| As
the most common allergic condition, allergic rhinitis affects
people of all ages. Allergic rhinitis is generally characterized
by frequent sneezing and a runny or stuffy nose sometimes
accompanied by watery eyes. Certain populations, such as young
children and adolescents, require special consideration for
safe and effective diagnosis and treatment.
Boys are twice as likely to get allergic rhinitis
than girls. The median age of onset of the condition is 10
years old, meaning that equal numbers of children develop
the condition before and after age 10. The prevalence of allergic
rhinitis may vary greatly by region. A study in Tucson, Arizona,
for example, found that 42% of children were diagnosed with
allergic rhinitis by the age of six.
A family history of allergic rhinitis is the
greatest known risk factor for the condition. Other risk factors
include higher social class, male gender, breast feeding for
more than one month, being the first born, having a mother
with asthma and having a dog in the home.
Children with rhinitis may suffer learning
impairment related to annoying symptoms, daytime fatigue from
sleep loss, as well as an impaired quality of life. Rhinitis
may also cause infection of the sinuses (sinusitis), dysfunction
of the eustachian tubes that connect the ear to the throat
(resulting in temporary hearing loss), aggravation of asthma
and changes in the formation of the mouth, such as a high-arched
palate.
A common cold or upper respiratory infection
can be confused with allergic rhinitis, but the presence of
eye irritation and the lack of fever generally point to allergic
rhinitis. Food allergies can cause rhinitis symptoms in 70%
of infants and young children, but are frequently associated
with symptoms of skin or gastrointestinal irritation. Foreign
bodies placed in the nose and anatomic abnormalities may cause
rhinitis-like symptoms.
Diagnosis and Treatment
To determine what allergens an individual
is allergic to, patients of any age may undergo a skin test
in which they are exposed to various substances, such as pet
dander, dust mites or mold. The first line of treatment is
avoiding these allergens whenever possible. Avoiding second-hand
tobacco smoke is crucial.
Allergy medicine, such as antihistamines,
may be prescribed. The so-called “second-generation”
antihistamines provide relief from symptoms while minimizing
side effects, such as drowsiness or irritability. For chronic
allergic rhinitis, antihistamines are prescribed everyday.
Otherwise, they should be taken prior to exposure
to allergens. Cetirizine (Zyrtec), for ages 2 and up, and
loratadine (Claritin), also for ages 2 and up, are effective
second-generation antihistamines for children. Fexofenadine
(Allegra) is appropriate for ages 6 and up.
Decongestants, which unblock stuffy noses,
may be prescribed as pills or sprays. They should be used
with caution in young infants because of potential adverse
reactions. Azelastine (Astelin) is a second-generation antihistamine
available in a nasal spray for ages 6 and up.
The most effective drug intervention for nasal
allergy symptoms is corticosteroids sprayed into the nose.
Steroidal pills are also available, but may cause more side
effects than a nasal spray, and are only recommended for cases
that don’t respond to other treatments. Fluticasone
(Flonase) is approved for ages 4 and up. Mometasone (Nasonex)
was recently shown to be safe and effective for ages 3 and
up.
For long-term control of multi-seasonal, moderate-to-severe
allergic rhinitis, allergen immunotherapy is a safe and effective
treatment. Immunotherapy involves injections of allergens
over a number of months until the body becomes accustomed
to them. Because severe reactions are possible, immunotherapy
is not recommended in very young children because they can’t
communicate effectively should a problem arise.
Seriousness
of Allergy Rhinitis | Perennial
Allergic Rhinitis |
Relieving
Toddler Nasal Congestion |
Non-Allergic
Rhinitis| Causes
of Allergic rhinitis| Treatment
of Allergic rhinitis|
History
of Allergic rhinitis| Abnormal
production of nasal secretions|
Allergic
Rhinitis in Children|
How
can chronic rhinitis and post-nasal drip be treated?|
What
are rhinitis and post-nasal drip?
|
