Patient A
Doctor, I have often caught colds in recent months, and I have caught colds 4 times this month alone. Nasal congestion, nasal itching, runny nose, sneezing…
Patient B
The old rhinitis happened again in the past two days. The doctor said it was allergic rhinitis, that is, allergic rhinitis. It can’t be cured, so I didn’t bother to go to the hospital. Just last time, I prepared a bunch of medicines, and I ate and sprayed them, but I didn’t see any roots.
Doctors:……
Such words often appear in the mouth of rhinitis patients. So today we will talk about “allergic rhinitis”.
Allergic rhinitis, increasingly
“Allergic rhinitis” , commonly called “allergic rhinitis” , is a type of rhinitis. “Allergy” in allergic rhinitis refers to “allergic reaction”, which is a medical term. Because the word “abnormal” is easy to be misunderstood, doctors often use “allergic reaction” when communicating with patients.
The incidence of allergic rhinitis is increasing year by year｜pexels
In recent years, the incidence of allergic rhinitis has increased significantly , which is inseparable from global environmental pollution, especially air pollution . Data from European countries have shown that the incidence of suspected allergic rhinitis in children can be as high as 25%, the incidence of suspected allergic rhinitis in adults can be as high as 40%, and the incidence of suspected allergic rhinitis is 28.5%. It is conservatively estimated that there are more than 500 million patients with allergic rhinitis worldwide.
Allergic rhinitis is a growing concern due to the continued increase in prevalence and significant effects on other parts of the body, especially the lower respiratory tract.
The “cold” you thought might be rhinitis
Common symptoms of allergic rhinitis include nasal congestion, nasal itching, sneezing and runny nose; some patients also feel itchy eyes, easy to shed tears, etc.; some patients even have symptoms such as cough and itchy palate.
The patient A mentioned above had symptoms of nasal congestion, nasal itching, sneezing, and runny nose, so he thought he had a “cold”. Indeed, light nose symptoms can easily be mistaken for what the folks call “cold and cold”. However, from the patient’s history of frequent attacks, accompanying symptoms, and doctor’s examination, the diagnosis of “rhinitis” will most likely be obtained.
Allergic rhinitis must be distinguished from a cold | Photo courtesy of the author
At the same time, allergic rhinitis is closely related to asthma , and the academic circles use “same airway, same disease” to summarize, and believe that allergic rhinitis and allergic asthma can be said to be the same disease. Data show that nearly 40% of patients with allergic rhinitis may have a history of asthma attacks, and nearly 85% of patients with asthma may have nasal symptoms of allergic rhinitis.
find allergens
To diagnose allergic rhinitis, the most important thing is to identify the allergen that caused the allergic reaction, that is, the allergen . If the onset of rhinitis has obvious seasonality, the allergens are mostly pollen, fungi and other substances that are closely related to the season. If the onset of rhinitis is perennial, the allergens are mostly dust mites, cockroaches, animal hair dander, etc.
Allergic rhinitis has specific allergens | Photo courtesy of the author
Of course, more reliable detection methods will be adopted clinically. The most commonly used allergen detection methods are skin prick test and serum IgE test . The former is similar to the penicillin skin test we are familiar with, and its sensitivity and specificity are as high as 80%.
However, the skin prick test can be affected by drugs. For example, if the patient has recently taken anti-allergic drugs, the skin prick may show false negatives. Although the sensitivity of serum IgE test is not as high as that of skin prick test, it is applicable to any age and is not limited by skin conditions. The results are judged more objectively, and there is basically no risk of triggering allergic reactions in the test subjects.
How to improve allergic rhinitis?
The treatment of allergic rhinitis should first avoid the allergen (allergen), that is, try to avoid contact with the substance . For example, avoid the pollen period in outdoor activities, or use special masks, glasses, nasal filters, pollen blockers, etc.
Source: pexels
The second is to use various drugs under the guidance of a doctor , including nasal hormone sprays, antihistamine sprays, decongestants, etc., as well as oral hormones, antihistamines, and leukotriene receptor antagonists. wait.
Special emphasis is placed here on the use of nasal steroids and decongestants.
Nasal corticosteroids are actually relatively safe, and systemic side effects are rare after long-term topical use. However, when patients hear the corticosteroids, their color changes, so that they cannot use nasal corticosteroids correctly and continuously, which affects the curative effect.
The use of nasal decongestants is just the opposite. Because of its strong nasal mucosal contraction effect, it can quickly and powerfully relieve nasal congestion symptoms, and patients are prone to overuse, leading to drug-induced rhinitis. Therefore, patients with rhinitis must follow the doctor’s advice, and do not adjust the frequency of drug use based on personal feelings in a short period of time.
Patients suffering from allergic rhinitis need medical advice｜pexels
In addition to conventional drug treatment programs, there are some new and better ways. Among them, allergen-specific immunotherapy has been recommended as the first-line clinical treatment. To put it simply, it is to extract the previously identified allergen substances, make a vaccine-like substance, put a very small amount into the body and gradually increase the dose, and induce the body to develop tolerance to the substance. When officially exposed to the allergen substance again, the patient’s symptoms will be significantly reduced, and even the previous symptoms of nasal congestion and runny nose will not be produced. However, the time of immunotherapy is relatively long, and the onset of effect is slow, and the total course of treatment takes 3 years.
If none of the above measures can help the patient, or the patient cannot adhere to long-term drug treatment, surgical treatment can be considered. Surgical treatment is only used as an adjuvant treatment for allergic rhinitis , such as turbinoplasty to improve nasal ventilation, or neurotomy to reduce nasal mucosal sensitivity. If you have the willingness for surgical treatment, you must fully communicate with the doctor and do a full preoperative evaluation.
Surgical treatment requires full communication with doctors｜pexels
The last thing to say is that with the current medical level, it is true that allergic rhinitis cannot be cured , and the purpose of treatment is to control symptoms. However , the deeper the patient’s understanding of the disease, the better the treatment compliance and self-confidence will be, and the relatively satisfactory treatment effect will be obtained. As shown in the words of patient B, if the disease is not well understood and stays at the level of not being able to cure it, it will often reduce the quality of life and affect the physical and mental health.
So, never ignore it.
Author: Feng Shaowei
Editors: Li Xiaoqiu, Mai Mai
an AI
“Can’t cure” sounds terrible, but you still have to struggle to get up to work/school/exam/pay rent…
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