Allergic Rhinitis (Hay Fever)

Rhinitis is a seasonal or year round IgE mediated inflammation of nasal mucus membrane. Usually it manifests with common cold. It may be seasonal or perennial

 

Aetiology: Allergic rhinitis is due to an immediate hypersensitivity reaction in the nasal mucosa. Seasonal antigens include pollens from grasses, flowers, weeds or trees.

 

Predisposing factor:

  1. Hereditary, patient with high serum IgE suffers more.
  2. Psychological.
  3. Endocrinal- puberty, pregnancy.
  4. Temperature variation

 

Precipitating factors:

  1. Inhalants: pollen, dust, smokes. pungent odours or fumes, including strong perfumes, cold air and dry atmospheres
  2. Ingestants:  foods e.g. egg, prawn, hilsha & other fishes.
  3. Infections: bacteria, Virus.
  4. Drug; aspirin, iodine, antibiotic.
  5. Synthetic material.

 

Clinical features:

  1. Characteristic features are bouts of sneezing followed by rhinorrhoea- clear watery discharge which is profuse in amount
  2. Nasal obstruction, which is alternating in character.
  3. Nasal irritation & anosmia are common.
  4. Nasal mucosa is oedematous, pale, & boggy in appearance.
  5. Sometimes accompanied by smarting and watering of the eyes (and conjunctival infection may associate.)
  6. In the perennial variety the symptoms are similar but more continuous and generally less severe.
  7. Skin hypersensitivity tests with the relevant antigen are usually positive in seasonal allergic rhinitis and are thus of diagnostic value, but they are less useful in perennial rhinitis.

Management:

  1. Prophylactic- precipitating factors (allergen) should be removed or avoided.
  2. During attacks- aconite, alium cepa, bell, ars alb, rhus tox, nat sulph, lamna minor, tucrium, sulphur, merc sol etc. should be given according to homeopathy.
  3. To remove nasal congestion- use lemna minor 10% solution with 0.05% sodium chloride solution.
  4. Surface electrocautery, submucosal diathermy etc.  may be done in some cases, yet don’t get relief permanently.
  5. General body nutrition is improved by vitamin C, B-complex & good diet.