Naseer Ahmed, a young banker, suddenly felt a nasal obstruction and started sneezing. Other symptoms of his illness included itchy eyes and a runny nose and they continued for several days. The severity of these symptoms did not allow him to attend office or carrying out his other routine activities. He consulted some doctors, who diagnosed his illness as sinusitis. He was prescribed different medicines, but they did not work. He later consulted an ear, nose and throat (ENT) specialist and discovered that he was suffering from allergic rhinitis.
The allergy problem would have remained a part of his life had he not consulted a specialist. Like Ahmed, there are a number of allergy patients, who are compromising on their quality of life. This results in loss of work, absenteeism from school and office and a disturbed daily routine. A common problem in Pakistan is that people are either ignorant about a disease or become confused over the common symptoms of different illnesses.
Allergic rhinitis is a common problem in Pakistan, but most patients confuse it with common cold, flu or other illnesses. Many family physicians or general practitioners also have difficulty differentiating between allergic rhinitis and sinusitis.
“Allergic rhinitis is a collection of symptoms, mostly in the nose and eyes, which occur when you breathe in something that you are allergic to including dust, dander, or pollen. The body as a reaction releases chemicals, including histamine. This causes allergy symptoms such as watery/itchy eyes, stuffy and congested nasal passages, runny nose and mucus production,” said Dr Samia K Babar, director of the Health Awareness Society. She said that symptoms of some patients worsen with seasonal changes whereas others have varying severities of the disease all year long.
Quoting Health Awareness Society data, she said that pollen can be the main trigger for allergic rhinitis patients in rural areas, but in cities and urban areas, there are a number of trigger factors such as air pollution, pollen, smoke, dust mites, pet dander, and different types of sprays.
“Allergic rhinitis is a global health problem, affecting up to 25 percent of the world population. In a study of 11 Asian countries, the prevalence of allergic rhinitis was found to be up to 30 percent in adults and 46 percent in children,” she added.
Unavailability of proper medication is not an obstacle in treating the problem of allergic rhinitis; rather it is the ignorance and lack of awareness about the disease. If patients suffer from any of the allergic rhinitis symptoms like runny nose, sneezing, nasal congestion, watery/itchy eyes, redness of the eyes, nasal itching, they should consult an ENT specialist and inquire about allergic rhinitis.
Different types of medication are available for the treatment of the disease like antihistamines and decongestants –however, they do not give long-term or complete relief from all the symptoms.
According to the Allergic Rhinitis and its Impact on Asthma guidelines, intranasal corticosteroids are the most effective treatment for the disease. It causes direct reduction of nasal inflammation and has the ability to reduce nasal hyperactivity. Although research has shown that 70 percent of patients suffering from nasal symptoms have ocular (eye) symptoms as well, present intranasal corticosteroids have limited efficacy against ocular symptoms. However recent clinical research has led to the development of a novel glucocorticoid, fluticasone furoate, which has shown efficacy against both the nasal and ocular symptoms of seasonal allergic rhinitis and nasal symptoms of perennial (year-long) allergic rhinitis in adults and adolescents.
“Allergic rhinitis is not as a disease but a hyper exaggerated response of the nasal epithelium, in which immunoglobulin E (IgE) – an antibody – is involved causing reactions,” said Dr Ahsan ul Haq, ENT consultant at the Hamdard University Hospital. Speaking on the prevention and treatment for allergic rhinitis, Dr Haq said that prevention from allergens is important. It is better to avoid contact with allergens like pollens and dust mites. “In the house, use a wet cloth for wiping surfaces and also cover your face. In the pollen season, avoid visiting pollen-rich areas. For controlling the symptoms, drugs including antihistamines are used to stop the release of histamine. Nebulisers are also used to make breathing easier,” he added.
