AR is a 34-year-old farmer, who complained to her doctor of having repeated episodes of runny nose. “My nose is never dry,” she said with tears running down her eyes. She also sneezes repeatedly and has itchy eyes. Her complaints worsen during the dry season or just before the rainy season. The doctor explained to her that she had allergic rhinitis.
Allergic rhinitis is a condition that manifests as swelling, redness, and/or pain in the inner lining of the nose following sensitization by environmental triggers. Although it is not life-threatening, complications can occur and the condition can significantly impair quality of life. Individuals affected by allergic rhinitis may have complaints that are seasonal (temporary) in nature, or present all year round, or related to their occupation.
Causes of allergic rhinitis: Broadly speaking, the causes can be classified into two:
• Genetic tendency towards allergic disease: Some individuals are always sensitive to environmental triggers like cold, smoke, dust, et cetera. This sensitivity is due to their genetic make up. Similar experience is often found among other members of the family. An affected individual can also have other allergic diseases like asthma.
• Exposure to triggers of allergic rhinitis: Common environmental triggers of runny nose include mould, dust, strong perfumes, flowering plants, smoke, pets, cockroaches, and occupational exposures (glue, gloves powder, cloth fibre). Affected individuals were fine until they got exposed to these triggers.
Clinical features of allergic rhinitis: Aside recurrent runny nose, individuals who have allergic rhinitis may also experience sneezing, itchy nose, blocked nose, inability to smell, headache, earache, red eyes, watery eye discharge, and fatigue.
Investigation: Often, the diagnosis of allergic rhinitis is made only by clinical evaluation of the individual. Allergy testing may be appropriate if symptoms are severe or the diagnosis is uncertain.
Management of allergic rhinitis: Persons who have recurrent runny nose with its associated symptoms would benefit from the following.
- Intranasal medications. These are administered directly into the nose. The common medications used are steroids. They help in stopping the ongoing episode of runny nose and help to prevent a new one.
- Oral medications. These help to reduce the symptoms of sneezing and itching.
Prevention of allergic rhinitis: Preventing an episode of runny nose and the associated complaints is the most recommended approach. Avoidance of known triggers in addition to environmental control is encouraged.
For example, staying away from a dusty environment, avoiding or covering the nose when working with flowering plants, et cetera, may reduce the episodes of attacks in the year.
Dr Olagoke Ewedairo is a consultant family physician with over a decade experience as a clinician. He obtained his MB: BS degree from the University of Lagos. He completed a post-graduate training in Family Medicine and was awarded the Fellowship in Family Medicine by the National Post-graduate Medical College of Nigeria. He also has a Master of Public Health degree from the Harvard School of Public Health. He is passionate about improving patients’ health outcome as well as patient education. He can be
reached via email at firstname.lastname@example.org.