Description, Causes and Risk Factors:
Perennial rhinitis is on of the most important upper respiratory conditions encountered by the physicians. It occurs more frequently than any other allergic manifestation of the respiratory tract. In the beginning it is often so slight that it is usually ignored by the patient, or the patient's family, and the doctor. The early stage is the best time for diagnosis and treatment, thus preventing disabling conditions from developing in the future.
The nose being situated at the entrance of the respiratory system is therefore subjected to many insults produced by many different factors. These factors may be extreme changes of temperature, fumes of all sorts, unpleasant or obnoxious odors, dust, plant particles, animals and insect emanations, molds and spores.
The incidence of perennial allergic rhinitis is rather higher. Many mild cases of perennial allergic rhinitis never come to the attention of the doctor. The number of these cases is unknown but undoubtedly higher than we would expect. Perennial rhinitis is a forerunner of asthma in about 50% of cases of asthma.
The most common cause of perennial rhinitis are inhalants, ingestants, and infection.
The commonest inhalant to cause trouble is dust. Inhalants such as insect sprays, paints, varnishes, oils, perfumes, occupational dusts and odors, fumes and smokes will aggravate or incite the attacks.
Ingestants include foods, drinks and oral medications. The most common exciters of allergic conditions are usually the most common food eaten. Cereals, nuts, chocolate, fish, fruit, milk, eggs, spices and vegetables are the most likely to produce allergic manifestation. Drinks such as coffee, tea, alcohol, beer, and soft drink sometimes exciting factors.
Infection also plays an important role in the symptoms and findings of perennial rhinitis. The membranes of the allergic nose have a weakened resistance and do not respond to bacterial invasion as do normal structures. Allergy and infection do not counteract each other and their presence together result in damage and discomfort.
There is no uniform pattern of symptoms that presented to the doctor. The most common cases are patient who have frequent, but brief attacks of nasal itching, sneezing, runny nose or stuffy nose. The attack may last a few minutes to a several hours. The attack may start at any time, any place or with any activity. The patient or patient's family usually finds out that there is no fever associated with the attack of hay fever. Some patients feel as thought they have a cold most of the time. The severity of the symptoms varies with the amount of exposure and the degree of sensitivity. The constant or frequent exposures to the allergen or allergens bring about the pale, swollen, grayish colored nasal mucosa which in turn is more susceptible to infection.
The mildest case of perennial rhinitis is worth of investigation. A complete detailed comprehensive and searching history is of the utmost importance. In a large number of cases the diagnosis can be made from the history alone. The association of the symptoms with the activities, weather, location and physical well being are of great importance in diagnosis.
The help of the ENT and throat specialist aids a great deal.
Skin tests are essential and must be carefully evaluated according toe the clinical picture and experience of the physician.
When a working diagnostic pattern has been established, treatment is carried out usually in a combination of the following procedures: Complete avoidance, partial avoidance and desensitization, and desensitization.
The complete avoidance of agents found to be offenders is an ideal goal to seek, but hard to achieve. The inhalants such as animal dander and feather can be avoided by getting rid of the animal and avoiding them. Dust can be greatly reduced by keeping the home, office, or plant cleaner and the carrying out other procedures that will help to prevent or reduce the dust. If the pillows or mattresses are offenders, they can be covered by plastic or replaced by rubber foam pillows and mattresses. Furniture may be covered or replaced. Rugs and carpets may be to be removed.
The partial avoidance of the factors found to be offenders is another form of treatment. The minimizing exposure to the offending factors may reduce the allergenic activity of a patient below the threshold or response level.
Desensitization becomes absolutely necessary when relief is not obtained by complete or partial avoidance of the offending factors. The best form of therapy is specific hyposensitization. In this cases inhalants injections are used. Caution has to be used in the desensitization program begin with a small doses to weak concentration, increase the concentration gradually and be alert for reactions.
Injection rarely gives complete protection unless procedures and carried out to avoid or partially avoid the offending factors. Partial avoidance is therefore vital to the success of desensitizing treatment.
NOTE: The above information is educational purpose. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition.
DISCLAIMER: This information should not substitute for seeking responsible, professional medical care.