Klinik Temasya
Primary Care Medicine

Allergic Rhintis: Nothing To Sneeze About

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Allergic rhinitis or commonly known as Hay fever is cause by overstimulation of immune system to an allergen such as dust, pollen, house dust mites, animal dander, certain type of foods and perfume. It causes inflammation of the mucosal soft tissue inside the nose. Symptom can occur acutely, after initial exposure and sometime can last for hours everyday, often worse in the morning and tend to improve later part of the day

Allergic rhinitis is very common in Malaysia and affect about 40% of the population especially among school-aged children. Allergic rhinitis can be debilitating and may significantly interfere in one's quality of life. Chronically it can cause fatigue, headache, sleep disturbances, cognitive impairment and interfere with school and work performance

Beside environmental stimuli, genetic factors play a big role. Antigen- specific responses are controlled by regulatory genes, and allergic rhintis is much more common in person with a positive family history. Allergic rhinitis is one of the triad under the umbrella of atopy, which is a predisposition to hypersensitivity reaction. The two other atopic diseases are asthma and eczema. So, it is no wonder that an individual with allergic rhinitis may also have an eczema or asthma with family members who have one or the other atopic disease 

Many people often confused allergic rhinitis and rhinosinusitis. Both can share similar features such as profuse watery nasal discharge, nasal congestion, sneezing and post-nasal drip but rhinosinusitis have more severe clinical features such headache, facial pressure or pain, loss of sense of smell, fever and bad breath (halithosis). Allergic rhinitis is certainly one of the risk factors for developing rhinosinusitis

Management of allergic rhinitis is patient's education toward understanding allergic rhinitis. There is no cure for allergic rhinitis as an immune response is inherently unique and innate to every individual. Symptoms can be reduce by avoidance of triggers or environmental factors in the surrounding area. This can be by regular cleaning of the house, vacuuming, avoiding use of carpets, fabric furnitures and draperies around the house that can collect dust. Avoid irritants such as cigarette smoke, vape smoke and strong perfume or soap. Humidifying the indoor enviroment can reduce mite and dander concentrations. Most pet such as cats, dogs and birds usually have to be avoided entirely if symptoms are disabling. Simply keeping the pet out of the bedroom does not help sufficiently because the dander can circulates in the air and throughout the house

Medication such as oral anti-histamine can be given to relief symptoms and for patient with persistent symptoms, use of nasal steroid therapy such as Avamys, Flixonase and Nasonex has been proven to be  more effective and cost-effective than chronic use of anti-histamines medication. Caution is needed when using steroid preparation in children due to risk of growth retardation. Prolong use of steroid- containing nasal spray can also cause nasal irritation and nose bleeding. Other treatment for allergic rhinitis are hypertonic saline and short course of nasal decongestants (such as Oxymetazoline)

If you have any more questions about allergic rhinitis and treatment, talk to our doctor for more information. 

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