Allergic rhinitis that makes life difficult

Many patients who visit ENT say they have allergic rhinitis. However, only 50 to 60 percent of them are diagnosed with allergic rhinitis, while the rest are diagnosed with other non-boosting diseases such as non-allergic rhinitis and chronic sinusitis. 

This is due to the overlapping symptoms of allergic rhinitis and other non-boostive diseases. The symptoms are similar, but the treatment method is different, so accurate diagnosis and treatment are needed through medical treatment and examination.

Symptoms of allergic rhinitis

The four major symptoms of allergic rhinitis are nasal congestion, sneezing, clear runny nose, and itching. When an external antigen enters the nose, itching occurs within a few seconds and sneezes, and a clear runny nose causes nasal congestion is a common progression of symptoms. Sneezing and clear runny nose are severe in the morning and then decrease in the afternoon, instead continuing to have stuffy nose.

The degree of nasal congestion varies from person to person and can become worse when accompanied by other non-intrinsic diseases such as septal curvature, non-species, and chronic sinusitis. Itchiness can occur not only in the nose but also in the eyes, neck and ears. They also overreact to unspecific stimuli such as sudden temperature changes, cold air, and cigarette smoke.

Symptoms of allergic rhinitis are chronic and in severe cases can interfere with daily life, reducing the quality of life. Anyone who has lived with tissue because of a constant runny nose, or who has had trouble sleeping at night because of an unbearable nasal congestion will know the pain. It is common to experience mental stress such as irritation and depression.

The problem is that not only allergic rhinitis but also non-allergic rhinitis have similar symptoms, making it difficult to distinguish.

Acute rhinitis is a very common nasal inflammatory disease. I sneeze, but it lasts for a relatively small number of times and all day long. It has a sticky runny nose rather than a clear runny nose, and over time, it changes to a sit-in runny nose and recovers after about a week. It is often accompanied by systemic symptoms such as fever and general muscle pain, which cannot be seen in allergic rhinitis.

▲ Vascular motor rhinitis is rare in sneezing and itching, while runny nose is the main symptom and allergic reaction tests are normal. Antihistamines and topical steroids do not work well.

▲ Acidocytic non-allergic rhinitis has occasional sneezing and itching, and a runny nose test shows an increase in acetic acid cells, but an allergic reaction test shows negative. Antihistamines are mediocre and topical steroids are excellent.

Allergic rhinitis diagnosis and treatment.

Methods for diagnosing allergic rhinitis include: a medical examination to check symptoms, family history, residential environment, and past treatment details, a laboratory examination to measure specific IgE for a specific antigen, or a non-surgical examination to check mucous membrane conditions in the nasal cavity.

Among them, skin reaction tests are the most basic diagnostic tools, including a "skin terminal test" in which small wounds without bleeding with fine saliva and antigen solutions are dropped to penetrate the epidermis, and an "skin test" in which antigen solutions are injected into the dermis of the skin.

The first way to treat allergic rhinitis is avoidance therapy. Although antigens cannot be completely avoided in real life, they are useful in that they can alleviate symptoms and reduce drug use.

The main sources of house dust mites, the most common antigens, are mattresses, pillows, blankets, carpets, cotton toys, and textile curtains. Therefore, it is helpful to remove this and use a house dust mite non-permeable cover. The indoor temperature and humidity can be adjusted to below 20, and 45% respectively, washing bedding with water above 60 이상의 every week, and drying mattresses, blankets, and carpets in strong sunlight for more than three hours can suppress tick reproduction.

The second is drug therapy. Antihistamine, which is used to treat allergic rhinitis, competitively acts on histamine receptors in target cells to prevent histamine binding, reducing runny nose, sneezing and itching. Non-intrinsic steroids effectively inhibit allergic inflammatory reactions to non-mucosal membranes at various stages while minimizing side effects. If these drugs don't work, you can also try oral administration of steroids.

Third, nasal cleaning, which removes mucus containing various inflammatory mediators, can also be considered. It is known to wash secretions to relieve symptoms of allergic rhinitis and increase mucus cilia exercise.

The fourth is immunotherapy. It is a way to improve symptoms by injecting an allergic antigen into patients by increasing the amount of the antigen. It is reported to be effective in house dust mites, pollen, cat antigens, allergic rhinitis and asthma caused by fungi, allergic conjunctivitis and insect poison irritability. It is also known to prevent new antigen sensitization and reduce the risk of developing asthma in the future.

The last fifth method is surgery. If the nasal congestion is severe due to the bending of the septal cartilage or bone, the septal correction can be performed, and if the nasal area can be widened by performing the septal surgery if the septal nasal mucus is present. If non-species or chronic sinusitis accompanying allergic rhinitis do not respond to medication, they are treated with endoscopic sinus surgery. Surgery is mainly effective for nasal congestion. However, runny nose, sneezing, and itching can remain, and symptoms can recur over time, so medication should be taken at the same time after surgery. Rhinitis is usually taken good care of, but if you catch a cold, symptoms are likely to occur again, so be careful not to catch a cold and drink enough water to keep your nasal mucous membrane moist.