Allergic Rhinitis: Symptoms, Causes, and Treatment Options

Nasal allergies

Hello, doctor.
I have a question.
My nose is very prone to allergies, and I often have a runny nose, which can become severe and sometimes even causes itching in my eyes! I always experience these symptoms when I wake up in the morning or when I am exposed to cold air.
This has been bothering me for a long time.
I also have persistent phlegm in my throat, even when I am not sick.
When I do have a cold, the phlegm tends to be yellow, while it is normally clear and white.
Is there a connection? With winter approaching, I am becoming increasingly concerned.
I had sinusitis as a child, but I no longer have it; could this be related? I previously read a medical report in the newspaper stating that allergies can be tested through a blood test to identify allergens, and that there are injections available to treat these allergens, with a success rate of 80-90%.
Is this true? Where can I find this service? I would appreciate your explanation.
Thank you!

afro, 20~29 year old female. Ask Date: 2004/10/10

Dr. Cai Hongyan reply Otolaryngology

Itchy eyes, phlegm in the throat, and nasal allergies with post-nasal drip are related, and they are not typical symptoms of sinusitis.
However, it is still advisable to come to the hospital for a detailed examination.
You can have blood tests for allergens done at our outpatient clinic.
Additionally, allergy immunotherapy is not effective for every type of allergen; it depends on what specific allergens you are sensitive to.

Reply Date: 2004/10/10

More Info

Allergic rhinitis is a common condition that affects many individuals, characterized by symptoms such as sneezing, runny or stuffy nose, itchy eyes, and throat irritation. It occurs when the immune system overreacts to allergens in the environment, such as pollen, dust mites, mold, or pet dander. Understanding the symptoms, causes, and treatment options for allergic rhinitis can help you manage this condition effectively.

Symptoms of Allergic Rhinitis
The symptoms of allergic rhinitis can vary in severity and may include:
1. Nasal Symptoms: These include sneezing, nasal congestion, runny nose (rhinorrhea), and postnasal drip, which can lead to throat irritation and coughing.

2. Ocular Symptoms: Many individuals experience itchy, watery eyes, which can be quite bothersome.

3. Facial Pressure: Some people report a feeling of pressure or pain in the sinuses, particularly around the forehead and cheeks, which can sometimes mimic sinusitis.

4. Throat Symptoms: Chronic throat irritation and the presence of phlegm can occur, even in the absence of a cold or flu.

5. Fatigue: Persistent symptoms can lead to fatigue and decreased quality of life.

Causes of Allergic Rhinitis
Allergic rhinitis is primarily caused by exposure to allergens. Common triggers include:
- Pollen: Trees, grasses, and weeds release pollen, especially during certain seasons.

- Dust Mites: These microscopic organisms thrive in bedding, upholstery, and carpets.

- Mold: Mold spores can be found indoors and outdoors, particularly in damp areas.

- Animal Dander: Proteins found in the skin flakes, saliva, and urine of furry pets can trigger allergic reactions.

Treatment Options
Managing allergic rhinitis typically involves a combination of avoiding triggers and using medications. Here are some common treatment options:
1. Avoidance: Identifying and avoiding allergens is the first step. This may include using air purifiers, keeping windows closed during high pollen seasons, and regularly cleaning your living space to reduce dust and mold.

2. Medications:
- Antihistamines: These can help relieve sneezing, itching, and runny nose. They are available over-the-counter and by prescription.

- Nasal Corticosteroids: These are effective for reducing inflammation in the nasal passages and are often considered the first-line treatment for allergic rhinitis.

- Decongestants: These can help relieve nasal congestion but should not be used for extended periods due to potential rebound congestion.

- Leukotriene Receptor Antagonists: These medications can help with nasal symptoms and are particularly useful for individuals with asthma.

3. Immunotherapy: For those with severe allergic rhinitis that does not respond to medications, allergen immunotherapy (allergy shots or sublingual tablets) may be an option. This treatment involves gradually exposing the individual to increasing amounts of the allergen to build tolerance over time. The success rate for immunotherapy can be quite high, often cited at 80-90% for effective symptom relief.

4. Allergy Testing: Blood tests or skin prick tests can help identify specific allergens that trigger your symptoms. This information can guide your treatment plan and help you avoid specific triggers.

Conclusion
Your symptoms of nasal congestion, runny nose, and throat irritation are indeed consistent with allergic rhinitis. The presence of phlegm, especially if it changes color during a cold, can indicate a secondary infection or inflammation. Given your history of sinusitis, it is possible that your current symptoms are related to previous nasal issues, but they are likely exacerbated by allergies.

If you are considering immunotherapy, consult with an allergist or an ENT specialist who can provide the necessary testing and treatment options. They can also guide you on the availability of these services in your area. Managing allergic rhinitis effectively can significantly improve your quality of life, especially as the winter season approaches.

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