Managing allergic rhinitis

Managing allergic rhinitis

This module will help you to understand the allergic response, the presenting features of allergic rhinitis, the management options and any possible complications. It will also equip you to help patients manage their allergic rhinitis using prescribed and OTC treatments and to deal with people seeking advice about the condition.

Contributing author: Dr Christine Clark PhD, FRPharmS, specialist clinical writer

Introduction and module overview

Allergic rhinitis (AR) is defined as a symptomatic disorder of the nose induced after allergen exposure by IgE-mediated (type I hypersensitivity) inflammation.¹ The characteristic symptoms are sneezing, rhinorrhoea, nasal itching and obstruction – but the severity of symptoms can vary considerably.

Allergic rhinitis is a risk factor for the development of asthma, can impair asthma control and increase the costs of treatment.z² Eighty per cent of asthmatics also have rhinitis.

There has been a steady increase in prevalence in the UK and Western Europe over the past 50 years. In the UK the prevalence of AR in adults is 26 per cent. Depending on the allergen(s) responsible, it can be intermittent (e.g. hayfever) or persistent (e.g. caused by allergy to house dust mites, animal dander or occupational allergens such as latex particles). The condition can be associated with allergic conjunctivitis, asthma and eczema. It can also be associated with the development of nasal polyps that further obstruct nasal passages.

Allergic rhinitis is more common in individuals with a personal or family history of atopic disease and is one component of the ‘atopic march’ – the phenomenon of disordered immune responses that starts with skin barrier defects in infancy leading to the progressive development of atopic eczema, food allergy, asthma and allergic rhinitis.³ Atopy is typically associated with heightened immune responses to common allergens, especially inhaled allergens and food allergens.