Disease Information

Allergies > Patients: Rhinitis Information

Patients

Who is Affected

Allergic rhinitis is the most common allergic disease.

- 10% of people may have seasonal allergic rhinitis

- 10–20% of people may have perennial allergic rhinitis

- In the US, 20–40 million people may have allergic rhinitis

Allergic rhinitis is more common in children.

-20% of children with allergic rhinitis develop their symptoms by 2–3 years of age, and 40% develop symptoms by 6 years of age

The number of people affected by allergic rhinitis is increasing.

-The reason for the increase is not clear, but may be because of increasing levels of air pollution, rising dust mite numbers, less ventilation in houses and offices, dietary factors, sedentary lifestyles, and high hygiene standards that reduce exposure to natural microbes (the hygiene hypothesis)

-The number of children with allergic rhinitis has doubled in the last 20 years

Classification of Allergic Rhinitis

There are three types of allergic rhinitis:

- seasonal allergic rhinitis

- perennial allergic rhinitis

- perennial allergic rhinitis with seasonal worsening

Seasonal Allergic Rhinitis

Approximately 20% of all cases of allergic rhinitis are seasonal allergic rhinitis.
This is commonly caused by tree, weed, and grass pollen, and mould spores. Seasonal allergic rhinitis caused by pollen is also known as hay fever.

The main symptoms are:

- a runny nose
- an itchy nose
- sneezing
- a blocked nose (less common)
- watery, itchy eyes (less common)

Symptoms occur when pollen and spores are airborne, and this is mainly during the summer.

Some people may find that these symptoms persist after the pollen season in response to irritants such as tobacco smoke, bad smells, changes in temperature, and exercise.

Perennial Allergic Rhinitis

Approximately 40% of all cases of allergic rhinitis are perennial allergic rhinitis.
This is caused by year-round exposure to dust mites, pollen (in those areas where exposure is all year), cockroaches, indoor moulds, and pet danders (eg fur, feathers, and skin).

Perennial allergic rhinitis generally lasts for over 9 months of the year.

The main symptoms are:

- a blocked nose
- an itchy nose (less common)
- sneezing (less common)
- a runny nose (less common)

Perennial Allergic Rhinitis with Seasonal Worsening

Approximately 40% of all cases of allergic rhinitis are perennial allergic rhinitis that worsens during the pollen season.

People who suffer from this have symptoms of perennial allergic rhinitis during the year, plus symptoms of seasonal allergic rhinitis during the pollen season.

Other types of rhinitis include:

- infectious

- non-allergic

- occupational

- hormonal

- drug-induced

- food-related

What Causes Allergic Rhinitis?

Allergic rhinitis is a reaction to small particles in the atmosphere such as pollen.

When these particles come into contact with the lining of the nose of a susceptible person, they trigger an immune response in the nose lining, and this causes the symptoms of allergic rhinitis.

This process is known as an allergic reaction, and the particles that cause it are termed allergens. It happens when the immune system, which is designed to stop invasion by foreign bodies such as bacteria, mounts an inappropriately strong response to harmless substances. This over-reaction by the immune system is what distinguishes individuals with allergy from healthy persons.

Symptoms

If you have allergic rhinitis, you may have some of the following symptoms:

- a runny nose
- an itchy nose
- sneezing
- a blocked nose
- watery, itchy eyes

These are caused when you breathe in foreign bodies (allergens).

There are different types of allergic rhinitis. These have slightly different symptoms and are caused by different allergens.

Your doctor can help you identify whether you have allergic rhinitis. He or she will ask you about your symptoms and may also examine your nose, eyes, and ears. This will find out how severe your disease is and whether you have any other diseases instead of, or as well as, allergic rhinitis.

To find out what causes your allergic rhinitis, your doctor will probably ask you questions about when you get symptoms, and what foreign bodies you might be exposed to. To find out exactly what you are allergic to, your doctor may give you a skin prick test.

If your symptoms are very bad, your doctor may ask you see an allergy specialist.

Allergic Rhinitis in Children

Parents should be aware of signs of allergic rhinitis in their children, such as sneezing, or frequent wiping of the nose with the hand, as children do not always complain such problems. Children who have symptoms for a long time may even assume that this is normal. A blocked nose is likely to occur at night and may result in snoring.

AThe Impact of Allergic Rhinitis on Daily Living

People with allergic rhinitis are often troubled by their symptoms eg repeated nose blowing, fatigue, and a reduced ability to concentrate. Children may experience anxiety, find it hard to mix with other children and family members, and find it difficult to learn.

When allergic rhinitis affects the ability of people to do normal daily activities, it is said to affect their "health-related quality of life".

The extent of this impact varies between people, so that out of two people with the same disease severity, one may find the symptoms bearable, but the other may find them difficult to cope with.

Ideally, therapy for allergic rhinitis should directly improve your quality of life as well as reduce physical symptoms.

Reference

Skoner DP. Allergic rhinitis: definition, epidemiology, pathophysiology, detection, and diagnosis. J Allergy Clin Immunol 2001;108:S2-S8.