Allergic Rhinitis is allergic inflammation of the nasal and sinus passages. Symptoms can include nasal congestion, runny nose, sneezing and itchy nose. This can also cause postnasal drainage that can trigger cough. Irritability and fatigue can also be related. Symptoms can be seasonal from pollens or perennial (throughout the year) due to a combination of pollen allergens and indoor allergens such as dust mites, molds, cat and dog; to name the most common.
Allergic Conjunctivitis is allergic inflammation of the conjunctiva which is the lining covering our eyes. Symptoms can include itching, tearing/watering, redness and burning. Up to 60% of people with allergic rhinitis also have allergic conjunctivitis. This is also triggered by the same environmental allergens as listed for allergic rhinitis.
Sinusitis means inflammation of the sinus passages but typically is used to describe a bacterial infection of the sinuses. Inflammation in the sinus passages due to allergies can then progress to a secondary bacterial sinus infection, thus people with allergies have more sinus infections than people without allergies. It is not unusual for people with allergies to have seasonally sinus infections. Treating allergic rhinitis effectively reduces sinus infections. Other factors that are evaluated if people continue to have sinus infections despite optimizing treatment for allergies include anatomic abnormalities of the sinuses (e.g. poor outflow drainage of the sinuses) or an immune deficiency (weak immune system). A sinus CT can determine if any anatomic abnormalities are a factor and if an ENT consultation is needed for surgical intervention. Our specialty also includes Immunology so we can evaluate the immune system with blood testing to see if an immune deficiency is a contributing factor.
Evaluation and Management
Allergy testing is necessary to identify if environmental allergies are playing a role and the extent of allergies to allow us to best guide treatment options. Modifying our indoor environment to minimize exposure to allergens is important in many cases. Also strategies to reduce outdoor pollen exposure and preventing these from coming indoors are discussed. Once avoidance measures are optimized then the options include improving symptoms with appropriate medications and/or allergy immunotherapy (ie allergy injections, drops) which builds up tolerance to allergens to prevent symptoms.
Learn more about Immunotherapy here.