Definition:
- Allergic rhinitis is a chronic inflammatory disorder of the nasal mucosa caused by an allergic reaction to inhaled allergens.
Etiology:
- Atopic predisposition
- Genetic factors
- Environmental factors such as exposure to allergens like dust mites, pollen, and pet dander
Types:
- Seasonal allergic rhinitis (SAR)
- Caused by pollen from trees, grasses, and weeds
- Typically occurs during spring and summer months
- Perennial allergic rhinitis (PAR)
- Caused by allergens such as dust mites, pet dander, and mold
- Occurs throughout the year
- Occupational allergic rhinitis
- Caused by exposure to specific allergens at work
- Examples include latex, wood dust, and animal dander
Mechanism and Pathology:
- Allergens enter the nasal cavity and bind to IgE antibodies on the surface of mast cells
- This leads to the release of histamine and other chemical mediators
- Histamine causes blood vessels to dilate, leading to increased blood flow and swelling
- It also causes mucus production and increased secretions
- Chronic inflammation leads to nasal congestion, sneezing, and runny nose
Clinical Features:
- Nasal congestion
- Sneezing
- Runny nose
- Itchy nose, throat, and eyes
- Postnasal drip
- Loss of smell
- Headaches and facial pain
Investigations:
- Medical history and physical examination
- Skin prick test (SPT) or blood tests to confirm the presence of specific IgE antibodies
- Nasal endoscopy or imaging studies to evaluate nasal anatomy and rule out other conditions
Complications:
- Sinusitis
- Eustachian tube dysfunction
- Middle ear effusion
- Allergic asthma
- Conjunctivitis
Management:
- Avoidance of allergens
- Medications such as antihistamines, decongestants, and corticosteroids
- Immunotherapy (allergy shots) to build up tolerance to specific allergens
- Nasal corticosteroids to reduce inflammation
- Saline nasal sprays to moisturize the nasal passages
Homoeopathic Therapeutic Medicines:
- Antimonium tartaricum for nasal congestion and sinusitis
- Euphrasia for itchy eyes and allergic conjunctivitis
- Histaminum hydrochloricum for allergic reactions and histamine release
- Ipecacuanha for nasal discharge and postnasal drip
- Lachesis for allergic rhinitis with nasal congestion and sinusitis
- Nux vomica for allergic rhinitis with headaches and facial pain
Treatment:
- Oral antihistamines for mild symptoms
- Nasal corticosteroids for moderate symptoms
- Immunotherapy for severe symptoms or for patients who do not respond to other treatments