Effective Treatments for Severe Allergic Rhinitis and Its Connection to Asthma

Allergic rhinitis is an allergic reaction that occurs when the immune system overreacts to allergens in the air, such as pollen, dust mites, mold, and pet dander. Symptoms typically include sneezing, runny

Hello Dr.
Hu: I have severe nasal allergies, often experiencing continuous sneezing and itching all over my face.
I keep rubbing my nose, which sometimes leads to bleeding.
The doctor mentioned that my nasal bridge is slightly crooked.
I would like to know if there is a fundamental solution for this.
Can surgery resolve the issue, or will I need to continue taking medication? Additionally, I have asthma; is this related to my nasal allergies? Thank you!

Lin Lin, 10~19 year old female. Ask Date: 2003/09/03

Dr. Hu Kexin reply Otolaryngology

Hello Lin Lin,
It seems that your nasal allergies are quite severe and may be affecting your quality of life.
Nasal allergies often coexist with asthma and atopic dermatitis, so both your asthma and nasal allergies are likely due to your allergic predisposition.
There are many treatment options for nasal allergies, primarily focusing on pharmacological treatment, with surgical options considered afterward.
However, there is currently no method guaranteed to provide a permanent cure.
Regarding what the doctor mentioned about your nasal bridge being slightly crooked, it may refer to "deviated septum," which can cause breathing difficulties and can be addressed with surgery.

Wishing you peace and good health.
Sincerely,
Dr.
Hu Ke-Hsin, ENT Department, Taoyuan Hospital, Ministry of Health and Welfare

Reply Date: 2003/09/03

More Info

Hello! Thank you for your question regarding severe allergic rhinitis and its connection to asthma. Allergic rhinitis, commonly known as hay fever, is an allergic reaction that causes sneezing, congestion, runny nose, and itchy eyes. It occurs when your immune system overreacts to allergens in the air, such as pollen, dust mites, mold, or pet dander. Given your symptoms of persistent sneezing, facial itching, and even bleeding from frequent rubbing, it's clear that your condition is significantly impacting your quality of life.

Effective Treatments for Allergic Rhinitis
1. Medications: There are several classes of medications that can help manage allergic rhinitis:
- Antihistamines: These are often the first line of treatment. They work by blocking histamine, a substance your body releases during an allergic reaction. Common over-the-counter options include cetirizine (Zyrtec), loratadine (Claritin), and fexofenadine (Allegra). These can help alleviate sneezing, itching, and runny nose.

- Intranasal corticosteroids: These are highly effective for reducing inflammation in the nasal passages. Examples include fluticasone (Flonase) and mometasone (Nasonex). They can be used daily and are often recommended for long-term management.

- Decongestants: These can provide temporary relief from nasal congestion. However, they should not be used for more than a few days in a row to avoid rebound congestion.

- Leukotriene receptor antagonists: Montelukast (Singulair) is an example that can help with both allergic rhinitis and asthma.

2. Allergen Avoidance: Identifying and avoiding triggers is crucial. This may involve measures such as using air purifiers, keeping windows closed during high pollen seasons, and regularly cleaning your living space to reduce dust mites and mold.

3. Immunotherapy: For some patients, allergy shots (subcutaneous immunotherapy) or sublingual tablets can be effective. This treatment involves gradually exposing the patient to increasing amounts of the allergen to build tolerance over time.

Surgical Options
Regarding your question about surgery, if your nasal structure is contributing to your symptoms (such as a deviated septum), surgical intervention may be beneficial. A procedure called septoplasty can correct a deviated septum, potentially improving airflow and reducing symptoms. However, surgery is typically considered when other treatments have failed or if there are anatomical issues that need correction.

Connection to Asthma
You mentioned that you have asthma, which is indeed closely related to allergic rhinitis. Both conditions are part of the "allergic march," where allergies can lead to asthma and vice versa. In fact, individuals with allergic rhinitis are at a higher risk of developing asthma. The inflammation in the nasal passages can also affect the airways, leading to asthma symptoms such as wheezing, coughing, and shortness of breath.

Conclusion
In summary, managing severe allergic rhinitis often requires a combination of medication, allergen avoidance, and possibly immunotherapy. If structural issues are present, surgical options may be considered. Given your asthma, it is essential to manage both conditions effectively, as they can exacerbate each other. I recommend discussing your treatment options with your healthcare provider to create a comprehensive plan tailored to your needs. Regular follow-ups can help monitor your symptoms and adjust treatment as necessary.
Take care, and I hope you find relief soon!

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