Allergic Rhinitis (Hay Fever)
What Does Allergy Mean?
Allergy is a reaction to the body itself against a substance that enters or comes into contact with the body. It is a reaction that causes harm. If these reactions are at normal levels, it is to protect the body. However, in allergic people, the reactions are so high that they can be harmful. The nose is one of the organs most affected by such allergic reactions. Allergy has a genetic predisposition and can start at any age. Substances called histamine are secreted 2-3 minutes after the allergen enters the body. It reaches its maximum level within 15 minutes. Allergy can occur at any time or can only be seen in certain seasons.
What Does Rhinitis Mean?
All kinds of inflammation of the mucosa lining the inside of the nose is called rhinitis. If this inflammation is caused by allergic factors, it is called allergic rhinitis.
What Causes Allergies?
There are many known or unknown factors that can cause allergies. The most common ones include dust, pollen, mold fungi, some foods (milk, eggs, strawberries, etc.), chemicals, and pets.
What Symptoms Does It Cause?< br /> The most common ENT-related symptoms of allergy include runny nose, sneezing, nasal congestion, itching, postnasal drip, scratchy throat, chronic cough, and pressure problems in the middle ear. Sinusitis, nasal flesh growth (turbinate hypertrophy or polyp), asthma and skin reactions are more common in allergic people than in non-allergic people.
What is Seen in the Examination?
Allergic Nasal discharge can be directly observed during the examination of patients with rhinitis. In addition, pale color, increased transparent secretion, edema (swelling), and flesh growth, if any, are observed in the nose. The image of the inside of the nose is sometimes diagnostic even without listening to the patient's complaints. When viewed from inside the mouth, postnasal drip and pharyngitis may be seen.
What kind of tests are performed?
When allergy is suspected after the examination, the most frequently performed tests are skin tests. However, negative results of these tests do not indicate that the patient does not have allergies. There is a possibility of a reaction to an allergen that has not been studied in skin tests, or whether an allergen does not cause allergy when it enters the skin. There is a possibility that they may cause allergies when inhaled. With skin tests, it can be learned to what extent the allergy is to which substance. Apart from these tests, the amount of a substance called IgE in the blood can be measured. There are also some blood tests that are more reliable than skin tests, but difficult and expensive to perform.
How to Diagnose?
The most important issue in diagnosing Allergic Rhinitis is what the patient tells (anamnesis). and examination findings. If an allergy diagnosis is considered based on these findings, that patient is considered allergic. Skin tests and other blood tests are used to determine what the allergen is. If these tests are negative, allergy treatment is started for the patient.
How to Treat?
There are 3 main categories in the treatment of Allergic Rhinitis.
1-Allergen. prevention
2-Medication Treatment
3-Immunotherapy (Vaccine Treatment)
Allergen Protection
It is the basic treatment method of allergic rhinitis. However, this is usually not possible. Factors such as not being able to determine the allergen exactly, being allergic to more than one substance, and not being able to avoid the allergen even if the allergen is determined, make the treatment difficult. However, there are still some precautions the patient can take.
– Avoiding being in dusty and smoky environments, wearing a mask if necessary
– Adjusting temperature and humidity
– Being indoors as much as possible during seasons when pollen is high. and keeping doors and windows closed
– Leather, vinlex and plastic items should be used instead of carpets, rugs and blankets whenever possible in the house
– Plants and pets should not be kept in the house
– Specially prepared bedding and sheets should be used If it is not available, all sheets and duvet covers should be washed regularly with hot water. should take his own precautions
Drug Treatment
The most commonly used substances are antihistamines. These medications aim to reduce histamine, which plays a role in allergic reactions. They are generally very useful. They are more beneficial when used before exposure to the allergen. Self They are especially effective on itching, discharge and sneezing. However, which antihistamine will be more beneficial to the patient is determined by some trial and error. If its effect begins to decrease, it should be replaced with another antihistamine. The most important side effects of these drugs are drowsiness, dry mouth, palpitations, difficulty urinating, and increased intraocular pressure. However, these side effects have decreased considerably in the latest generation antihistamines. The drug that I believe is most beneficial after antihistamines is corticosteroids (cortisone). These drugs are more effective when administered orally or buttock, but their side effects are also more severe. For this reason they are used as nasal sprays. When used as a nasal spray, it has very few side effects and its effectiveness is good. There are also nasal sprays called decongestants and medicines called cromolyn that prevent allergic reactions.
Immunotherapy (Vaccination Treatment)
Increasingly, starting from a low dose of the substance to which the patient is allergic. It is a treatment of giving into your body. In this way, it is based on the principle that the body recognizes this substance and does not show an allergic reaction. However, it does not always give good results. It requires vaccination, initially once a week, for years. Although sometimes good results are obtained, it is not always recommended.
In Which Situations Is Surgery Required?
Allergy-related flesh growths and chronic sinusitis negatively affect the success of drug treatments, and in these cases, surgery may be required.
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