Allergic Rhinitis Information

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Allergic Rhinitis

An allergic reaction involving thelining of the nose is the most common of the atopic dis-orders, presumably because the nose is so often the firstpoint of contact with airborne allergens. Symptoms oc-cur with equal frequency among girls and boys and in-clude a watery discharge and stuffiness of the nose,reddened lining of the lower eyelids, frequent clearing ofthe throat, mouth breathing, snoring, and the "allergicsalute," an upward wiping of the nose with the palm ofthe hand. Many such wipes may result in the appearanceof a line across the nose known as an "allergic crease." There is often a history of repeated nosebheadaches, earaches, dizziness, a nasal tone to theand dark circles under the eyes.

There are two primary types of allergicPerennial allergic rhinitis causes symptoms thro=the year but especially during winter months when children spend more time indoors and have ongoing efIrsvg.sure to house dust or any indoor pets. Seasonal alk•rga.rhinitis, more commonly known as hay fevc.brought on primarily by plant pollens that m,..7 tirblown for miles by winds. While the seasons andflora vary from region to region, troublesome poliesare typically produced by trees in the late winter ainr.early spring, grasses in the spring and early summer. atmweeds (especially ragweed) in the late summer am.:Molds may also cause seasonal nasal allergy symr.rs.Irritants such as dry air, tobacco smoke, pollution. -caseweather changes, humidity, cosmetics, and perfumealso trigger episodes of allergic rhinitis.

The treatment of allergic rhinitis will depend wagthe frequency and severity of the symptoms.

•Antihistamines interfere with the action ofhistamines, which are biochemical mediators inmany (but not all) allergic reactions. Ira best-agescenario, an antihistamine will reduce congest.,dripping, and sneezing for a few hours. Howewzr,side effects (most commonly drowsiness, espin many of the nonprescription antihistamines.limit the usefulness of these medications, and insome cases a trial-and-error approach is needed 'Infind the best preparation for a particular child.Some of the newer antihistamines last longer l;24 hours) and cause less drowsiness, but theyrequire a prescription and are more expensive. Yborchild's physician can guide you to an appropriaaantihistamine for your child with allergic think.

•Decongestants can shrink swollen membraneswithin the nose and ease breathing throughcongested nasal passages. As with antihistamires,effectiveness varies in children, and irritabilitypotential side effect.

•Decongestant nose drops and sprays can bebought without prescription and may temporeilarelieve congestion associated with allergic rhirms,Local side effects can include stinging, burningirritation, nosebleeds, and sneezing. When usedregularly for more than a few days, "rebound-nasal congestion (which can be worse than therhinitis) may develop each time the medicationwears off. If used at all, decongestant nose drops srsprays should be limited to occasional treatmenrte :'ere and disruptive congestion (for example, thatwhich is interfering with sleep).

•Cromolyn or steroid nasal sprays may beprescribed for long-terns use in a child who hasextended bouts of allergic rhinitis. These do notprovide immediate relief but may reduce the aller-gic activity within the nose for extended periodsof time, without side effects such as sedation orirritability. To be effective, they should be usedconsistently on a daily basis.

•Immunotherapy (or hyposensitization), morecommonly known as allergy shots, is a type ofimmunization in which small amounts of allergenare injected into the child at regular intervals andat gradually increasing doses. Eventually anti-bodies develop that can reduce or prevent theallergic response to the allergen. Typically theinjections must be given regularly (usually weekly)for at least one to two years. If they are effective,the interval between them is gradually increased.Immunotherapy can be particularly helpful intreating allergic rhinitis caused by allergens thatcannot be easily avoided, such as airborne pollens.

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