51. One hundred questions and answers on allergy rhinitis. 51. 알레르기 비염에 관한 100가지 질문과 답변

51. One hundred questions and answers on allergy rhinitis .51. 알레르기 비염에 관한 100가지 질문과 답변

Q. Is allergic rhinitis a genetic disease?

A.That’s right. In one generation to follow, it is inherited as a dominant autosomal disorder.

It can be inherited by both grandparents, fathers, mothers, sons, and daughters in one household.

Q. Is allergic rhinitis a common disease?

A.15% to 22% of people of all ages in the United States suffer from allergic rhinitis.

Another study found that 8.8 to 16% of Americans suffer from allergic rhinitis.

According to another study, 20-30% of children and adolescents suffer from allergic rhinitis.

The incidence rate is on the rise.

10% of American children before puberty,

Twenty percent of adolescent children and young people in the United States suffer from allergic rhinitis.

According to a survey of 13,579 children and adolescents aged 0-17 years old in the United States, the incidence of allergic rhinitis was 4.8% in the 0-4 years old, 10.5% in 5-11 years old, was 14.2% in the 12-17 years olds.

It can be thought that about 10-20 children out of 100 children and adolescents have allergic rhinitis.

The most common chronic disease of the respiratory system is allergic rhinitis.

allergens_2.jpg

Figure 3. Antigens that can cause allergic diseases including allergic rhinitis

Pet hair, dandruff, house dust mites, molds, fungus, pollen, drugs, fish or shellfish, cow milk and milk foods, eggs, flour food, cosmetics, chocolate, nuts, peanuts, beans, etc.

These are antigens that can cause allergies relatively more often.

Children with severe allergic rhinitis can develop an adenoid face shape.

allergy_Foods-3s.jpg

Photo 5. Various allergic diseases are easily caused by the foods as seen in the above photo.

Fish, shellfish, cow milk, milk foods, wheat, nuts, eggs, peanuts, and walnuts can cause allergies relatively more often.

Copyright ⓒ 2012 John Sangwon Lee, MD., FAAP

Q. What is the cause and pathogenesis of allergic rhinitis?

A. As already mentioned, they are born with a genetic factor that is inherited as autosomal dominant disorders that can cause allergic rhinitis.

In addition, antigens that can cause allergies to enter the body through the nose, mouth, through the mucous membrane of the gastrointestinal tract, through the skin or mucous membrane layers of another organ, and through other organs in other systems of the body, and antigen-antibody abnormalities occur in the nasal mucosa in case of allergic rhinitis.

At that time, histamine granules are released from mast cells from the nasal mucosal wall, and other biochemicals act in combination, causing allergic rhinitis.

Q. What are some of the antigens that cause allergic rhinitis?

A. Pollen from grass and trees, mold, fungus, hairs, or dandruff from dogs, cats, cattle, horses, chickens, birds, etc., can be sucked into the airways through the nasal passages when breathing. Feathers, saliva, dead insect powder, house dust mites, and house dust can cause allergic rhinitis.

Antigens such as cow milk, eggs, chocolate, flour food, soybeans, fish, peanuts, etc., taken orally and through the gastrointestinal tract, can enter the bloodstream and reach the mucous membrane of the nasal cavity, causing allergic rhinitis.

Allergic rhinitis can be caused by antigens entering the body through the skin or the mucous membrane of each organ and also the blood.

Allergic rhinitis can develop in the mucous layer of the nasal cavity when a cat’s fur, dandruff, or saliva is inhaled directly into the nasal cavity.

When the nasal mucosa layer is no longer in contact with cat hair, dandruff, or saliva, and so on, it is common for allergic rhinitis to no longer develops from cat hair, dandruff, or saliva.

When the nasal mucosa layer comes in contact with the cat’s hair, saliva, and dandruff again, allergic rhinitis can occur again as a cat hair antigen.

Q. How is allergic rhinitis triggered?

A. When an antigen that can cause allergic rhinitis arrives at the nasal mucosa, histamine granules are released from the mast cells in the nose, causing the nasal mucosa to swell, capillaries in the nasal cavity are congested, runny nose, itchy nose, red and itchy eyes, and nose. It is common to have signs of nasal airway clogging, open the mouth, and breathing thru the mouth.

If allergic rhinitis lasts for a long time, symptoms such as allergic salute, allergic shinner, and malocclusion may occur.

In severe cases,adenoid face can also be developed.

 

Q.What is the annual medical bill for treating allergic rhinitis in the United States?

A. It is said that it costs $450 million annually.

Q. What are the possible signs of symptoms in children with chronic allergic rhinitis?

A. In addition to the main symptoms and signs described above, sometimes

· Sleep disorder,

· Learning disabilities,

· Lack of concentration (attention deficit disorder) and/or hyperactivity (hyperactivity disorder),

· Adenoid hypertrophy,

· Tonsil hypertrophy,

· Enlarged lymph nodes in the anterior neck area just under the chin,

· Adenoid facial appearance,

· Obstructive sleep apnea (sleep blocked apnea),

· Teeth, malocclusion,

· Trichosis- many body hairs,

· Palm excess lines,

· Allergic salute,

· Dennie’s lines,

· Nasal polyp may occur.

Q. Are there other diseases that may be more prevalent in children with allergic rhinitis?

A. Sinusitis and bronchial asthma, eye allergies, otitis media, and allergic conjunctivitis may occur simultaneously.

Q. What is the atopic constitution?

A. A constitution that is not a typical constitution is called an atopic constitution or atopy.

There seem to be few people who are not atopic these days.

Children with the atopic constitution are more susceptible to allergic diseases such as allergic rhinitis, bronchial asthma (asthma), atopic dermatitis, ragweed contact dermatitis and hives, and food allergies are more prone to children with the atopic constitution.

Q. How are allergic rhinitis and bronchial asthma-related?

A. Allergic rhinitis can be triggered in 90% of children with a past history of bronchial asthma, and bronchial asthma can also be treated well if allergic rhinitis is treated well.

The incidence of bronchial asthma in children with allergic rhinitis is three times higher than that in children without allergic rhinitis.

Children with allergic rhinitis have a 40% chance of developing bronchial asthma.

Allergic rhinitis and bronchial asthma are caused by biochemical mediation such as IgE, cytokines, histamine, and leukotriene, and bronchial asthma can be treated with corticosteroids, bronchodilators, antileucotrene, and anti-IgE drugs, and allergic rhinitis can be well treated with allergic rhinitis medications that contain drugs used to treat bronchial asthma

Q. What are seasonal allergic rhinitis, perennial allergic rhinitis, and mixed allergic rhinitis?

A. When children with allergic rhinitis caused by an antigen such as mold or fungus go to a dry place where mold or fungus does not grow, it is common that allergic rhinitis is no longer caused by the mold or fungus antigen. When the children go to a humid place where mold or fungus grows, it is common for allergic rhinitis to be triggered again by mold or fungus antigen.

Symptoms of allergic rhinitis caused by mold or fungus may be worse in good temperatures for mold or fungus or seasons where mold or fungus is likely to grow, such as in wet summer.

Also, children suffering from allergic rhinitis due to acacia flower pollen can have allergic rhinitis when acacia flowers are blooming from May to June. This kind of allergic rhinitis is called seasonal allergic rhinitis.

Allergic rhinitis caused by ragweed pollen antigens can be induced in the fall when ragweed is grown, and allergic rhinitis is caused in spring with the Maple tree pollen antigen, which blooms a lot in the spring in the New England region of the United States.

This type of allergic rhinitis is called seasonal allergic rhinitis.

Allergic rhinitis can most often be triggered by antigens, such as house dust, dust mites, molds, fungus, or foods eaten almost daily.

Allergic rhinitis can develop year-round in children who have year-round contact with that type of antigen.

This type of allergic rhinitis is called perennial allergic rhinitis. Perennial allergic rhinitis (allergic rhinitis with symptoms throughout the year) caused by house dust mites. It is less common in children 9 years old of age.

Many children develop seasonal allergic rhinitis as well as perennial allergic rhinitis.

This allergic rhinitis is called mixed allergic rhinitis.

Q. What is the relationship between cold or stress and the symptoms of allergic rhinitis?

A. In general, symptoms of allergic rhinitis can become even more severe when you have a viral upper respiratory infection such as a cold or flu, or when under a lot of stress. Also, the more you are exposed to many types of antigens, the more severe the symptoms.

Q. What are the typical symptoms of acute allergic rhinitis

A. It depends on age, type of antigen, and the presence or absence of complications.

Typical symptoms of allergic rhinitis include:

· Runny nose

· The nose is stuffy and itchy

· Sneeze.

· The eyes may be red, itchy and tearful,

· The palate may be itchy

· Symptoms of these symptoms may recur according to seasonally and

· Signs of these symptoms can be triggered temporarily and can occur throughout the season.

· Signs and such symptoms may be mild, moderate, or severe.

Q. Can newborns or infants develop allergic rhinitis?

A.Theoretically, the symptom and signs of allergic rhinitis can start in the neonatal period and then at any age.

When they start eating artificial nutrients containing cow milk protein, allergy rhinitis starts to develop, especially in newborns with the atopic constitution.

Allergic rhinitis may develop less in breastfed babies, but depending on the food the nursing mother ate, allergic rhinitis may develop in newborns and infants.

Q. What is the incidence of allergic rhinitis that can be caused by cow milk or milk food

A. The incidence of allergic rhinitis caused by cow milk or milk-based foods is about 0.3%.

Q. What is the relationship between artificial nutrition and allergic rhinitis that newborns and infants with atopic constitution eat?

A. Newborns and infants, especially newborns and infants with the atopic constitution, eating artificial nutrition, whole cow milk (whole cow milk), or milk food containing cow milk protein can cause allergic rhinitis due to cow milk protein.

Q. Can allergic rhinitis be worse if exposed to multiple antigens at once?

A. When children with allergic rhinitis from cow milk food are exposed at the same time to house dust mites, they may get more likely allergic rhinitis due to house dust, mite antigen, and also allergic rhinitis caused by cow milk protein and allergic rhinitis caused by house dust mites can.

Q. What is the word “allergic salute”?

A. If your nose is itchy due to allergic rhinitis, there are symptoms of raising one hand to rub your nose in a salute position. This symptom is called “Allergy salute.

Q.What is the relationship between allergic rhinitis and oral breathing?

A. When your nose is stuffed with allergic rhinitis, you often open your mouth and breathe through your mouth rather than thru your nose.

This breathing is called “oral breathing” and is also called “gaping”.

People with chronic allergic rhinitis tend to open their mouths and breathe in front of anyone, day or night.

Sometimes some people think because he is stupid and he can not close their mouth.

When newborns and infants develop allergic rhinitis, their noses are often stuffed and their mouths open and breathe with mouth open.

These symptoms are called gaping in English and oral breathing in Korean.

If allergic rhinitis is not treated properly and well, these symptoms may persist from neonatal to puberty and then may continue to appear after adulthood.

Q. What is the relationship between malocclusion and allergic rhinitis?

A. Long-term allergic rhinitis can lead to oral breathing, enlarged adenoids, enlarged tonsils, changes in the structure of the mouth and the face, and dentition problems.

And severe malocclusion can occur.

There are pros and cons here too.

In my experience, there is a close relationship between malocclusion and allergic rhinitis.

So, I think that allergic rhinitis treatment plays an important role in the treatment of malocclusion.

Q. What is the relationship between allergic rhinitis and adenoid facial appearance?

A. Allergic rhinitis can cause long-term symptoms of open mouth and breathing.

Teeth may have abnormalities such as pimples, jade teeth, and malocclusion. Interrelationship changes in the anatomical facial structure such as the eyes, the nose, the mouth, the face, and gums may occur and abnormalities may occur.

So, unusual funny facial features can appear in children with allergic rhinitis.

This facial feature is called adenoid facial features.

Q. What’s the difference between cold and allergic rhinitis?

A. A cold is a viral infection that occurs in the upper respiratory tract, such as the nose, nasal cavity, pharynx, sinuses, adenoids, and tonsils.

When you catch a cold, you have a mild or high fever, a sore throat, and a sore body.

The cold usually heal naturally within 10-14 days.

With allergic rhinitis, the mucous membranes in the nasal cavity are swollen and red, the nasal cavity may be blocked, you have a runny nose, and you can sneeze.

They usually can’t sleep well.

Allergic rhinitis is an allergic disease, and when you suffer from allergic rhinitis, it usually lasts more than two weeks without a fever, no sore throat, no sickness.

In this way, cold and allergic rhinitis are different.

Sometimes these two diseases can be together.

Q. What is the relationship between allergic rhinitis and adenoids or tonsils

A. Adenoids are a type of lymphoid tissue located in the p0sterior back of the nasal cavity and the top of the pharynx.

Adenoids protect against infectious diseases by catching sources such as bacteria, and viruses that enter through the nose and preventing them from entering deeper into the body other than the upper respiratory tract.

It also catches harmful antigens that enter the body through the nose and prevents them from entering the body any more.

Excessive use of these adenoidal functions results in anatomically enlarged adenoids.

In almost the same way, the pharyngeal tonsils on both sides of the mouth will also become enlarged.

In particular, children with allergic rhinitis usually have abnormally larger adenoids and tonsils.

Q. Children with allergic rhinitis may snore more often, why?

A. In children with allergic rhinitis, adenoids and tonsils are abnormally larger, the nose airway partially is blocked, oral breathing and anatomical changes such as the nasal cavity, palate, and dentition occur.

As a result, they often make a snore when talking and snore when sleeping.

In particular, allergic rhinitis in school-age children can cause frequent clogging of the nose, adenoids in the back of the nasal cavity, and abnormally large tonsils in both sides of the mouth.

That’s why they snore too.

Q. When you have allergic rhinitis, your nose bleeds well. Why?

A. With allergic rhinitis, the nasal mucosa is swollen, pale and the capillaries in the mucosa wall are abnormally dilated.

Sneezing, coughing, minor nasal trauma, or even lightly rubbing the nose can cause the dilated mucosa capillaries to burst and noes bleed easily.

Q. Do they cough even with allergic rhinitis?

A. If they have allergic rhinitis, they may cough a little intermittently. In particular, when they lie down at night, their runny nose flows to the posterior part of the nasal cavity and the nasopharynx, which irritates the pharynx, which can cause intermittent coughing while sleeping.

In addition, 30% of children with allergic rhinitis suffer from simultaneous bronchial asthma.

That can also cause coughing and sometimes coughing with both allergic rhinitis and bronchial asthma.

Most children with bronchial asthma have nocturnal bronchial asthma attacks while they sleep at night, so it is common to cough while sleeping.

Sometimes you cough like this for several days.

Bronchial asthma attacks caused by this sleep are called nocturnal bronchial asthma.

Differentiate diagnosis of whether children with allergic rhinitis cough at night, cough with nocturnal bronchial asthma, cough with allergic rhinitis, or coughing due to both allergic rhinitis and nocturnal bronchial asthma sometimes it is difficult.

Q. If I have allergic rhinitis, can I easily get a sinusitis?

A. That’s right.

 

If you have allergic rhinitis, you may be more prone to sinusitis.

The nasal mucosa layer and the sinus mucosa layer are made up of the same type of mucous membrane cells, and the sinuses and nasal cavity are connected to each other by small natural vents.

In addition, the swollen and inflammation of the mucous membrane layer of the upper respiratory tract caused allergic rhinitis and It may frequently block small natural vents too.

Obstruction of the natural airway makes it easier to infect the sinuses, making it more prone to sinusitis.

There are altogether 8 paranasal sinuses on both sides of the face, including the frontal, ethmoid, sphenoid, and maxillary sinuses around the nasal cavity.

The paranasal sinuses in and around the nasal cavity are normally connected to each other by small vents.

The mucous membranes in the vents can be swollen due to allergic rhinitis, which can block the vents, resulting in paranasal sinusitis and sinus headaches.

For this reason, most children with allergic rhinitis are more prone to sinusitis and

sinus headache.

Q. Can they have frequent headaches with allergic rhinitis?

A. When they have allergic rhinitis, the small vents that connect between your paranasal sinuses and your nasal cavity is easily clogged, which can often lead to clogged sinus headaches.

In addition, sinusitis can occur, which can cause headaches as a symptom of sinusitis, and tension fatigue syndrome can occur in children with the atopic constitution, which can also lead to frequent headaches.

Q. Can they get more otitis media if they have allergic rhinitis

A. they can have more.

There is the Eustachian canal which connects between the orifice at the posterior nostril airway and middle ear cavity. It can be swollen, causing frequent blockage by allergic rhinitis.

At this time, negative pressure may develop in the middle ear cavity.

Exudate may collect in the middle ear cavity and otitis media may develop.

This can lead to bacterial infection in the effusion of the middle ear, resulting in acute otitis media.

The Eustachian canal may be swollen, causing frequent clogging, and air can not flow between the posterior pharyngeal cavity and the middle ear cavity.

They may have acute otitis media or otitis media often.

Sometimes hearing impairment can occur.

Q. Is there a difference between a runny nose when they have allergic rhinitis and a runny nose when they have paranasal sinusitis?

A. When allergic rhinitis is alone without complications, it is common to have a clear runny nose.

However, when both allergic rhinitis and bacterial sinusitis are present, it is common for the runny nose to be a yellow or bluish runny nose. Sometimes there is no difference in a runny nose.

Q. If I have allergic rhinitis, does a runny nose come out?

A. Even if you have allergic rhinitis alone, you may not have a runny nose, and even if you have sinusitis alone, you may not have a runny nose.

Or, even when both ailments are present at the same time, a clear runny nose may come out little by little, sometimes even a little less.

Q. Does allergic rhinitis cause allergic diseases in the eyes and the mouth?

A. It is likely to occur.

Allergic diseases may occur simultaneously in the eyes, sinuses, adenoids, tonsils, pharynx, and mouth.

For example, allergic conjunctivitis can develop.

Allergic conjunctivitis can cause frequent conjunctivitis with red eyes, frequent tears, and itchy eyes, leading to the frequent rubbing of the eyes.

Allergic rhinitis can cause frequent geographic-shaped tongues.

Q. I’ve been told that some of the children with allergic rhinitis can choke during sleep, resulting in apnea, sometimes painfully breathing or snoring. Why?

A. The adenoids of children with the atopic constitution are usually much larger and enlarged than the adenoids of children who do not have an atopic constitution.

Also, the tonsils are also usually larger.

Because of this, children with allergic rhinitis have a much narrower upper respiratory tract.

That’s why you can briefly choke during sleep, breathing laboringly, or snoring.

Sometimes blocked apnea (obstructive sleep apnea) can also develop.

Q. I read that some of the kids with allergic rhinitis have enlarged lymph nodes in the neck just below the lower jaw, and why?

A. Children with allergic rhinitis usually have enlarged lymph nodes in the neck area just under the lower jaw.

The lymph nodes just under the lower jaw are like adenoids and tonsils, which are a kind of lymphoid tissue, and the lymphatic tissue functions to protect against infectious diseases by preventing antigens and bacteria from entering the body through the mouth or nasal cavity through the nasal and pharyngeal cavity anymore.

With such a defense function, the lymph nodes in the neck also become excessively large.

Q. Most of the children with allergic rhinitis have a habit of getting teeth grounding during sleep at night. Why is that?

A. If you have allergic rhinitis, it can be itchy in your eyes and nose, as well as your pharynx and palate.

There are some doctors who claim that they ground teeth unconsciously as a way to solve the itching in the nasal cavity, the pharynx, and/or palate and they try to move the upper and lower jaw to relieve the itching feeling while sleeping.

Most children with allergic rhinitis have a habit of sleeping at night and having their teeth grounding frequently.

Q.What can happen to your mouth or face if you have allergic rhinitis?

A. Because the nose is often blocked and the mouth is open to breathe, many changes in the interrelationship of the anatomy of the mouth, face, nose, jaw, teeth, and gums can occur in children with allergic rhinitis.

One of the resulting tooth changes is malocclusion.

The second is the adenoid face. I already mentioned it before.

There are many other changes that can happen to their face.

Q. It is said that children with allergic rhinitis sometimes get more body hair, but why?

A. The antigen enters the body by the mouth, the nasal passages, or through the skin or the mucous membrane. More body hair will prevent those antigens that enter the body from entering the body any more.

It’s almost the same thing to have more hairs in your nostrils.

Q. How is allergic rhinitis diagnosed?

A. It is common to comprehensively diagnose the current medical history, past medical history, family medical history, symptoms and signs, and physical examination findings.

If necessary, the diagnosis is made by several other methods, such as an allergy trigger test, an allergy skin test, and a blood test.

Q. Do children with allergic rhinitis suffer from a cold differently than children without allergic rhinitis?

A. Symptoms of allergic rhinitis may worsen when children with allergic rhinitis have cold or other types of viral upper respiratory tract infections.

And symptoms of upper respiratory tract infection, such as a cold, can be even more severe.

Q. What are the common complications and coexistences of allergic rhinitis?

A. With allergic rhinitis, children may have coexisting morbidities such as bronchial asthma, sinusitis, otitis media, atopic dermatitis, food allergy, drug allergy, and insect allergy.

Q. What are the signs and symptoms that are very important in diagnosing allergic rhinitis.

A. Because the nose is itchy, the habit of rubbing the nose which can cause the horizontal skin wrinkle on the nose where the nasal bones and nasal cartilage of the nose are connected. Skin wrinkle is called Dennie lines.

Signs of raising your hand and rubbing your nose are called ‘allergic salutes’ or ‘Allergy salutes.’

The darkish color of the skin just under the lower eyelids under both eyes changes to a dark skin color tone.

They are called allergic shinners.

Allergic shinners can occur temporarily or can last for months or longer after one onset.

Shinner means that when a bruise on the face or any part of the body is injured, the skin color temporarily changes to darkish after the bruise.

When allergic rhinitis lasts for a long time, the anatomical interrelationships of the nose, nasal cavity, mouth, adenoids, tonsils, etc. change unusually.

The shape of your face can turn into a foolish-looking face.

This shape of the face is called an adenoid face, or adenoidal face.

Adverse signs are of considerable value in diagnosing allergic rhinitis.

Q. How is allergic rhinitis diagnosed?

A. Although already explained, it is mainly diagnosed by synthesizing the patient’s past and present medical history, family medical history, symptoms and signs, and examination findings.

Blood tests, allergic skin tests, parenteral tests as needed. Diagnosis is performed by examining the nasal cavity with a nasal endoscope.

Symptoms of typical allergic rhinitis, conjunctival conjunctiva, and rhinoscope physical examination of the nasal cavity with pale nasal mucosa and abnormally wet signs are helpful in diagnosing the disease. In addition, there may be symptoms such as frequent blockage of the Eustachian ear canal, coughing intermittently, and a feeling of pressure in the paranasal sinus area.

Q. Is family medical history important to diagnose allergic rhinitis

A. If you have a family history of allergic diseases such as bronchial asthma, allergic dermatitis, allergic rhinitis, drug allergies, contact dermatitis, food allergies, etc., it can be very helpful in diagnosing allergic rhinitis.

And, if any of your parents’ siblings have an atopic constitution, it is very helpful in diagnosing.

Q. How do you know if allergic rhinitis can also be triggered by food antigens?

A. Allergic rhinitis is inherited as autosomal dominant disorders.

Allergic rhinitis can also be caused by food antigens.

One of the ways to find out what foods are causing allergic rhinitis is a trigger test.

You can also diagnose by avoiding eating that food.

Q. What is a provocative test

A. Allergic rhinitis caused by food antigens is diagnosed with a trigger test.

Do not eat any food suspected to cause allergic rhinitis for 2-4 weeks, and while not eating the food for 2-4 weeks, carefully observe whether the symptoms of allergic rhinitis improve, disappear, add to, or change.

If the symptoms and signs of allergic rhinitis improve significantly at this time, it may be thought that the food may have caused allergic rhinitis.

However, it is not possible to make a diagnosis this way.

If you then re-eat the food that you suspected triggered allergic rhinitis, and the symptoms of allergic rhinitis recur almost the same as before, you can think that it is very likely that the food caused allergic rhinitis.

The method of diagnosing an allergic disease by finding the food (antigen) that caused allergic rhinitis in this way is called a challenge test or Provoking tests.

Provoking tests should not be done at any time and should never be done at the discretion of the parents or patient himself

Q. How to avoid or eliminate any antigens or triggers that may cause allergies as much as possible.

A. It is an ideal treatment method.

More specifically, it is as follows.

Antigens that can cause allergic rhinitis or any other types of allergic disorder –food should be avoided as much as possible.

Give breastfeeding as much as possible or feeding hypoallergenic artificial nutrition to newborns or infants born to siblings of biological parents or siblings with an allergic disease or atopic constitution, instead of feeding artificial nutrition with cow milk, milk protein, or soy protein to prevents it from being triggered and treats allergic rhinitis that has already occurred properly.

To prevent allergic rhinitis and other allergic diseases, avoid eating other foods that may well trigger allergic diseases.

In particular, foods such as cow milk, eggs, and chocolate are well known as foods that can more induce other types of allergic diseases, including allergic rhinitis.

Avoid such food as much as possible. Sometimes food cravings that cause allergic rhinitis can occur, so caution is advised.

It is recommended that pets such as dogs, cats, and birds are not kept in the home if possible.

Inevitably, when raising a pet at home, do not let it come into contact with or inhale the animal’s fur, saliva, dander, feathers, etc., and bathe the dog frequently.

Grass or trees should not be planted in the house where children with the atopic constitution or allergic rhinitis live as much as possible.

Mold or fungus grows in humid places such as wet basements, so make sure that the humidity in the house is properly controlled to prevent mold or fungus from growing.

It is better to have a carpet that you can reap or not cover as needed because fixed carpets can get more house dust and more dust mites in your house can grow.

You have to wash the curtains often.

Cleans up house dust in the house and prevents dust mites from growing.

Children with allergic rhinitis or atopic predisposition should not put anything other than bedding in the bedroom.

Cover the bed mattress and spring box with plastic covers to prevent dust mites from growing.

In spring when flowers are in full bloom, close the windows so that pollen and mold do not enter the house.

When planting or mowing the lawn, pollen and mold can be inhaled into the airways, which can lead to allergic rhinitis, allergic conjunctivitis, or bronchial asthma.

It is difficult to absolutely avoid such antigenic contact but avoid it as much as possible.

You should wear a mask and mow the lawn as needed, wearing glasses that prevent dust from entering your eyes.

During the season when the ragweed flower is in bloom, do not go where the ragweed weed grows.

Do not wear clothes made of animal hair, bird feathers, and never use feathers pillows, or blankets with fur.

Reduce house dust mites with HEPA air filters or Acaricides.

Exterminate cockroaches.

Q. I want to know about allergic rhinitis medication

• Antihistamines.

• Anti-inflammatory therapy,

• Antigen immunotherapy

• Treatment of leukotriene-receptor antagonists.

• Treatment with corticosteroids.

• Mast cell stabilizer treatment.

• Nasal mucosa decongestant treatment that is put directly into the nasal cavity.

• Alpha adrenaline agonist treatment.

• Comprehensive treatment.

Q. Tell us about antihistamines used in allergic rhinitis medications.

A. Antihistamines are drugs used to treat allergic diseases by blocking the histamine isolation from mast cells and basophilic cells from binding to the cell feeder.

Antihistamines are divided into the 1st generation antihistamines and the 2nd generation antihistamines.

Antihistamines such as Periactin, Chlor-trimeton, Benadryl, and Pyribenzamine are the first-generation antihistamines.

Allergic rhinitis can be treated with just one type of the first-generation antihistamine.

When treated with the first-generation antihistamines, it has the effect of treating allergic rhinitis, as well as sedative effect and sleeping effect, which can lead to various side effects such as sleepiness.

So these days, allergic rhinitis is more often treated with second-generation antihistamines such as,

• Claritin,

• Astemizole,

• Cetirizine,

• Fexofenadine,

• Loratadine

• and also others are second-generation antihistamines.

When treating allergic rhinitis with the second-generation antihistamines, the therapeutic effect is good, the sedative effect is low, and side effects such as sleepiness may appear less.

Treating allergic rhinitis with antihistamines improves symptoms of runny nose, sneezing, itchy nose, and tearing.

The disadvantage of the second-generation histamine treatment is that it has a very little decongestion effect on the nasal mucosa.

For that reason, there are also methods of taking first-generation antihistamines before going to bed in the evening and second-generation antihistamines during the day.

Q. Tell me please about anti-inflammatory medications used in allergic rhinitis medications.

A. Antihistamines can treat allergic rhinitis by preventing histamine from working.

However, inflammation in the nasal cavity is not treated.

Anti-inflammatory drugs are used to treat such inflammation.

Anti-inflammatory drugs

• Budesonide,

• Fluticasone,

• Vansenase (Vancenase Aq Nasal Spray 0.084%),

• And beclomethasone.

Allergic rhinitis can be treated with nasal sprays made of corticosteroids, which are applied to the nasal mucosa.

Q. The side effects of treatment with the first-generation antihistamines are

A. No matter what type of antihistamine is treated, side effects can occur while treating allergic rhinitis with that antihistamine, and the side effects depend on the type of antihistamine.

When treating allergic rhinitis or other allergic diseases with first-generation antihistamines, there may be side effects such as sleep, sedation, poor concentration, and dry saliva.

However, when treated with second-generation antihistamines, such side effects are less common.

Q. When treated with antihistamines, is it only treated with one type of antihistamine?

A. When allergic rhinitis is treated with one of the antihistamines, it can be treated well with one type of antihistamine.

Sometimes, treatment with two types of antihistamines at the same time will be more effective.

Antihistamines, nasal decongestants, and anti-inflammatory drugs are sometimes used in combination.

Q. Can tolerance develop when treated with one type of antihistamine

A. There is.

Depending on the symptoms and severity of allergic rhinitis, one or two types of first-generation antihistamines can be selected and treated.

When treating allergic rhinitis with a first-generation antihistamine, the treatment effect appears well for the first time after the start of treatment, but after a while, if the treatment effect no longer appears, even when no further treatment with the first-generation antihistamine is required according to the doctor’s instructions.

When treating allergic rhinitis with one type of antihistamine, if the treatment works well, you can continue treatment with that drug as needed.

In addition, when treatment with one type of antihistamine, the therapeutic effect is very good for the first time, but if you continue treatment for a long time with the same antihistamine, the therapeutic effect may gradually decrease, and the treatment effect may disappear very later.

That’s why there are times when you switch to other types of antihistamines.

Q. What are some things to watch out for when choosing allergic rhinitis as an antihistamine

A. Even when treating allergic rhinitis with antihistamines, it is ideal to select and treat an appropriate antihistamine according to the doctor’s diagnosis and prescription.

Q. What are the typical second-generation antihistamines?

A. Loratadine (Claritin), Cetirizine (Zyrtec), Fexofenadine (Allegra),

and Desloratadine (Clarinex).

Previously, a doctor’s prescription was required to buy and treat these second-generation antihistamines, but second-generation antihistamines such as Loratadine (Claritin) and Cetirizine (Zyrtec) can be purchased at a pharmacy without a doctor’s prescription.

Treating allergic rhinitis with second-generation antihistamines has good therapeutic effects and does not cause sleep-related side effects that cause sleep, so it is not common to treat them with first-generation antihistamines these days.

Q. What are the side effects of second-generation antihistamine?

A. It is less sedative and has very few side effects, such as drowsiness.

There is also a comprehensive treatment for allergic rhinitis made by combining the second-generation antihistamine and Sudafed, a capillary decongestion drug in the nasal mucosa.

Q. Can Pseudoephedrine treat allergic rhinitis?

 

A. of course.

Sudafed is an alpha adrenaline agonist.

Treating allergic rhinitis with Sudafed improves the symptoms of swelling of the mucous membrane due to decongestion of the nasal mucosa and a stuffy nose.

These types of drugs are also called decongestants in the nasal mucosa.

Nasal mucosa decongestants include oral pills (tablets) and sprays that can be sprayed directly into the nasal cavity, and nasal drops that can be dropped into the nasal cavity as drops.

Some drugs contain only the ingredients of the nasal mucosa decongestant, and there is also a comprehensive nasal mucosa decongestant made by combining the ingredients of an antihistamine and a nasal mucosa decongestant.

Pseudoephedrine, which is commonly used these days, is a kind of decongestant in the nasal mucosa and its medicinal properties.

A. It can be treated with a decongestant in the nasal mucosa swollen that is put directly into the nasal cavity.

Afrin (oxymetazoline) nasal spray or Neosynephrine nasal spray alleviate congestion in the nasal mucosa.

Nasal drops (nose-drops) can be dropped into the nasal cavity or sprayed into the nasal cavity to relieve congestion of the nasal mucosa, thereby quickly clearing the nasal cavity blocked by allergic rhinitis.

Neosynephrine has nasal spray and nasal drops.

There is also a nasal spray such as Afrin.

Treatment by dropping nasal drops directly onto the nasal mucosa or treatment with a nasal spray can quickly and temporarily relieve nasal congestion.

Depending on the type of drug, the effect of decongestion of the nasal mucosa layer may last for 6 to 12 hours, and symptoms of the nose blocked by allergic rhinitis may be temporarily improved.

Continued treatment with these drugs for more than 5 days can damage the nasal mucosa.

When treating with nasal mucosa decongestants, such as nasal sprays made of Afrin or nasal sprays made of neo synephrine, you must follow your doctor’s prescription.

These drugs can be bought at pharmacies without a doctor’s prescription.

Q. What are the mast cell stabilizers used to treat allergic rhinitis?

A. Mast cell stabilizers are sprayed directly into the nasal cavity to prevent the release of histamine granules in mast cells.

Cromolyn nasal spray is a mast cell stabilizer and has a pharmacological action that prevents the release of histamine granules in mast cells.

Cromolyn nasal spray is used to prevent bronchial asthma from being triggered. Cromolyn nasal spray can prevent allergic rhinitis from occurring and treat allergic rhinitis that has already occurred.

It is easy to treat and preventive effect by spraying a cromolyn spray into the nasal cavity.

Even with continued use of cromolyn spray for weeks to months, the preventive effect continues to be good.

Side effects of cromolyn sprays are very rare.

You can buy and use it without a prescription, but the big disadvantage is that it is expensive.

Q. About corticosteroids used to treat allergic rhinitis

A. Corticosteroid nasal sprays are anti-inflammatory.

For mild allergic rhinitis, a second-generation antihistamine is selected and treated first, and when treating moderate allergic rhinitis or severe allergic rhinitis, a corticosteroid nasal spray is a preferred treatment.

Corticosteroids such as Beclomethasone, Budesonide, or Triamcinolone are sprayed directly into the nasal cavity to treat allergic rhinitis.

Beclomethasone nasal spray and Budesonide nasal spray are available in two types: a powder form spray and a liquid form spray that can be sprayed into the nasal cavity.

Some types of corticosteroid nasal sprays are treated by spraying them into both nasal passages once or twice a day as prescribed by your doctor.

Allergic rhinitis may be treated for weeks to months, depending on the course of treatment.

In general, when treating allergic rhinitis with a corticosteroid nasal spray sprayed in the nasal cavity, the therapeutic effect usually begins to appear around 12 hours after the start of treatment.

Side effects such as nasal bleeding, increased intraocular pressure, glaucoma, and delayed growth may occur, but these side effects are usually rare even after continued treatment for several weeks.

In particular, when treating allergic rhinitis with a corticosteroid nasal spray, the medication must be used according to only the doctor’s prescription.

Q. Can allergic rhinitis be treated with corticosteroid injections

A. When severe allergic rhinitis can not be treated with other types of treatment, oral corticosteroids or intramuscular depot corticosteroids can be treated for several days.

Q. Can it be treated with leukotriene receptor antagonists?

A. It can be treated with Leukotriene-receptor antagonists.

Treatment with nasal Montelukast sodium (Singulair) can definitely improve the symptoms of allergic rhinitis.

These days, treatment with leukotriene receptor antagonists tends to lead to suicide, so research is underway.

Q. Is it treated with anticholinergics?

A. It can be treated with anticholinergics.

Allergic rhinitis can be treated by spraying a nasal spray from Ipratropium bromide (Nasal Atrovent 0.03%) into the nasal cavity.

When you have a lot of clear runny nose, treatment with this type of drug is effective.

Q. Can antihistamines and nasal corticosteroids be treated at the same time?

A. You can.

Antihistamines and corticosteroids can be used simultaneously.

If severe allergic rhinitis cannot be treated well with oral antihistamines alone or corticosteroid nasal sprays alone. Allergic rhinitis can be treated with oral antihistamines and corticosteroid nasal sprays at the same time.

Q. In what cases can antigen immunotherapy be used?

A. Moderate allergic rhinitis or severe allergic rhinitis that is not well treated with proper drug treatment

Severe allergic rhinitis requiring treatment with systemic corticosteroids

Severe allergic rhinitis that does not improve even with proper treatment with an appropriate corticosteroid

Allergic rhinitis can be treated with antigen immunotherapy when sinusitis and, or both, bronchial asthma and allergic rhinitis are present.

Q. Please tell me about antigenic immunotherapy

A. Pure antigenic substances can be purified and extracted from such as cat hair, dog hair, dandruff, vegetation pollen, or house dust mites, which can cause allergic rhinitis.

The degree of skin reaction that occurs when various kinds of antigenic substances purified and extracted are brought into contact with or injected into the skin layer of children with allergic rhinitis or other allergic diseases. What kind of antigen is the allergic disease the child has? You can see if it is caused by.

Antigen immunotherapy treatment can be performed by subcutaneous injection of a very small amount of antigenic substances found in the results of skin reaction tests tested on children with allergic rhinitis.

Initially, immunotherapy is started with a minimum amount of antigenic substances, and the dose is gradually increased to the maintenance dose of antigenic immunotherapy.

After increasing the maintenance dose to the antigen immunotherapy maintenance dose, it is common to perform antigen immunotherapy by giving the maintenance dose every 2 to 6 weeks.

It is said that treatment with these antigenic immunotherapy alleviates symptoms of allergic rhinitis by ⅔. However, antigen immunotherapy is not the first choice of a method of treating allergic rhinitis.

While antigenic immunotherapy seems theoretically the ideal treatment for allergic rhinitis, it is not the first choice for a number of reasons when treating allergic rhinitis.

As previously explained, even if appropriate treatment with allergen (antigen) avoidance or elimination, allergy treatment drugs, or antigen removal and avoidance, the symptoms of allergic rhinitis are not well treated or symptoms and signs of allergic rhinitis are severe, so you can not sleep well. When it is impossible to study at school or at home, and when there is a lot of trouble with daily life, it is common to treat allergic rhinitis with antigen immunotherapy.

Allergic rhinitis in infants and young children before 3 years of age is not usually treated with antigen immunotherapy.

Studies have shown that bronchial asthma is much less common in children aged 4 to 14 years old who have been treated for allergic rhinitis with antigen immunotherapy.

When treated with antigen immunotherapy, systemic side effects can occur in 5 to 10%, and some side effects can be life-threatening.

The disadvantage is that the treatment cost is also substantial.

Antigen immunotherapy is usually administered by subcutaneous injection, but in the West, antigen immunotherapy is also performed by placing an antigen under the tongue.

Q. The results of treatment with corticosteroids and second-generation antihistamines

A. Severe allergic rhinitis is treated with a corticosteroid nasal spray sprayed into the nasal cavity and a second-generation antihistamine that has a very low non-sedative effect.

36-80% of seasonal allergic rhinitis or 55-86% of perennial allergic rhinitis are treated well.

Q. What is Coblation turbinate reduction treatment?

A. Chronic allergic rhinitis can cause congestion of the nasal mucosa and swelling and blockage of the nasal cavity.

Allergic rhinitis or other causes can cause the nasal turbinate to become irritated, inflamed, and bulky. The surgical treatment method that reduces the volume of the swelling, inflamed, and enlarged turbinate without damaging the tissues of the nasal mucosa is called Coblation turbinate relief.

When the nose is blocked (the nasal airway area is blocked) and there is no significant therapeutic effect even after all medical treatments, this surgical method can be used (Source-Pediatric News, July 2007).

Q. I heard in recent news that the age at which allergic rhinitis begins depends on the trigger.

Explain about it?

A. The age at which allergic rhinitis begins to develop depends on the triggering factor.

Suffering from allergic rhinitis is also a problem, and the cost of treatment is substantial.

And children with allergic rhinitis are more prone to having sinusitis, nasal polyps, otitis media, sleep problems, and bronchial asthma.

The age at which allergic rhinitis begins to develop depends on the triggering factor.

Suffering from allergic rhinitis is also a problem, and the cost of treatment is substantial.

And children with allergic rhinitis are more prone to sinusitis, nasal polyps, otitis media, sleep problems, and bronchial asthma.

Cow milk, eggs, flour foods, cockroaches, cats, dogs, and house dust mites are “well-known” as triggers of allergic rhinitis.

Various health problems can occur due to sleep problems, apnea, lack of concentration, study difficulties, and decreased productivity.

Allergic rhinitis can be triggered before 1 year of age, but real allergic rhinitis does not develop before 1 year of age.

Allergic rhinitis is less common before 1 year of age.

Allergic rhinitis caused by pollen usually takes about 3 years after exposure to pollen begins, so it is not common to develop pollen allergic rhinitis before 3 years of age.

Perennial rhinitis (allergic rhinitis with symptoms throughout the year) caused by house dust mites is less common before age 9 years old.

Allergic rhinitis caused by cow milk or milk-based foods is about 0.3%.

The incidence of allergic rhinitis in children with the atopic constitution will be higher.

Bronchial asthma can also develop in 50% of infants under 2 years of age with allergic rhinitis. However, it will occur at a much higher frequency than that.

Fexofenadine (Allegra), Loratadine (Claritin), Cetirizine (Zyrtec), etc. are non-sedative histamines and do not show a sedative effect during treatment with this drug.

Azelastine (Astelin) is a drug that has antihistamine and anti-inflammatory properties and is sprayed into the nasal cavity.

There are corticosteroid nasal sprays such as Beclomethasone, Budesonide (RhinocortAqua), Dexamethasone, Flunisolide, Fluticasone propionate, Mometasone furoate, and Triamcinolone acetonide. These corticosteroids have anti-inflammatory properties. These are topical allergic rhinitis treatments used to treat allergic rhinitis by spraying into the nasal cavity.

The Atrovent nasal spray is a nasal capillary decongestant

Cromolyn sodium nasal spray has anti-inflammatory properties.

Depending on your age and the severity of the main symptoms of allergic rhinitis, the treatment of allergic rhinitis by choosing one or two of the above-described drugs is very effective.

Severe allergic rhinitis is treated with a corticosteroid nasal spray that is sprayed into the nasal cavity and a second-generation antihistamine that has a very low non-sedative effect.

36-80% of seasonal allergic rhinitis and 55-86% of perennial allergic rhinitis are treated well.