Managing Allergic Rhinitis: Seeking Effective Treatment and Specialist Guidance

Allergic rhinitis

It cannot be completely cured; I can only use a nasal spray.
After using it, do I need to continue returning to the clinic to get more nasal spray? I frequently visit the doctor due to conditions like tonsillitis, bronchitis, sinusitis, gastroenteritis, gastroesophageal reflux, and acute upper respiratory infections.
In total, I have visited the doctor nearly 40 times without finding the underlying cause.
Recently, I need to see an allergist, but I'm unsure if this is the right specialty to consult.
I have dust mite allergies, but when I see an ENT specialist, I only receive medication and nasal sprays.
Considering the high costs of medical visits, I usually go to clinics or community hospitals, which has led to a habit of frequently visiting hospitals.
Is it necessary to go to a medical center to find a solution? Will just picking up medication after an outpatient visit be effective? What recommendations do doctors have? Is it feasible to see an allergist, or should I continue consulting an ENT specialist?

Ping, 30~39 year old female. Ask Date: 2021/04/14

Dr. Ji Zhaoyun reply Otolaryngology

Regarding allergic rhinitis, there are several important concepts: The individual's constitution and environmental allergens and irritants are the primary triggers.
If one parent has allergic rhinitis, the likelihood of their child developing it is four times higher.
The most common allergen is dust mites, followed by animals, insects, mold, and pollen.
Recently recognized fine particulate matter (PM2.5) is also a significant irritant.

Treatment typically begins with oral medications and nasal sprays, and surgery may be considered if necessary.
The main medications include oral antihistamines and intranasal corticosteroid sprays, often used in combination.
Depending on the situation, local antihistamines/vasoconstrictors or oral leukotriene receptor antagonists may also be employed.
If symptoms do not improve with medication and there is significant structural obstruction, such as a deviated septum, enlarged inferior turbinates, or nasal valve narrowing, appropriate surgical intervention can be performed.
Recently, minimally invasive surgical techniques have been developed, which require shorter operation times and do not necessitate hospitalization, making them widely applicable.
To avoid allergens and reduce irritants, wearing masks, maintaining a clean home environment, regularly washing bedding, avoiding extreme temperature/humidity changes, and reducing outdoor activities during severe PM2.5 air pollution are key points for daily care.
Although allergic rhinitis can be bothersome, with appropriate medication or combined surgical intervention, and by avoiding allergens and irritants as much as possible, it can be well controlled, significantly improving quality of life and making academic and work tasks easier to manage.

Reply Date: 2021/04/14

More Info

Managing allergic rhinitis can be quite challenging, especially when symptoms persist despite various treatments. Allergic rhinitis is an inflammatory condition of the nasal passages caused by allergens such as dust mites, pollen, mold, and pet dander. It can lead to a range of symptoms including nasal congestion, sneezing, itching, and runny nose. Given your history of recurrent infections and multiple visits to healthcare providers, it’s understandable that you are seeking effective treatment options and guidance from specialists.

Firstly, it’s important to recognize that while allergic rhinitis cannot be completely cured, it can be effectively managed with a combination of pharmacological and non-pharmacological approaches. The use of nasal sprays, particularly corticosteroid nasal sprays, is a common and effective treatment for controlling symptoms. These sprays help reduce inflammation in the nasal passages and can provide significant relief. However, it is essential to use them consistently and as directed by your healthcare provider. If you find that you need to return frequently for refills, it may indicate that your current management plan needs to be reassessed.

In terms of specialist consultations, seeing an allergist or immunologist can be beneficial. These specialists can perform allergy testing to identify specific allergens that trigger your symptoms. Once identified, they can recommend targeted treatment strategies, which may include allergen avoidance measures, immunotherapy (allergy shots), or other medications tailored to your specific needs. This could potentially reduce your reliance on nasal sprays and improve your overall quality of life.

You mentioned that you have been experiencing recurrent infections such as tonsillitis, bronchitis, and sinusitis. These conditions can be exacerbated by underlying allergic rhinitis, as inflammation and congestion in the nasal passages can lead to secondary infections. It may be worthwhile to discuss these recurrent infections with your healthcare provider, as they may need to be addressed in conjunction with your allergic rhinitis treatment.

Regarding your concern about the costs associated with frequent visits to clinics or hospitals, it’s understandable to seek cost-effective solutions. However, it’s crucial to ensure that you are receiving comprehensive care. While local clinics can provide basic treatment, a referral to a medical center or a specialist may be necessary for more complex cases. A medical center often has access to a broader range of diagnostic tools and specialists who can collaborate on your care.

In summary, managing allergic rhinitis effectively requires a comprehensive approach. Here are some steps you can consider:
1. Consult an Allergist: Seek a referral to an allergist or immunologist who can perform allergy testing and provide tailored treatment options.

2. Medication Management: Discuss your current medication regimen with your healthcare provider. If nasal sprays are not providing adequate relief, there may be alternative medications or therapies to consider.

3. Allergen Avoidance: Work on identifying and minimizing exposure to known allergens, such as dust mites. This may include using allergen-proof bedding, regular cleaning, and maintaining low humidity levels in your home.

4. Monitor Symptoms: Keep a symptom diary to track your reactions to different environments and treatments. This information can be valuable for your healthcare provider in adjusting your management plan.

5. Consider Immunotherapy: If appropriate, discuss the possibility of allergy shots or sublingual immunotherapy with your allergist, as these can provide long-term relief.

6. Follow-Up Care: Regular follow-ups with your healthcare provider are essential to monitor your condition and make necessary adjustments to your treatment plan.

By taking these steps, you can work towards better managing your allergic rhinitis and improving your overall health. Remember, effective communication with your healthcare providers is key to finding the right treatment strategy for you.

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