Allergic Rhinitis, Sinusitis, and Rhinosinusitis

ALLERGIC RHINITIS, SINUSITIS, and RHINOSINUSITIS

Allergic rhinitis is a diagnosis associated with a group of symptoms affecting the nose. These symptoms occur when you breathe in something you are allergic to, such as dust, animal dander, or pollen. Symptoms can also occur when you eat a food that you are allergic to.

Causes
An allergen is something that triggers an allergy. When a person with allergic rhinitis breathes in an allergen such as pollen, mold, animal dander, or dust, the body releases chemicals that cause allergy symptoms.
Plants that cause hay fever are trees, grasses, and weeds. Their pollen is carried by the wind. (Flower pollen is carried by insects and does not cause hay fever.) Types of plants that cause hay fever vary from person to person and from area to area.

The amount of pollen in the air can affect whether hay fever symptoms develop or not.

Hot, dry, windy days are more likely to have a lot of pollen in the air.

On cool, damp, rainy days, most pollen is washed to the ground.

Hay fever and allergies often run in families. If both of your parents have hay fever or other allergies, you are likely to have hay fever and allergies, too. The chance is higher if your mother has allergies.

Symptoms
Symptoms that occur shortly after you come into contact with the substance you are allergic to may include:

Itchy nose, mouth, eyes, throat, skin, or any area

Problems with smell

Runny nose

Sneezing

Watery eyes

Symptoms that may develop later include:

Stuffy nose (nasal congestion)

Coughing

Clogged ears and decreased sense of smell

Sore throat

Dark circles under the eyes

Puffiness under the eyes

Fatigue and irritability

Headache

Treatment

LIFESTYLE AND AVOIDING ALLERGENS

The best treatment is to avoid the pollens that cause your symptoms. It may be impossible to avoid all pollen. But you can often take steps to reduce your exposure.

You may be prescribed medicine to treat allergic rhinitis. The medicine your doctor prescribes depends on your symptoms and how severe they are. Your age and whether you have other medical conditions, such as asthma, will also be considered.

For mild allergic rhinitis, a nasal wash can help remove mucus from the nose. You can buy a saline solution at a drug store or make one at home using 1 cup (240 milliliters) of warm water, half a teaspoon (3 grams) of salt, and pinch of baking soda.

Treatments for allergic rhinitis include:

ANTIHISTAMINES

Medicines called antihistamines work well for treating allergy symptoms. They may be used when symptoms do not happen often or do not last long. Be aware of the following:

Many antihistamines taken by mouth can be bought without a prescription.

Some can cause sleepiness. You should not drive or operate machines after taking this type of medicine.

Others cause little or no sleepiness.

Antihistamine nasal sprays work well for treating allergic rhinitis. Ask your doctor if you should try these medicines first.

CORTICOSTEROIDS

Nasal corticosteroid sprays are the most effective treatment for allergic rhinitis.

They work best when used nonstop, but they can also be helpful when used for shorter periods of time.

Corticosteroid sprays are generally safe for children and adults.

Many brands are available. You can buy four brands without a prescription. For all other brands, you will need a prescription from your doctor.

DECONGESTANTS

Decongestants may also be helpful for reducing symptoms such as nasal stuffiness.

Do not use nasal spray decongestants for more than 3 days.

OTHER MEDICINES

Leukotriene inhibitors are prescription medicines that block leukotrienes. These are the chemicals the body releases in response to an allergen that also trigger symptoms.

ALLERGY SHOTS

Allergy shots (immunotherapy) are sometimes recommended if you cannot avoid the pollen and your symptoms are hard to control. This includes regular shots of the pollen you are allergic to. Each dose is slightly larger than the dose before it, until you reach the dose that helps control your symptoms. Allergy shots may help your body adjust to the pollen that is causing the reaction.

SUBLINGUAL IMMUNOTHERAPY TREATMENT (SLIT)

Instead of shots, medicine put under the tongue may help for grass and ragweed allergies.

Prevention

You can sometimes prevent symptoms by avoiding the pollen you are allergic to. During pollen season, you should stay indoors where it is air-conditioned, if possible. Sleep with the windows closed, and drive with the windows rolled up.

Sinusitis

Sinusitis is present when the tissue lining the sinuses become swollen or inflamed. It occurs as the result of an infection from a virus, bacteria, or fungus.

Causes

The sinuses are air-filled spaces in the skull. They are located behind the forehead, nasal bones, cheeks, and eyes. Healthy sinuses contain no bacteria or other germs. Most of the time, mucus is able to drain out and air is able to flow through the sinuses.

When the sinus openings become blocked or too much mucus builds up, bacteria and other germs can grow more easily.

Sinusitis can occur from one of these conditions:

Small hairs (cilia) in the sinuses fail to properly move mucus out. This may be due to some medical conditions.

Colds and allergies may cause too much mucus to be made or block the opening of the sinuses.

A deviated nasal septum, nasal bone spur, or nasal polyps may block the opening of the sinuses.

There are two types of sinusitis:

Acute sinusitis is when symptoms are present for 4 weeks or less. It is caused by bacteria growing in the sinuses.

Chronic sinusitis is when the swelling of the sinuses is present for longer than 3 months. It may be caused by bacteria or a fungus.

The following may increase the risk that an adult or child will develop sinusitis:

Allergic rhinitis or hay fever

Cystic fibrosis

Going to day care

Diseases that prevent the cilia from working properly

Changes in altitude (flying or scuba diving)

Large adenoids

Smoking

Weakened immune system from HIV or chemotherapy

Abnormal sinus structures

Symptoms

The symptoms of acute sinusitis in adults very often follow a cold that does not get better or that gets worse after 5 to 7 days. Symptoms include:

Bad breath or loss of smell

Cough, often worse at night

Fatigue and general feeling of being ill

Fever

Headache

Pressure-like pain, pain behind the eyes, toothache, or tenderness of the face

Nasal stuffiness and discharge

Sore throat and postnasal drip

Symptoms of chronic sinusitis are the same as those of acute sinusitis. However, the symptoms tend to be milder and last longer than 12 weeks.

Symptoms of sinusitis in children include:

Cold or respiratory illness that has been getting better and then begins to get worse

High fever, along with a darkened nasal discharge, that lasts for at least 3 days

Nasal discharge, with or without a cough, that has been present for more than 10 days and is not improving

Treatment

SELF-CARE

Try the following steps to reduce stuffiness in your sinuses:

Apply a warm, moist washcloth to your face several times a day.

Drink plenty of fluids to thin the mucus.

Inhale steam 2 to 4 times per day (for example, while sitting in the bathroom with the shower running).

Spray with nasal saline several times per day.

Use a humidifier.

Use a Neti pot or saline squeeze bottle to flush the sinuses.

Be careful with use of over-the-counter spray nasal decongestants such as oxymetazoline (Afrin) or neosynephrine. They may help at first, but using them for more than 3 to 5 days can make nasal stuffiness worse.

To help ease sinus pain or pressure:

Avoid flying when you are congested.

Avoid temperature extremes, sudden changes in temperature, and bending forward with your head down.

Try acetaminophen or ibuprofen.

MEDICINE AND OTHER TREATMENTS

Most of the time, antibiotics are not needed for acute sinusitis. Most of these infections go away on their own. Even when antibiotics do help, they may only slightly reduce the time it takes for the infection to go away. Antibiotics are more likely to be prescribed sooner for:

Children with nasal discharge, possibly with a cough, that is not getting better after 2 to 3 weeks

Fever higher than 102.2°F (39°C)

Headache or pain in the face

Severe swelling around the eyes

Acute sinusitis should be treated for 10 to 14 days. Chronic sinusitis should be treated for 3 to 4 weeks. Some people with chronic sinusitis may need special medicines to treat fungal infections.

At some point, your provider will consider:

Other prescription medicines

More testing

Referral to an ear, nose, and throat or allergy specialist

Other treatments for sinusitis include:

Allergy shots (immunotherapy) to help prevent the disease from returning

Avoiding allergy triggers

Nasal corticosteroid sprays and antihistamines to decrease swelling, especially if there are nasal polyps or allergies

Surgery to enlarge the sinus opening and drain the sinuses may also be needed. You may consider this procedure if:

Your symptoms do not go away after 3 months of treatment.

You have more than 2 or 3 episodes of acute sinusitis each year.

Most fungal sinus infections need surgery. Surgery to repair a deviated septum or nasal polyps may prevent the condition from returning.

Prevention

The best way to prevent sinusitis is to avoid colds and flu or treat problems quickly.

Eat plenty of fruits and vegetables, which are rich in antioxidants and other chemicals that could boost your immune system and help your body resist infection.

Get an influenza vaccine each year.

Reduce stress.

Wash your hands often, particularly after shaking hands with others.

Other tips for preventing sinusitis:

Avoid smoke and pollutants.

Drink plenty of fluids to increase moisture in your body.

Take decongestants during an upper respiratory infection.

Treat allergies quickly and appropriately.

Use a humidifier to increase moisture in your nose and sinuses.

Alternative Names

Acute sinusitis; Sinus infection; Sinusitis - acute; Sinusitis - chronic; Rhinosinusitis

Reference: https://medlineplus.gov/ency/article/000813.htm

https://medlineplus.gov/ency/article/000647.htm
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Atlantic Ear Nose and Throat

Allergic Rhinitis, Sinusitis, and Rhinosinusitis

Treatment

SELF-CARE

Try the following steps to reduce stuffiness in your sinuses:

Alternative Names

Acute sinusitis; Sinus infection; Sinusitis - acute; Sinusitis - chronic; Rhinosinusitis

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Atlantic Ear Nose and Throat

Allergic Rhinitis, Sinusitis, and Rhinosinusitis

Treatment SELF-CARE Try the following steps to reduce stuffiness in your sinuses:

Alternative Names Acute sinusitis; Sinus infection; Sinusitis - acute; Sinusitis - chronic; Rhinosinusitis

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Contact us

Treatment

SELF-CARE

Try the following steps to reduce stuffiness in your sinuses:

Alternative Names

Acute sinusitis; Sinus infection; Sinusitis - acute; Sinusitis - chronic; Rhinosinusitis