Allergic rhinitis .Allergic rhinitis - Causes, Symptoms and Treatment .MF .
Allergic rhinitis or allergic rhinitis - one of the most common diseases, which come to the doctor allergologu- immunologist.Presented article contains all the necessary information on symptoms, diagnosis and treatment of allergic rhinitis.Having read it, you can safely say that I now know enough about allergic rhinitis.Article is intended for patients, their families, and anyone interested in this issue.
Allergic rhinitis (nasal allergies) - an inflammation of the mucous membranes of the nose which is based on an allergic reaction.Allergic rhinitis or runny nose is usually manifested by sneezing, rhinorrhea (runny nose active watery secretions), itching in the nose, difficulty in nasal breathing.
According to medical statistics, allergic rhinitis in Russia suffers from 11 to 24% of the total population.
Cause Allergic Rhinitis
The disease is an allergic reaction, or to be more precise, immediate-type hypersensitivity.This term designated the majority of allergic disorders, the sy
possible allergens that can cause allergic rhinitis:
- home or library dust;
- mites that live in house dust;
- allergens insects;
- allergens are molds and yeast;
- certain foods;
Genneticheskaya predisposition is a risk factor for allergic rhinitis.
Symptoms of allergic rhinitis
Key signs and symptoms of allergic rhinitis following:
1) sneezing, often paroxysmal character;
2) presence of nasal discharge watery, transparent character.When you join secondary infection character of discharge from the nose can change by mucopurulent;
3), itchy nose;
4) shortness of nasal breathing is less common and is characterized, as a rule, for the severe forms of allergic rhinitis.Nasal congestion is often worse at night.
Characteristic appearance of the patient during an exacerbation of allergic rhinitis.There is some swelling of the face, nasal breathing is difficult, the patient breathes predominantly mouth.The eyes are often red, possibly tearing.Sometimes there are dark circles under the eyes.Patients with allergic rhinitis may inadvertently and quite often rub their nose with his hand.This symptom is called - "allergic salute".
Allergic rhinitis is usually first manifest (seen) in childhood or in adolescence.Among the relatives of patients with allergic rhinitis often can identify people with allergic diseases.
Depending on the intensity of symptoms distinguish mild, moderate and severe allergic rhinitis.If symptoms of allergic rhinitis do not reduce the performance and do not interfere with sleep, talk about mild;if moderately reduced daily activity and sleep, talk about moderate, and in the case if symptoms of severe allergic rhinitis.
Depending on the extent of symptoms allocate seasonal (the symptoms only during spring and summer) and perennial allergic rhinitis.Seasonal allergic rhinitis occurs most often as a result of an allergy to pollen, at least in the mold spores.
Often patients can specify provoking (causing symptoms of allergic rhinitis) factors.This may be contact with animals carrying cleaning the apartment, being in a dusty environment, leaving the nature of a summer day, etc.
Trial receiving antihistamines often brings temporary relief.
Often the symptoms of allergic rhinitis combined with boards of allergic conjunctivitis, and sometimes are the precursors of asthma.
similar symptoms, except for some nuances that have almost all rhinitis, and they are about ten (infectious rhinitis, hormonal rhinitis, drug-induced rhinitis, psychogenic rhinitis, atrophic rhinitis, occupational rhinitis, etc.).Each requires their fundamentals of therapeutic interventions, individual treatment.Therefore, an accurate diagnosis must still provide specialist.
As a rule, patients are very long-term use vasoconstrictor drugs to the nose and eventually abuse of such drugs can worsen the disease.Many people suffering from allergic rhinitis there is increased sensitivity to stimuli such as a sharp odor, household chemical agents, tobacco smoke.
What tests need to take in cases of suspected allergic rhinitis
case of suspected allergic rhinitis should immediately visit two specialists allergist-immunologist and ENT doctor.An allergist can accurately confirm or exclude the contrary, the allergic nature of the problems with the nose and the ENT doctor will be able to identify comorbidities ENT.Consultation "ear-nose-throat" should not be neglected, even if you are sure that you are allergic to 100 percent, becauseoften coexisting (eg, allergic rhinitis and pollipoz nose or allergic rhinitis and sinusitis).In this case, the reception only antiallergic drugs is not effective enough, and conducted an inadequate treatment of the disease will contribute to the weighting.
To confirm the diagnosis may be asked to pass a swab from the nose to the eosinophils or blood test for total IgE (immunoglobulin E total).Finding eosinophils in the smear (more than 5% of all detected cells) or an increase in total immunoglobulin E (greater than 100 IU) will indicate the nature of the allergic nasal congestion.
The most important question in diagnosing allergic rhinitis - identifying the cause and significant allergen, ie,of contact with substances that cause the symptoms and above.To do this, the most commonly used two kinds of diagnostics:
1) formulation of skin tests.One of the most informative and economical types allergodiagnostic.It must be carried out only in specially designed for this procedure the office.In a survey of the patient make a few cuts (scratches) on the skin and on top of drip 1-2 drops of specially prepared allergen.The reaction is estimated to be within 15-30 minutes.This method has the highest reliability, but has some limitations.So skin tests are not put in the time of exacerbation of the disease, they are not carried out in pregnant and lactating.The optimal age for this type of study is from 4 to 50 years.At least 5 days prior to the procedure override antihistamines (suprastin, Kestin, etc.).
2) blood test for specific immunoglobulin E (IgE-specific).This identification of allergens by a blood test.This method is more convenient than skin tests.Analysis can be taken against the background of an exacerbation and patients receiving anti-allergic drugs.It is not contraindicated neither pregnant nor lactating, or people with common skin diseases.No age restrictions.In this method, only two minuses: quite high cost (from 2,000 to 16,000 rubles per allergens panel or 300 rubles per 1 allergen), and relatively high (up to 13-20% depending on the manufacturer of reagents), the frequency of false positive results.Repeatedly faced with cases where children up to 1 year, blood tests revealed an allergy to seafood (crab, shrimp, mussels, etc.), or exotic fruits.In this case the parents swore that these delicacies and even a child could not see, that is allergic to them is impossible in principle.
Therefore, if the state allows, it should still seek it to the formulation of skin tests.
Sometimes, if not lucky with the medical institution, you may be asked to donate blood at the reaction leucosis reaction with food.In this case it will be necessary to bring the food samples for analysis.This method has a negligible certainty, and to agree on it is meaningless.The results can be thrown out immediately.
addition to the above tests, when in doubt, a physician, you can assign a clinical blood test, X-ray sinuses, nasal swab on the microflora and fungi.
Rarely offer to go forward Rhinomanometry.This method allows us to determine how disturbed patency of the upper airway.
Treatment of allergic rhinitis
therapeutic treatment, ie the treatment of allergic rhinitis is only possible after confirming the exact nature of the disease and determine its allergic nature.
treatment of allergic rhinitis, as, indeed, and most other allergic diseases, is made up of several components.
1. Reduction of allergic inflammation in the mucous membranes.
2. Implementation of allergen-specific therapy.
anti-inflammatory treatment of allergic rhinitis
anti-inflammatory treatment of allergic rhinitis is the integrated application of a variety of drugs.Often
for allergic rhinitis antihistamines appointed inwardly in the form of tablets or drops.The preferred use of second (tsetrin, Claritin, zodak, Kestin) and third (erius, Telfast, zirtek) generations.They are appointed by mouth, in the age dosages once per day.Duration of treatment is determined by a physician, but rarely less than 14 days.Despite the fact that these drugs are released from allergies in pharmacies without a prescription to appoint them for himself alone for a long time can not.This is due to the fact that some drugs revealed cardiotoxic effect (negative impact on the heart), a number of them are able to inhibit the cognitive (thinking) abilities.The greatest safety profile, of course, have the latest generation of drugs, but their relatively high cost is often a limiting factor, especially with prolonged use.
With the ineffectiveness of previous measures for the treatment of allergic rhinitis requires the appointment of "local agents" acting exactly on the nasal mucosa.
When mild allergic rhinitis, to this end appointed derivatives sodium cromoglycate (trade names - kromogeksal, kromoglin, kromosol).The formulations are produced in the form of nasal sprays, injection of nazanachayutsya 1-2 (1-2 drops) to the nose 3 times a day throughout the exacerbation.Note that the effect of the appointment of such treatment occurs no earlier than 5-10 days (and sometimes later).Therefore, they operate more preventive than curative.Drugs in this group often prescribed to treat allergic rhinitis in children with mild or severity of the disease in adults.The treatment of allergic rhinitis is usually not less than 2-4 months.Probably year-round use of drugs.
Separately, I want to highlight a relatively new drug that is based on plant cellulose - Nazaval.The drug is available as a nasal spray and assigned 4-6 times per day.The result is a microfilm on the mucous membranes of the nose, mucus prevents contact with the allergen.The drug has a rather low efficiency during exacerbation of already developed and can only be recommended for the prevention of disease.
In-severe allergic rhinitis - nasal drugs of choice are corticosteroids (aldetsin, nasobek, bekonaze, Nasonex, Fliksonaze, nazarel, benorin) issued in the form of nasal sprays.The drug is prescribed 1-2 times a day in dosages of age.Duration of treatment is determined by the doctor.A very common misconception about the poor tolerability and the numerous side effects of intranasal corticosteroids.To date, the safety and efficacy of these drugs is confirmed by numerous international studies, they are the basis of so-called "gold standard" treatment of allergic rhinitis and have helped many hundreds of thousands of patients worldwide.
frequent mistakes made in the treatment of allergic rhinitis, is a long-term use of vasoconstrictive drops to relieve nasal congestion.It's like drugs naftizina, Vibrocil etc.Prolonged use of drugs of this group always leads to the development of medicinal rhinitis varying degrees of severity, the treatment of which may require surgery on the nasal passages.The use of vasoconstrictors is only advisable in severe nasal congestion before use of intranasal corticosteroids, but in general, it is desirable not to abuse vasoconstrictor nose during a diagnosis of allergic rhinitis.
against allergic rhinitis and for the prevention of diseases of ENT organs, as well as complications applied nasal lavage.However, most solutions for the treatment of rhinitis in the form of finished nose sprays imply irrigation procedure, rather than directly lavage.Unlike Irrigation washing may reduce a thick consistency nasal secretions, but does not solve the problem with their removal along with harmful bacteria.After irrigation mucous dries quickly, which further aggravates the cold, provokes edema.
Washing helps to reduce the inflammation of the nasal mucosa improve performance and reduce the risk of sinusitis and sinusitis.Modern technique involves rinsing the nasal passages with special antiseptic.For example, the components of the preparation "Dolphin" get to the sinuses, diluting mucus clots and naturally taking them out.
patients who respond poorly to conservative treatment or who have contraindications to the drug, it is advisable to discuss the possibility of allergen-specific immunotherapy.
allergen-specific therapy of allergic rhinitis
most radical method of treatment of allergic rhinitis is holding the allergen-specific therapy.This type of treatment is carried out only by trained doctors allergists in the hospital or allergist's office.The meaning of the treatment consists of the administration of small doses of the allergen in gradually increasing concentrations in order to develop tolerance to it (sustainability).Most often practiced by the parenteral (injection) administration of allergens.With the success of this type of treatment can achieve the complete disappearance of symptoms of allergic rhinitis.Earlier initiation of treatment increases the chances of developing a complete tolerance to allergens and thus cure the disease.The emergence of this treatment led to a complete cure allergic rhinitis in a number of patients.
Surgical therapies in the treatment of allergic rhinitis are rarely used, and only in the presence of concomitant pathology ENT (deviated septum, etc.).
Adherents of homeopathic treatment should pay attention to drug Rhinital (made in Germany) or rinosennay (Russia).
Treatment of allergic rhinitis folk remedies.
Allergic rhinitis is one of those diseases where traditional medicine can not help.Currently not aware of any really working method of this area, which I would recommend a wide range of patients with allergic rhinitis.Unreasonable craze similar means of treatment may lead to exacerbation of the disease, the accession of secondary infection (that only people currently in the nose and pour stuffing) and delaying the appointment of adequate medical treatment.
One possible method is to wash the nasal saline solution.(1/3 teaspoon salt to 1 cup of boiled water to wash the nose 1-2 times a day).But even this seemingly innocuous method MUST be combined with drug treatment.By itself, its use is inadequate.
Features of diet and lifestyle in allergic rhinitis.
most important component of the treatment of allergic rhinitis is to reduce exposure to allergens.The recommendations drawn up after the Allergic diagnosis and identify the cause and significant allergen.
By its nature allergen may be food (for various food products), household (house dust, feather pillows, house dust mites), pollen (pollen plants), epidermal (animal dander, feathers, etc.)fungal, promyschlennye etc.
character of elimination events depends on the type of allergen.
So when food allergy exclude those products from the tests that were positive in the patient.
When pollen allergy in the period of exacerbation, the patient is not recommended to leave the city, into the countryside.If necessary, preference is given to the third-generation drugs (Telfast) in minimally effective doses.