Allergic+Rhinitis

=Allergic Rhinitis=

What it is
Rhinitis is inflammation of the lining of the nose causing congestion, rhinorrhoea (runny nose), sneezing and itching. It can be classified as infectious, allergic or other (including drug-induced, irritant or occupational). 

Allergic rhinitis is divided into seasonal and perennial:  
 * Seasonal allergic rhinitis** (‘hayfever’) is triggered by wind-borne pollen from grasses, weeds and trees. Symptoms occur mostly during spring and summer. Pollen exposure is highest in the morning, when outside, on windy days and after thunderstorms.


 * Perennial allergic rhinitis** occurs throughout the year and is most commonly triggered by exposure to house dust mites. Symptoms are often worse in the early morning or at night. Animal dander (especially cat), mould spores and, occasionally, cockroaches may trigger similar symptoms.

Symptoms
//Symptoms generally begin in childhood, persist through adolescence and often decrease in adulthood.// - sneezing - clear rhinorrhoea - blocked nose - conjunctival itching (itchy eyes) - pharyngeal itching (itchy throat) - lacrimation (watery eyes) - loss of taste and smell - headaches - lethargy

Headache and congestion are more common in perennial allergic rhinitis. Allergic rhinitis commonly coexists with other respiratory infections such as asthma. - pregnant or breastfeeding - have found previous treatments ineffective - asthmatic and symptoms affect breathing
 * Refer when:**

How to Treat
//Medications should be started before exposure to allergen if possible (INCS a week before hayfever season or oral antihistamines before exposure to allergens).//

- Oral/intranasal/ocular antihistamine (less-sedating or sedating)
 * Mild/Occasional:** //no interference with sleep or daily activities//

- Intranasal Corticosteroids (INCS) - can use an antihistamine for immediate symptom relief for 3-5days during initiation of INCS
 * Moderate:** //symptoms interfering with daily activities or sleep//

- INCS + antihistamine
 * Severe:** //troublesome symptoms, cannot function properly during the day or sleep at night//

Intranasal saline: counteracts drying from INCS; also has mucus-diluting properties Anti-allergy eye drops: if allergic conjunctivitis persists beyond treatment Ipratropium bromide: effective in cases of intractable rhinorrhea
 * In all patients, consider:**

Other advice
- Advise on minimisation of allergen exposure and avoidance of irritants where possible (usually only recommended if allergen is proven) - Ask about presence of other symptoms that may indicate asthma (wheezing, chronic cough at night, chest tightness) - Keep house and car windows closed during pollen season - Hayfever symptoms are often worse during the morning and windy days (avoid pollens during this time) - Remove plants that trigger hayfever from the garden - Vacuum frequently - Reduce dust collecting furnishings, such as curtains, bed skirts, carpeting and stuffed animals, especially in the bedroom - Wear sunglasses and facemasks when mowing lawns - Smear petroleum jelly (like Vaseline) inside your nose to stop the pollen from touching the lining of your nose.

Additional Resources
[|NPS - Allergic Rhinitis] [|Facts behind the Fact Card - Hayfever] [|Self-care Card - Hayfever] [|Better Health - Hayfever]