Patients with intermittent or seasonal allergic rhinitis have symptoms of sneezing, rhinorrhoea, and watery eyes, while patients with chronic AR often complain of postnasal drip, chronic nasal congestion, and obstruction.³

AR is not a trivial disease

According to the Allergy Foundation of South Africa (AFSA) many patients with AR suffer badly from their symptoms, but do not get help as they have just got used it. AR is not a trivial disease, stresses AFSA.⁴

Uncontrolled AR severely impact the quality of life of patients and should not be dismissed. A South African study showed that 76.6% of patients with AR have sleep disturbances, and 85.2% felt miserable due to their allergic rhinitis, which have a profound impact on work productivity and academic performance.²

Diagnostic criteria

Table 1:Diagnosis criteria of AR based on clinical symptoms and laboratory characteristics criteria¹

Treatment approach to seasonal allergies

Spring is a few weeks away. To help your patient deal with seasonal AR (SAR), recommend the following:³

1. Avoid triggers: Although not always practical, take precautions to avoid dust mites, animal dander, and upholstery. Allergen-impermeable bedding covers, washing sheets in hot water, and the use of a vacuum cleaner with high-efficiency particulate air filters may also lessen symptoms³
2. Pharmacotherapy: Antihistamines (second-generation), intranasal steroids, leukotriene receptor antagonists, and immunotherapy are recommended by guidelines for the treatment of AR. Intranasal corticosteroid therapy (ICS) can be as monotherapy or in combination with oral antihistamines in patients in patients with mild, moderate, or severe symptoms. Nasal decongestants reduces nasal congestion symptoms but their overuse can cause rhinitis medicamentosa (rebound congestion upon withdrawal of nasal decongestants), which can be treated by administering ICS^1,3
3. Immunotherapy: A fraction of AR patients do not respond toward treatment with conventional pharmacotherapy, thus disease-modifying therapeutic agents are adopted such as allergen immunotherapy.³

REFERENCES:

1. Nur Husna SM, Tan HT, Md Shukri N, Mohd Ashari NS, Wong KK. Allergic Rhinitis: A Clinical and Pathophysiological Overview. Front Med (Lausanne), 2022.
2. Seedat RY, Sujeeb M, Ismailb W, et al. Allergic rhinitis in medical students at the University of the Free State. South African Family Practice, 2018.
3. Akhouri S, House SA. Allergic Rhinitis. [Updated 2022 Jun 5]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK538186/
4. AFSA. Allergic rhinitis. https://www.allergyfoundation.co.za/patient-information/en/allergic-diseases/allergic-rhinitis/