Allergic rhinitis

Allergy is a response of the immune system. The immune system responds against all foreign objects in the body. This is a protective response under normal conditions. In addition, some people make different immune responses to a number of substances and it gives higher reactions when they again meet with these substances. These substances are called allergens and such type of people is called “allergic”. Allergy passes genetically and if both parents are allergic, the frequency of occurrence of allergy in children equals to 50%.

Allergens give impetus to the formation of antibodies in the body. These antibodies cause the release of some chemical substances combined with allergens. Among them, histamine is the best known. This substance causes concha swelling, itching, abundant mucus secretion and irritation.

What is the frequency of occurrence of allergic rhinitis?

It is the most common allergic disease. The frequency of occurrence is 20 %. Every year many people face with allergic rhinitis. It shows itself with mild symptoms in some people and severe symptoms in others.

The symptoms of allergic rhinitis:

Runny nose, sneezing, nasal itching, nasal congestion, impairment of smell, watery eyes and fatigue. Perception difficulty, sleep disorders disrupt the normal quality of life. This disease can be found in all ages, but, it mainly starts at the age between 1 – 20. Mostly, there are the same or similar diseases in the family.

Are there any types of allergic rhinitis?

Allergic rhinitis related to season: It is rhinitis generated against tree, grass and weed pollens. The patients complaints show themselves when these allergens are much more in the atmosphere. The duration of the disease within the year is closely associated with geographical region and climate. Generally, patients are relaxed during pollen season. Tree in the beginning of spring, meadow in the middle of spring and weed pollens from the middle of spring until autumn cause to these complaints.

Year-round allergic rhinitis: It is a type of allergic rhinitis in which contact with allergens continues throughout a year and complaints exit during the year. Causing allergens are house dust mite, cockroaches, pet allergens (cat, dog) and spores.

The most important allergen is house dust mite. When the patient is always exposed to mite allergens at the place of residence, it causes his/ her complaints continue throughout the year.

Other house allergens are pets. Especially, cat allergens are of great importance. They can remain for month at the place of spread. It is not found only at the house, but at schools, workplaces and buses in large amounts.

Allergic rhinitis related to profession: It is associated with allergens and irritating substances at workplaces. Symptoms such as sneezing, runny nose and nasal congestion occur after entering into the workplace. Patients are relaxed on weekends and holidays.

Is Allergic Rhinitis related to other allergic diseases?

Bronchial sensitivity and allergic asthma are observed in 30-40 % of the patients with allergic rhinitis and other allergic diseases are observed in less frequency.

How Allergic Rhinitis is diagnosed?

It is made with anamnesis, skin allergy test and nasal smear thinning together with the physical examination sings. Skin test is used mostly for the diagnosis, but if the patient has allergy any allergen which is not in skin test, this test wouldnt be so useful and give negative result. As well, though some allergens dont react to the skin, they cause reaction in respiratory tract. In addition, IgE is examined in blood.

Treatment of allergic rhinitis

• Avoiding contact with allergens
• Drug treatment
• Hyposensibilization (vaccine therapy)
• Surgical treatment
• Phototherapy (Rhinolight)

1) Avoiding contact with allergens

The main aim in the treatment of allergic rhinitis is to avoid allergens. However it is not so easy. Measures to avoid pollens:

• Dont be outdoors between 05.00-10.00 hours when pollens are much more. You can go out only with nose masks.
• Dont do exercise in the open air where there are pollens.
• Hair catches dust. For this reason, every evening wash your hair and take a shower.
• Children should change their clothes when they come home.
• Dont open the window in the car.
• Close doors and windows during pollen season.
• The filter of air conditioners should be often changed.
• Select the seashore for the rest.
• Use glasses and hats in the outdoor. Every day wash glasses with running water.
• Dont change your daily clothes in the bedroom.
• Consult doctor against allergy.
• Avoid damp environment in order to be protected from house dust mite, remove the things and objects (carpet) which hold dust in the bedroom and use bed, blankets, and pillows that isolate allergens.

2) Drug treatment:

It will be determined whether the allergy cause to any infection or other anatomical disorder as a result of the examination carried out by your otorhinolaryngologist and appropriate treatment will be identified. Medicines and drugs used in the treatment of allergy are as follows:

• Antihistamines
• Decongestants
• Chromaline
• Cortisone drugs

These medicines are used alone or in combination according to the doctors recommendation.

3) Vaccine therapy (immunotherapy):

When it is not possible to be protected from this allergy or drug treatment doesnt benefit, it is an immunotherapy carried out by the method of injecting allergen under the skin in ascending order starting at less dose. In this case, the body is programmed not to give an allergic reaction recognizing this substance. Vaccine is carried out once a week during 3 -5 years. Recently, it was stated that giving allergen orally (under the tongue) or from nose has good results. Children under the age of 5, those who have the problems related to the immune system, cancer and severe psychological diseases, and the patients who cannot properly continue treatment are not appropriate contingent for vaccine.

Immunotherapy should be carried out under the control of specialist. The patient should wait 30 minutes after each vaccine. It should be controlled whether there i any reaction or not. If any symptom is observed after vaccine, you should consult your doctor.

4) Surgical treatment:

Concha grows in the patients with allergic complaints. It also increases their nasal congestion. In addition, allergy emerges in polyps in the nose. It increases further the nasal congestion existing in the polyps. In such case, surgery is more useful than treatment. The main aim of this surgery is to remove nasal congestion, in addition, other symptoms of allergy could also decrease after the surgery.

5) Phototherapy (Rhinolight):

It is a new method used in the treatment of allergy. Light therapy which is used for a few minute sessions is painless and it gives effect after one or two treatments. Itching, discharge, congestion, sneezing occurred in relation to nasal allergy decrease or disappears with light therapy in the patients who have seasonal allergic complaints and which continue throughout the year.

Light therapy inside the nose is especially used in some patient groups along with being used in patients who have allergic complaints.
These are:

• Patients whose complaints cannot be controlled with nasal spray and oral allergy medications
• Patients who are exposed to side effects of standard treatment combined with other used medicines
• Patients who dont want to administer medicines for long term

There is no any feeling of warmth and pain in the nose in the treatment of Rinolight consisting of 6 – 8 sessions used within two weeks. More than 70% of light given in the treatment of Rinolight is visible lights, 25% is ultra-violet A and 5% is ultra-violet B.

The main effect in the nose with Rinolight:

• Prevent the secretion of histamine in mucosa
• Prevent the secretion of mast cells creating histamine
• Decrease in the quantity of T lymphocyte and eosinophil.

The form of use of Light treatment

Rinolight is used in the patients with seasonal allergy in 6 sessions and in patients whose allergy continues throughout the year in 8 sessions. 3 treatments within 2 weeks in seasonal allergy should be carried out and 3 treatments in the first week and then 1 treatment per week during 5 weeks should be carried out in the patients whose allergy continues throughout the year.

In which patients is a Rinolight therapy contraindication?

• Patients with serious nasal curvature
• Patients with acute viral and bacterial infections of the nose
• Patients with tumor in the nose or in the nose and throat
• Patients with serious nasal dryness and peeling
• Patients with problems in the skin related to previous light therapy

As there is no any clinical data related to its use in children, Rinolight therapy should be carried out in the patients over the age of 14.