Every year when flowers bloom, it's a perfect time to stroll in the park and enjoy the blossoms. Wanting to embrace nature, but as soon as you enter the park, your nose starts itching, your eyes start itching, and you keep sneezing incessantly.

This is the mischief of allergic rhinitis. The prevalence of allergic rhinitis (AR) inworldwide is reported to be as high as 11%, while inChina, the reported prevalenceranges from 4% to 38% of the population, meaning on average one out of four people suffers from rhinitis. Click here to purchase Allergy Screening Package

1.What are the symptoms of AR?

The typical symptoms of AR include nasal congestion, nasal itching, watery nasal discharge, and consecutive sneezing, with consecutive sneezing being a characteristic symptom of AR. Some individuals with severe allergies may also experience symptoms of allergic conjunctivitis, such as redness, itching, and excessive tearing of the eyes, as well as symptoms of skin allergies, such as itching of the ears, itching of the skin, and the development of large patches ofwheals. In some cases, AR can even trigger symptoms of asthma, such as difficulty breathing.

2.Can AR be cured?

If you experience typical symptoms of AR, such as nasal itching, consecutive sneezing, and watery nasal discharge, and if these symptomslastfor more than half of the year on average, or if they severely affect your work and daily life, it is recommended totake anallergy testing to identify the allergens.

Based on the allergens, there are three scenarios:

①Allergy caused by dust mites:

This condition can be cured. Immunotherapy (also known as "desensitization therapy") is the only method to cure rhinitis caused by dust mites. Clinical methods include subcutaneous immunotherapy and sublingual immunotherapy, but the treatment duration is long, and the cost isrelativelyhigher. Currently, immunotherapy for allergy to pollen from the Artemisia genus is also available, but Artemisia pollen allergy is common in northern China, such as Inner Mongolia, and is less common in southern regions.

②Other identified allergens:

Other allergens cannot be cured temporarily, but the significance of allergentesting lies in knowing what you are allergic to and then avoiding contact or consumption as much as possible in daily life, which can greatly improve symptoms of rhinitis and other allergies.

③Unidentified allergens:

Thisconditioncannot be cured, and there are no targets to avoid contact with. However, it can still be controlled. Just like some people who have a rather irritable temperament, it's impossible for them to change their personalities. Even though they can control themselves through self-regulation, they might still explode when faced with something stressful. It's the same with rhinitis. Because the patient's allergic constitution cannot be changed, symptoms may recur after exposure to allergens.

3.Why can't allergens be identified?

Many patients find that all results of allergy testing are negative and assume that they don't have AR. However, there are countless allergens in daily life, and only a very limited number can be detected using current medical testing methods. Therefore, a negative result in allergy testing does not rule out the existence of allergic diseases. When AR significantly affects the quality of life, such as disturbing nighttime sleep or work performance, many patients will actively seek medical treatment. When symptoms are not severe, many patients may think that since it cannot be cured anyway, andalsothey are worried about adverse reactions from long-term medication, they might just give up treatment. Thisideaisnotcorrect.

4. What are the dangers of not treating AR?

1. Firstly, AR can lead to asthma, with 40% of AR patients developing asthma, which is a very high proportion.

2. AR can lead to allergic conjunctivitis, causing symptoms such as eye itching, tearing, and redness, meaning inflammation can spread to other areas.

3. Long-term untreated AR can gradually develop into chronic sinusitis, nasal polyps, secretory otitis media, otitis media with effusion, and other diseases. Chronic diseases are difficult to treat, and some may even require surgical treatment.

4. When the nasal secretions of AR flow back into the throat, it can lead to a type of disease characterized mainly by coughing, known as "upper airway cough syndrome." This is a common cause of chronic cough in both children and adults in clinical practice. Often, coughing caused by rhinitis is mistaken for chronic pharyngitis. (In clinical practice, many children with AR repeatedly cough, and parents may take them to a respiratory department for consultation, but no problems are found in the lungs. In fact, it's allergic cough caused by nasal secretions reflux irritating the throat.)

5. AR is a common cause of adenoid hypertrophy in children, leading to childhood OSAHS (obstructive sleep apnea-hypopnea syndrome), also known as snoring. Over time, this can affect the child's sleep, facial appearance, and even growth and development. (Further information on pediatric snoring will be provided in the future, so stay tuned.)

6. For adults, prolonged episodes of AR are bound to affect breathing and nighttime sleep efficiency, leading to poor daytime energy and decreased work efficiency, indirectly affecting daily life.

5. How to treat AR when the allergen cannot be identified?

1. Physiological saline nasal irrigation(there are many nasal irrigation brands on the market, but when choosing, be sure to use physiological (also called isotonic) saline solution. It is not recommended to use hypertonic saline solution for nasal irrigation for an extended period).

2. Intranasal corticosteroids(such as Rhinocort nasal spray, Nasonex nasal spray, etc.).

3.Intranasal antihistamines(such as Azelastine hydrochloride nasal spray, etc.).

4.Oral mucolytics(such as Eucalyptol, Limonene And Pineneenteric capsules,Sinupretdrops, etc.).

5.For severe symptoms, oral antihistamines(such as Loratadine tablets, Ebastine tablets, Levocetirizine hydrochloride tablets, etc.)can be added.

Furthermore, it's important to strengthen the body through exercise and maintain regular routines. Good lifestyle habits are also crucial. If the body's immunity is strong, the frequency of AR episodes can be reduced.

Article contributed byDr. Elena Li,Associate Chief Physician of ENT-Otolaryngology.

For more information or to make an appointment, please call400 819 6622orclick picture for online appointmentwithDr. Elena Li.

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