Allergic Rhinitis: Chronic Prescription and Treatment Options

What type of medical care is needed?

Allergic rhinitis can be managed with chronic disease prescriptions.
I often wake up with a dry mouth.
Recently, I've been trying to breathe through my nose, but sometimes my mouth still slightly opens.
However, since I work in the service industry, I feel uncomfortable wearing a mask.
Please explain this to me, doctor.

Wu, 30~39 year old female. Ask Date: 2015/09/08

Dr. Zheng Jueyi reply Otolaryngology

Hello, if allergic rhinitis symptoms require long-term management, a chronic prescription can be issued.
Dry mouth may be related to the use of antihistamines for allergic rhinitis, or it could be caused by mouth breathing, which often occurs due to prolonged nasal congestion.
If mouth breathing is necessary due to long-term nasal obstruction, it is recommended to use oral medications in conjunction with nasal sprays for better control.
If the results are still unsatisfactory, please discuss with your physician whether surgery is necessary.
Wishing you health and safety.
Sincerely, Dr.
Jue-Yi Cheng, Head of the Department of Otolaryngology, Taoyuan Hospital, Ministry of Health and Welfare.

Reply Date: 2015/09/08

More Info

Allergic rhinitis is a common condition that affects many individuals, characterized by symptoms such as sneezing, nasal congestion, runny nose, and itchy eyes. It occurs when the immune system overreacts to allergens in the environment, such as pollen, dust mites, pet dander, or mold. Understanding the management of allergic rhinitis, especially regarding chronic prescriptions and treatment options, is crucial for improving quality of life for those affected.

Chronic Prescription for Allergic Rhinitis
For individuals with persistent allergic rhinitis, healthcare providers often prescribe medications that can be taken on a long-term basis. These may include:
1. Intranasal Corticosteroids: These are considered the first-line treatment for allergic rhinitis. They help reduce inflammation in the nasal passages, alleviating symptoms like congestion and runny nose. Common examples include fluticasone (Flonase) and mometasone (Nasonex). These medications are safe for long-term use and can significantly improve symptoms.

2. Antihistamines: Oral antihistamines, such as cetirizine (Zyrtec) or loratadine (Claritin), can be used to relieve sneezing and itching. While they are effective, some individuals may experience drowsiness, especially with first-generation antihistamines like diphenhydramine (Benadryl).

3. Leukotriene Receptor Antagonists: Montelukast (Singulair) is an example of this class of medication. It can be used as an adjunct treatment for allergic rhinitis, particularly in patients with asthma or those who do not respond adequately to antihistamines alone.

4. Decongestants: While not recommended for long-term use due to the risk of rebound congestion, short-term use of oral or nasal decongestants can help relieve nasal congestion during acute episodes.

5. Immunotherapy: For individuals with severe allergic rhinitis that does not respond to standard treatments, allergen immunotherapy (allergy shots or sublingual tablets) may be an option. This treatment involves gradually exposing the patient to increasing amounts of the allergen to build tolerance over time.

Treatment Options and Lifestyle Modifications
In addition to pharmacological treatments, several lifestyle modifications can help manage allergic rhinitis:
- Avoidance of Triggers: Identifying and avoiding allergens is crucial. For example, if pollen is a trigger, staying indoors during high pollen seasons and using air purifiers can be beneficial.

- Saline Nasal Irrigation: Rinsing the nasal passages with saline can help clear allergens and mucus, providing relief from symptoms.

- Hydration: Staying well-hydrated can help keep the mucous membranes moist, which may alleviate dryness in the mouth and throat, especially if you are breathing through your mouth.

- Environmental Control: Keeping windows closed during high pollen seasons, using dust mite-proof covers on pillows and mattresses, and regularly cleaning your living space can help reduce exposure to allergens.

Addressing Dry Mouth
You mentioned experiencing dry mouth upon waking, which can be uncomfortable. This may occur if you are breathing through your mouth, particularly at night. Here are some suggestions to alleviate dry mouth:
- Stay Hydrated: Drink plenty of water throughout the day to keep your mouth moist.

- Use a Humidifier: Adding moisture to the air can help prevent dryness in your mouth and nasal passages, especially during sleep.

- Oral Care Products: Consider using saliva substitutes or mouth moisturizers available over the counter to help relieve dry mouth symptoms.

- Breathing Techniques: Practice breathing through your nose as much as possible. This can help filter and humidify the air you breathe, reducing dryness.

Conclusion
In summary, allergic rhinitis can be effectively managed with a combination of chronic prescriptions and lifestyle modifications. If you are experiencing persistent symptoms, it is advisable to consult with a healthcare provider who can tailor a treatment plan to your specific needs. They can also address any concerns regarding dry mouth and provide additional recommendations to improve your overall comfort and well-being.

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