Could your seasonal allergy flare ups be allergic rhinitis?

Allergy flare ups can be a true nuisance and cause you to miss out on your favorite activities. But what if the runny nose and sore throat you have lasts year round?

Jordan Garner, nurse practitioner with the Department of Otolaryngology at Baylor College of Medicine, explains how to spot signs of allergic rhinitis, screening procedures and treatment options to help alleviate your symptoms.

What causes allergy symptoms?

From outdoor pollen to dust mites and pet dander, allergic rhinitis has a wide range of potential causes. Garner says your history of symptoms plays a role in whether your allergies are temporary or if there is a larger issue.

“Are symptoms intermittent, year-round or do they come during certain seasons? The history gives us the biggest clue to what is causing the problems.”

The most common symptoms of allergic rhinitis are:

• Nasal congestion
• Runny nose
• Repeated sneezing
• Itchy and watery eyes
• Sinus pressure
• Headaches
• Cough
• Sore throat
• Snoring

Garner notes that if your symptoms improve when you travel, there may be allergens specific to your area causing flare ups. Indoor and outdoor allergens such as pet dander, mold, dust and grasses can all contribute to allergic rhinitis.

“A lot of times, people who have bad allergies to dust mites or mold actually feel a lot better when they get outside. This is a huge indicator that we may need to treat something inside the house.”

Types of allergic rhinitis include:

• Intermittent vs. persistent (seasonal and non-seasonal)
• Vasomotor (non-allergenic)
• Infectious rhinitis (sinusitis)
• Occupational/chemical allergic rhinitis
• Rhinitis medicamentosa (triggered by overuse of intranasal decongestants)

Testing and treatment options

Allergic rhinitis is diagnosed after a physical exam, evaluating history of symptoms and a combination of skin or blood tests.

“A skin test that reveals an allergic reaction doesn’t always mean that you are allergic to whatever the substance was. We need to get an understanding of the patient’s history and test in combination to tell us if the substance is a true allergen.”

If allergens are identified to be the cause of rhinitis, avoidance techniques such as using air purifiers in the home or washing sheets in hot water could help alleviate symptoms. Garner says oral decongestants can also be helpful, but to be cautious if you have heart disease.

“If you have high blood pressure or cardiovascular disease, you should stay away from pseudoephedrine (Sudafed, Allegra). We also recommend not using it in patients under six.”

Guaifenesin-based decongestants work by increasing the amount of drainage but making it thinner and less viscous. Garner says this is helpful in some patients but has little evidence of relieving allergic rhinitis.

“Patients will ask, ‘I’m taking Zyrtec but should I really be taking Allegra?’ There’s really no evidence out there that one is better than the other. It’s more subjective depending on each person.”

Immunotherapy

If decongestants, nasal sprays and avoidance techniques fail, Garner says immunotherapy is a long-term option to treat allergic rhinitis.

“Treatment consists of weekly injections for usually two to three years. Most patients start seeing an improvement of symptoms between six months and one year,” he said. “At two years, the patient is assessed for progress. Depending on the level of improvement, we determine if continued treatment or re-testing is needed.”

To request a visit with the Sinus Center at Baylor, call 713-798-5900 or schedule an appointment online.

-By Nicole Blanton