TREATMENT GOALS :

Treatment of nasal inflammation may be required in order to obtain full control of bronchial inflammation and asthma symptoms. Therefore it is important to perform screening of all patients who present with asthma symptoms to rule out rhinitis & vice versa. A combined strategy should ideally be used to treat the upper and the lower airway diseases in terms of efficacy and safety.

1. DIAGNOSE THE OFFENDING ALLERGEN!

The most common allergy-mediated clinical problem where specific testing may be needed is chronic rhinitis. Many physicians make a presumptive diagnosis of allergic rhinitis based on the medical history. Management of these patients may include use of antihistamines, decongestants, or intranasal steroids. This is a reasonable and effective approach in many patients. In some patients, specific allergy testing may be warranted.

2. BEHAVIOURAL MODIFICATIONS - REDUCE OR ELIMINATE THE INCITING ALLERGEN

Behavioural Modifications and Environmental Controls

In the case of managing allergies and allergy symptoms, patients should try and remove triggers from the environment. This may include cleaning for dust more frequently for those who are dust mite allergic and avoiding places where triggers are present in high volume. After allergy testing is complete and the doctor has identified the triggering allergens, your doctor can discuss other behavioural modifications that can be helpful in controlling allergy symptoms.

3. LESSEN THE ALLERGIC RESPONSE

The regimen in uncomplicated Seasonal Allergic Rhinitis : We teach the patient to anticipate the symptoms Seasonal prophylaxis is recommended

Antibiotics may be prescribed as required – usually after lab-proven evidence of infection

Oral 2nd gen oral anti-histaminic + decongestant + mucolytic + steroid as a short course Then 2nd gen oral anti-histaminic x 10 days + Topical steroid spray + anti-hist. Drops x 10 days Then steroid spray x 60 days + saline nasal spray for extended use

This regimen has been effective in many cases in our clinic.

Uncontrolled allergen exposure can lead to chronic irreversible changes in the upper and lower airway.

Chronic allergen exposure can lead to enlarged turbinates, polyps, etc. which are best addressed by surgery. Uncontrolled allergen exposure can lead to chronic irreversible changes in the upper and lower airway.

In patients with significantly discomforting or disabling symptoms that are NOT CONTROLLED with standard measures, surgery may also rarely be prescribed as an option WHERE NASAL OBSTRUCTION IS A PREDOMINANT SYMPTOM, SURGERY REMAINS THE METHOD OF CHOICE FOR AIRWAY CORRECTION.

Surgery may involve any or all of the following :

TIPS FOR CONTROLLING ALLERGENS

Constant exposure to allergens means constant allergy symptoms. That's why controlling or avoiding the allergens that cause your symptoms is an important part of your treatment. The more you do to keep all allergens away from your nose, the better you'll feel.

Pollen :

Pollen is in the air whenever trees, grasses, or weeds are blooming, so it's hard to avoid. But there are some things you can do to limit your exposure to pollen: After spending time outdoors, change your clothes, and wash your hair before bed. Stay indoors on windy days.

Mold :

If you're allergic to mold, pay special attention to areas where water tends to collect. Here are some tips for avoiding mold: Clean the bathroom shower or tub regularly with bleach, and check the shower curtain for mold growth.

Get leaky faucets or leaks in the roof fixed right away.

While bathing or showering, leave a window open or run a fan so moisture can escape.

If your house is damp, use a dehumidifier.

House-Dust Mites :

House-dust mites are almost impossible to get rid of. But you can keep them under control. Try some of these tips:

Enclose your mattress, box spring, and pillows in allergy-proof casings.

Wash sheets, blankets, and mattress pads every 1 to 2 weeks in hot water Wash bedding in hot water (at least 130°F) to kill house-dust mites. Warm or cold water won't kill them.

Remove stuffed animals and things that collect dust, such as wall hangings, knickknacks, and books–especially in the bedroom.

Have as little carpeting as possible.

Each week, have your home dusted with a damp cloth and vacuumed.

If someone else can't dust and vacuum for you, take your medication before doing these tasks. Wearing a filter mask may help.

Animals :

The dander, saliva, and urine of animals are all allergens. Cats produce more of these allergens than most other pets. Animal fur may also contain dust, mold, and pollen. The best way to avoid animal allergens is not to have a pet. If you already have a pet and can't bear to part with it, try to reduce your exposure as much as possible.

Use shades or vertical blinds instead of horizontal blinds, which collect dust. Replace drapes with curtains that can be washed regularly.

Enclose mattresses, box springs, and pillows in allergy-proof casings. Use washable blankets and quilts. Avoid feather pillows, down comforters, and wool blankets.

Install a fan to keep the bathroom well ventilated.

Don't let wet clothing sit and grow mold. And don't hang clothes outside to dry where they can collect airborne pollen. Dry clothing immediately in a clothes dryer that's vented to the outside.

Check stored food for spoilage and mold growth. Clean up spills right away.

Avoid dust-catching clutter. Have enclosed places to keep books, toys, and clothes. Keep closet doors closed.

Use washable throw rugs wherever possible, or have bare floors.

Put filters over forced-air heating vents. Change the filters regularly.

Keep your car clean. Vacuum the seats and carpets regularly. If you have air conditioning, use it instead of opening the windows.

Keep rain gutters clean. Remove leaves and debris that can grow mold.

Seal all the spaces

Do not use carpets.

Look for fungus on the walls and have the walls painted regularly