Do you frequently suffer from a runny nose? Or get sneezy and itchy when in dusty environments? If your answer is yes, there is a high chance that you might be suffering from allergic rhinitis.

 

Allergic rhinitis refers to inflammation of the nose that occurs due to an allergen, which is a substance that can cause an allergic reaction. According to the World Health Organisation, approximately 10-30% of the world's population (equivalent to about 400 million people) suffers from allergic rhinitis regardless of age, ethnicity and gender.

 

Classification of Allergic Rhinitis

 

There are two categories of allergic rhinitis: 

1. Seasonal allergic rhinitis: This type of allergic rhinitis is prevalent among people living in countries experiencing four seasons. It usually occurs in the spring, summer or early autumn season due to allergic sensitivity towards airborne spores or pollens from grass and flowering plants.

2.Perennial allergic rhinitis: People with this form of allergic rhinitis experience symptoms throughout the year. The common causes are dust mites, pet hair, or allergens present in food products.

 

Untreated Allergic Reaction Might Lead to Complications

 

Individuals with a hypersensitive immune system are at a higher risk of experiencing allergic rhinitis. When the immune system recognises an allergen, a type of antibody called immunoglobulin E (IgE) subsequently detect and respond to the allergen. The reaction leads to the release of various chemical mediators. Histamine is the most significant chemical amongst all of the mediators.

 

Histamine can cause nasal tissues to swell and release excessive fluid, leading to the hallmark symptoms of allergic rhinitis, which are runny nose, blocked nose, and itchiness. Other common allergic rhinitis symptoms include frequent sneezing, coughing, sore or itchy throat, watery eyes, excessive fatigue, eczema, and headaches.

 

Complications can occur if allergic rhinitis persists over a long time. Examples of complications are the worsening of asthma, insomnia, loss of focus, sinusitis, ear infections and nasal polyps. Sinusitis occurs when the sinus is infected, leading to pain around the cheeks, eyes or forehead.

 

The pain usually presents with unpleasant breath and green or yellow mucosal discharge. Nasal polyps, on the other hand, are soft fleshy swellings that grow on the nasal mucosa, which can potentially obstruct nasal airflow and cause breathing difficulties, depending on its size.

 

Treatment of Allergic Rhinitis

 

There are several medicines to treat allergic rhinitis:

 

1. Antihistamines

Antihistamines are medicines commonly used to treat allergic rhinitis as it has a direct effect on histamine. These medicines are available in various dosage forms such as tablets, syrups, eye drops, and nasal sprays.

 

2. Corticosteroids

Corticosteroids work by reducing nasal inflammation. Corticosteroid-containing nasal drops or sprays are efficient to ensure rapid and localised action allergic rhinitis treatment. The doctor usually prescribes corticosteroid nasal sprays as part of a long-term treatment plan to reduce allergy-related symptoms.

To ensure optimal outcomes and an appropriate length of treatment, it is imperative that patients first seek medical advice from healthcare professionals before starting steroid medications. Before using nasal sprays, the patient needs to learn the appropriate administration techniques through counselling sessions with pharmacists.

 

3. Saline nasal sprays

The saline nasal spray could alleviate symptoms associated with allergic rhinitis, particularly when the nasal cavities become too dry or if there is a build-up of nasal mucous.

 

4. Nasal decongestants

Nasal decongestants unblock the nasal airways that stuffed with mucous. They are available in the form of nasal sprays and tablets. Nasal decongestants are for short-term use only, usually for not more than three days, to reduce nasal congestion and sinus pressure. Long-term use of a decongestant may lead to a "rebound effect", with the possibility of symptoms worsening once the treatment ends.

 

The best way to prevent allergic rhinitis is by avoiding allergens. Maintain a healthy lifestyle and get enough sleep to reduce the worsening of the symptoms. Consult your doctor when the symptoms worsened; or before starting on any medicines to ensure the best treatment outcome. Talk to your pharmacist to understand the difference between products that are suitable for long-term and short-term use.

 

Please call the National Pharmacy Call Centre (NPCC) at the toll-free line 1800-88-6722, weekdays from 8 am to 5 pm if there are any inquiries regarding the use of medicines.

 

Prepared by :

Izzati Yussof

Pharmacist

Ministry of Health Malaysia