What is Allergic Rhinitis? (Sensitive Nose)

Rhinitis refers to the inflammation of the nasal mucous membrane, which produces symptoms such as sneezing, runny, congested and/or itchy nose which also extends to the eyes and throat. When rhinitis occurs as a result of allergies, the condition is known as allergic rhinitis. Allergic rhinitis is commonly known as having a sensitive nose.

As the name suggests, allergic rhinitis happens because of an allergy problem. Allergies are the outcome of a person’s immune system being hypersensitive. In this hypersensitive state, the nose will be inflamed upon exposure to even harmless allergens present in the environment (usually in the air). In Malaysia, the most common allergy triggers are house dust mites and pollution as reported by more than half of nasal allergy sufferers.

Allergic Eyes/Ears, Nose, Throat (ENT) Symptoms

  • Sneezing
  • Runny nose
  • Nasal blockage / congestion
  • Itchy and inflamed nose
  • Red, watery, and itchy eyes
  • Dry cough / throat
  • Fullness in the ears

If the sinuses are also inflamed,
symptoms such as facial pain and headaches may also be present.

What is Sinusitis?

Sinusitis refers to the swelling or inflammation of the sinus mucous membrane. This swelling causes the sinus openings that normally drain mucous to be blocked. Mucous then stagnates, causing facial pain and headaches besides attracting viral or bacterial infections. Sinusitis will almost always happen after rhinitis and rarely occurs alone. As the nasal and sinus passages are so closely inter related, otolaryngologists now refer to sinusitis as rhinosinusitis. Globally, it has been established that about 51% of rhinosinusitis cases are caused by allergies.

Chronic rhinosinusitis is defined as a long-term sinus inflammation of about 12 weeks or more which keeps recurring despite treatment. The estimated prevalence of sinusitis in Malaysia is about 13% equating to about 3.5 million Malaysians.

What causes Allergies?

Allergies result not from the presence of allergens which everyone is exposed to but to the individual’s immune system which is best described as being hypersensitive. In this hypersensitive condition, the immune system displays a high level of attack even against harmless substances present in the environment. As a result, inflammation in the nose and the sinuses are triggered into an angry flare-up.

A substance that causes an allergic reaction is called an allergen. In Malaysia, common allergens include house dust mites, pests (cockroaches), plat pollen (grass / oil palm), seafood and dairy products.

Worldwide Problem

Allergic rhinitis affects about 30% of people worldwide from all countries, all ethnic groups, and all ages (World Health Organisation statistics). People with nasal allergies in particular are at greater risk of suffering asthma, rhinosinusitis and middle ear infections lending to a significant impact on quality of life with symptoms such as difficulty breathing, facial congestion, pain, headaches and ear aches. In addition, people with nasal allergies are also more than twice as likely to suffer sleep problems.

Genetics Play a Role

Allergies often run in families. Children born into families where allergies already exist have a higher than average chance of developing allergies themselves. Even if there isn’t a familial predisposition towards allergies, there is naturally a 25% chance for people to develop allergies.

If one parent has an allergy (particularly if that parent is the mother), the risk is doubled. If both parents have allergies, the risk is increased to 60-80%. This increased tendency for individuals to develop allergies because of their genes is known as being atopic.

The burden of allergic diseases is huge at both an individual and a familial level. This translates to an increased burden at a national level, making allergies a public health issue. Allergic diseases are complex because both genetic and environmental factors influence disease development.

Treatment Options

The primary rule to manage allergies is avoidance. If the patient knows what causes their nose to start itching and sneezing, then the cause would have to be avoided. However, this is easier said than done. After all, it is not possible to control the environment wherever we go.

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