Allergic rhinitis, also known as Hay Fever is an allergic response to certain particles and  is a common health condition among adults and children. This condition can trigger an allergic response in the nasal mucosa leading to cold and cough. It is estimated that around 15-30% of the Indian population suffers from allergic rhinitis. As high as 70% of people with asthma may have allergic rhinitis as a co-existing health condition. The population of children having this condition is estimated to be approximately 40% especially in urban areas like Bangalore.

Allergic rhinitis is mostly seasonal and it can trigger due to the pollen particles among children and also due to freshly cut grass or flowers. Few might also get allergic rhinitis throughout the year due to dust mites, concrete dust particles, cockroach residue, animal dander or environmental pollutants. Along with this, a lot of other substances can also trigger allergy like reaction – strong perfumes, tobacco smoke, strong cooking aroma etc can also act as irritants.

Symptoms of allergic rhinitis among kids

Allergic rhinitis is triggered by the entry of the allergy-causing substance into the nostrils of a child who is prone to it. The symptoms are –

1. Stuffy nose with a feeling of constant blockage.
2. Water discharge from the nose (clear).
3. Throat irritation because of the nasal secretions dripping to the back of the throat.
4. Itching of the nose, eyes and ears.
5. Sneezing which happens in bouts of many.
6. Puffy eyes
7. Irritated congested red eyes
8. Cough which is usually dry.
9. Nose bleeds due to excessive rubbing of the nose.

These symptoms may then lead to other issues which include

1. Tiredness and fatigue due to poor sleep because of the nose blockage.
2. Irritable and lack of concentration due to constant itching in the nose.
3. Nose bleeds especially at night due to vigorous rubbing of the nose.
4. Low threshold of developing ear infections.
5. Headaches or heaviness of the head.
6. Excessive itching of the eyes can cause dark circles under the eyes.
7. A crease may develop at the top of the nose due to constant rubbing.

Is allergic rhinitis genetic?

‘Atopy’ or the tendency to develop allergies is commonly seen in a family across generations. However, there is no genetic basis to this argument that it is hereditary. For example if a child is diagnosed with allergic rhinitis then either of the parent may possible have the same condition or one of the other atopic conditions such as asthma, eczema or none at all.

Treating allergic rhinitis effectively

Allergic rhinitis can be treated better if it is diagnosed early. You can also take the support of your paediatrician to identify the symptoms.

Avoiding allergen:

• Avoid outdoor allergens. Keep windows shut especially in the flowering season and avoid dusty places
• Avoid walking on freshly cut grass
• Wet dusting of household surfaces and vacuum cleaning the house helps maintain dust free environment.
• Changing the sheets more frequently will reduce exposure to dust mites.
• Wash hands after playing with a pet.
• Pest control to contain cockroaches.
• Mold prevention especially in bathrooms.

Medications:

There are many medications available for the control of the symptoms of allergic rhinitis. Your Paediatrician will prescribe them in addition to the precautionary measures based on the child’s symptoms. When symptoms are particularly troublesome an allergy specialist will perform tests to try and pinpoint what exactly the child is allergic to. In certain types allergic immunotherapy can be instituted by them. Allergic rhinitis generally gets brushed off as dust allergy among children. It is important to identify the symptoms early and start the treatment.

Dr. Suruchi
Consultant – Paediatrics 
Columbia Asia Hospital
Whitefield, Bengaluru

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Allergy is a common ENT condition often seen in our city, nearly 15 – 25% of the urban population suffers from this disease so understanding this condition is of paramount importance. Allergy is quite secular when it comes to effecting people as it effects people of any race , gender and religion. Keep in mind that allergy is by far the commonest non-infectious disease especially effecting the early age group.

What is Allergy ?

Allergy is a body response to a outside particle which we call allergens. These substances called allergens are found almost everywhere you go. They are present in our office , cinema hall , shopping malls , and even in our house. These allergens are so small that we need a microscope just to find them. The most common allergens which are found in our day to day life are house dust mites, pollens, animal dander, etc.

So How Does Allergy present ?

Allergies usually present with ample number of symptoms. Initially on exposure to an allergen the individual might have itching in the nose and eyes followed by sneezing and watering of the eyes. Later there will be watery running nose discharge and redness of the eyes which can be accompanied with head ache and throat irritation.

How do we differentiate allergy from COVID 19 during this pandemic ?

Allergy is a bodily reaction to a substance which you are allergic to but where as COVID 19 is a viral infection caused by a type of Corona virus strain. As like all infections patients with COVID 19 will have fever , head ache , throat pain/irritation initially. The major difference between COVID 19 and allergy is the presence of fever, in allergy fever is never seen unless it is a very sever allergic reaction. Allergy is characterized with sneezing , running nose and itching of the eyes.

How do we test for allergies?

Testing Allergy is primarily by detailed history and examination of the individual by an ENT surgeon or a   specialist who is trained in the field of allergy. Giving a apt and precise history to your doctor is of at most importance. After the initial examination of the nasal cavity and throat next step is testing the individual for specific allergies by skin prick test and blood IgE level.

Skin prick test at present is the most effective tool for diagnosis of allergy all over the world. If history and clinical examination lay the foundation of allergy diagnosis , skin prick test provide a compliment of evidence for a specific diagnosis. Despite several new tests introduced , skin prick test is still the most used and effective tool around the world. The reason for the worldwide popularity is due to the fact that skin prick test are reliable, safe, specific, and it can assess sensitivity for wide range of allergens.

What are the various treatment available ?

In this modern era, there are various treatment modalities,  but it is very important to know that the patients role in the very important. Meaning that the patient should change their life style for example avoid exposure to allergens by wearing masks when you go outside, using hypo-allergic soaps and detergents to cleaning your clothes etc. Always consult your doctor when the symptoms first appear.

Initially when you consult your allergy specialist, the patient will be given topical nasal steroids and oral anti histamine to control the present allergic symptoms , in some sever cases oral steroids are recommended. once the allergic symptoms are under control , then its mainly avoidance of exposure of allergens and immunotherapy. For best results Topical steroids and Sublingual immunotherapy is advised.

What can happen if you don’t get treatment for allergic rhinitis?

Allergy cuts across the entire human body and can effect any part of your body , not only your nose and eyes. Generally allergy effects skin, eyes, nose, digestive tract & lungs. When allergy effects skin it manifest by urticaria, angioedema and atopic dermatitis. When it attacks the respiratory system it causes rhinitis, sinusitis, laryngitis, asthma etc. To compare allergy to any other disease , there appears no parallel at all. Allergy can be as simple as mild discomfort to life threatening condition.

Conclusion:

Allergic rhinitis is a common but very complex disease which is more prevalent in the urban society. A proper lifestyle modification and early consultation of allergy specialist is most important for effective treatment of this condition. The main difference between allergic rhinitis and COVID19 is the presence of fever.

And always remember, self diagnosis of any disease using internet or other methods are dangerous to you. Always consult your doctors or a near by qualified specialist for  diagnosis and treatment. A detailed clear history to your doctor will always help them to treatment faster. Skin prick test is the most effective way to test for the specific allergy. Early treatment and regular follow up can easily give relief to the patients.

“ Skin prick test is considered a gold standard for diagnosis of allergy all over the world. “

Dr Ashish Rao
Specialist in Allergy & Immunology
ANAND ENT & ALLERGY CENTRE
# 109, 1st FLOOR, 1ST MAIN ROAD
KATRIGUPPE, BSK3RD STAGE
BENGALURU 560085.
Ph – 8951711776, 08026692650

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Ahmedabad: Cadila Pharma has recently announced the launch of Bilastine syrup (30 ml) and Bilastine tablets in the strength of 20mg., which is an anti histamine drug  used in the treatment of allergic rhinitis.Bilastine is an anti histamine which addresses the current gap in the treatment of Allergic Rhinitis and meets the expectations of doctors to treat their allergic rhinitis patients. The Bilastine has advantage over other molecules available in the category, as faster onset of action, non-drowsy, cardiac safe.

Cadila Pharmaceutical’s product under the brand name Bilacad, also ensures better safety and efficacy. India has seen a growth in the number of cases of allergic rhinitis induced due to tobacco smoke, exposure to air pollutants, vehicular pollution, and other air pollution. Moreover as per a recent study published in Lung India 65% of the Indian allergic rhinitis patients also suffer from Asthma. Improved control of nasal allergies can help gain better control on Asthma.

Cadila Pharmaceuticals Ltd. is one of the largest privately-held pharmaceutical company of India. It has recently concluded USFDA inspection successfully in February 2020. Over the past six decades, Cadila Pharmaceuticals is engaged into development and manufacturing of affordable medicines and make them available for patients across the world. Its innovation-led drug discovery processes ensure the health and well-being of people around the world.

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