Allergic rhinitis - not just a runny nose

Itchy eyes, runny nose and constant sneezing are symptoms of this increasingly common condition. Dr. Lesley Hickin and Dr Chris Brown give advice on allergic rhinitis and its most common form, hay fever

What is allergic rhinitis?
Inflammation of the membrane lining the nasal cavity is known as rhinitis. It can affect people all year round (perennial rhinitis) or can be seasonal (usually called hay fever), occurring at a specific time of year.

To understand allergies you need to know a little about the immune system and how it works. Your immune system protects you from infection by producing antibodies that kill harmful organisms. When you have an allergy your immune system overreacts to substances that you eat, breathe or touch. Immune system cells are located in areas of the body where they are in the front line of attack when an allergen appears. These areas are the nasal cavity, including the tonsils, the lungs and the intestines.

Reducing your exposure to allergens may help prevent allergic reactions but this is not always practical, and various treatments are available to combat the problem.

Symptoms
The symptoms of allergic rhinitis appear soon after contact with the allergen. They tend to be worse with hay fever (pollen allergy). They include an itchy sensation in the nose and throat, frequent sneezing, a blocked runny nose and itchy red watery eyes (allergic conjunctivitis).

When symptoms are really bad you may feel as if you have a high temperature, hence the term hay fever. The impact of hay fever on quality of life can be enormous, with most sufferers putting the symptoms themselves at the top of the list. Poor sleep (probably from nasal blockage) can cause sleep deprivation, daytime tiredness and irritability. Young people particularly complain of problems in concentration - unfortunately at the time of year when many are studying and taking exams.

Diagnosis
Allergic rhinitis is usually easy to diagnose from the description of the symptoms, particularly if you can identify the trigger factor from the pattern of your symptoms. For example, do you sneeze when there is a cat in the room? Does your nose always run when you empty the vacuum cleaner bag?

If the cause is not clear, you might be sent to an allergy clinic where you can have skin prick tests and blood tests to try to identify the cause. However, these are not done routinely because the results can be confusing. Sometimes no obvious cause is found.

Skin prick tests are simple and painless tests to find out which substances (allergens) cause allergic reactions in affected people. Dilute solutions are made from extracts of common allergens such as pollen, dust, animal dander (shed skin flakes), food and house dust mite. A drop of the solution is placed on the skin, which is then pricked with a needle. The skin is observed for a reaction, which usually occurs within 30 minutes of the solution being applied.