitis are education, allergen avoidance, drug therapy, and allergy shots (specific allergen immunotherapy or desensitization).
Avoidance is key to successful treatment. All sources of an allergen at home or work should be removed. While avoidance is the best treatment, complete avoidance of a specific allergen may not be possible, in which case exposure should be minimized.
Drug therapy can include antihistamines, decongestants to reduce nasal congestion, and topical cromolyn sodium and corticosteroids to reduce the immune response. The older antihistamines have side effects which often include drowsiness; newer antihistamines do not. Nasal steroids are recommended as the first-line treatment for rhinitis. Clinical trials have indicated that immunotherapy is expensive and of limited benefit.
Allergy shots (immunotherapy or desensitization) are recommended when symptoms are persistent. Desensitization includes regular injections of the allergen(s) given in increasing doses to desensitize the body to the allergen. |
Source: Medical Disability Advisor
| While treatment can effectively reduce most symptoms of allergic rhinitis, treatment only affects the current exposure. Future exposures will cause another allergic reaction. Allergy identification through testing with attempts to avoid allergen exposure can reduce the number of future occurrences.
On occasion, an individual may outgrow an allergy as their immune system becomes less sensitive to the specific allergen(s). However, once a specific allergen has caused a reaction, it will generally continue to do so.
Desensitization generally requires 3 to 5 years of treatment and is effective in only about two-thirds of the individuals. |
Source: Medical Disability Advisor
| Complications associated with allergic rhinitis are few and generally minor. Most involve a superimposed viral or bacterial infection in the region of the nose and throat. Prolonged nasal congestion can precede a cold (nasopharyngitis) or can lead to obstruction of sinus drainage resulting in sinusitis. Nasal polyps are associated with longstanding symptoms. Continuous postnasal drip can cause inflammation of the throat (pharyngitis), tonsils (tonsillitis), or voice box (laryngitis). Although temporary use of a decongestant spray or drops may reduce symptoms, continued use can eventually make them worse. With immunotherapy, there is danger of a life-threatening allergic reaction (anaphylaxis) shortly after an allergy injection is given; this is a rare occurrence. |
Source: Medical Disability Advisor
| Workplace accommodations include the avoidance of inhaled irritants to which the individual is allergic. If complete avoidance is not possible at work, goggles and/or masks may need to be worn. Some over-the-counter and prescription drugs used to treat allergic rhinitis require that the individual avoid driving or operating heavy equipment while taking the medication; however, these medications can be readily replaced by equivalent products free of sedative effects. |
Source: Medical Disability Advisor
| If an individual fails to recover within the expected maximum duration period, the reader may wish to consider the following questions to better understand the specifics of an individual's medical case. Regarding diagnosis:
- Does individual have seasonal allergies to trees, grasses, and weed pollens? Do the symptoms occur at a specific time of the day or year?
-
Is individual at home or at work when most symptomatic? Is individual allergic to indoor allergens such as animal dander, dust, cockroaches, or mold?
-
Do symptoms include sneezing, itchy eyes, nose, mouth, throat, or skin? Does individual have a runny or stuffy nose, or a cough or headache?
-
On physical exam, were the affected areas reddened and swollen, or pale? Was postnasal drip present? Were the lungs clear?
-
Has individual undergone allergy testing? What were the results?
-
Have conditions with similar symptoms been ruled out?
Regarding treatment:
- Has the agent(s) causing the allergic reaction been identified? Does individual attempt to avoid the offending agents?
-
Has individual responded favorably to drug therapy? If not, have other drugs been tried?
-
Has individual undergone specific allergy desensitization?
-
Is individual compliant with the treatment regime?
Regarding prognosis:
- Can individual's employer accommodate any necessary restrictions?
-
Can individual avoid the allergens or use personal protective equipment such as masks, goggles, or gloves? Does individual follow these restrictions while at home?
-
Does individual have any conditions such as asthma or a compromised immune system that may delay recovery?
-
Does individual have any complications such as a superimposed viral or bacterial infection in the nose or throat? Does individual have sinusitis?
-
Is there irritation from the postnasal drip?
-
Have decongestant sprays or drops been used for an extended period of time?
|
Source: Medical Disability Advisor
| Skeikh, Javed. "Allergic Rhinitis." eMedicine. Eds. Jeffrey Lee Kishiyama, et al. 7 Aug. 2004. Medscape. 13 Sep. 2004 <http://emedicine.com/med/topic104.htm>. |
Source: Medical Disability Advisor
| Feedback |
| Send us comments, suggestions, corrections, or anything you would like us to hear. If you are not logged in, you must
include your email address, in order for us to respond. We cannot, unfortunately, respond to every comment.
If you are seeking medical advice, please contact your physician. Thank you! |
Send this comment to:
Sales
Customer Support
Content Development
|
|
| |
|
|
|
|
|
This publication is designed to provide accurate and authoritative information in
regard to the subject matter covered. It is published with the understanding that
the author, editors, and publisher are not engaged in rendering medical, legal,
accounting or other professional service. If medical, legal, or other expert assistance
is required, the service of a competent professional should be sought. We are unable to respond to requests for advice.
Any Sales inquiries should include an email address or other means of
communication.
|