Dr muaid I. Aziz FIMCS
Definition: its an inflammation of the lining of the nose characterized by two or more of the following symptoms nasal obstruction Facial pain Rhinorrhoea sneezing hyposmia or anosmia nasal congestion itching headache
Rhinosinusitis allergicinfectious other
Definition: Clinically defined by a combination of 2 or more of nasal symptoms Running Blocking Itching sneezing
Ig E ( TYPE 1 HSR)
Genetics & family hx. Environment Co – morbidities ( asthma, sinusitis, om,sleep disorders, LRTI) Patients with persistent AR should be evaluated for asthma, the converse is also true
How you classify allergic rhinitis?
persistant Allergic Rhinitis Intermittant
Intermittent Allergy The allergy appears at certain times of year when the pollens are carried by the wind. Examples are: tree pollen in the spring grass pollen in early to mid summer weed pollen and mold spores in autumn Persistent Allergy Perennial or “all year round” allergens give persistent symptoms that are similar to the seasonal variety or hay fever but they are there all the time. The most important allergens are the house dust mite and animal dander. Perennial allergy can also be worse in the hay fever season if the person is also sensitive to pollen.
Seasonal ( intermittent ) Sneezing rhinorroea Itching Perennial ( continous) Nasal obstruction Poor sense of smell Chronic inflammatory rhinosinusitis
History Examination investigation
Presenting sx., sx of co-morbidities, general medical, past,family, ocupational, enviromental, dietry &drug hx. As rhinorrhoea & conjunctivitis ( seasonal) While nasal obstruction is more common in (perennial rhinitis) Frequency, severity, duration, persistance or intermittent, affecting quality of life or not
Normal mucosaSwollen oedematous pale or bluish color
Allergy diagnosis 1. skin prick test (SPT)
How you can control allergic rhinitis?
avoidancediet Medical therapy immunotherapy Control of allergic rhinitis
Allergen avoidance Outdoor triggers Indoor triggers
Indoor allergens Dust mites Animal dander CockroachMold
dust & dust mites Dusting Washing w hot water Animal dander& other pet allergens By restricted location Get arid of it molds Cleaning bath tube showers
Outdoor triggers MoldPollen
Stay inside Closed windows & doors Avoid fan w open window Avoid bringing pollen back into your home
Avoid going outside on rainy or windy days Avoid activity as gardening Remove excess leaves from surrounding Keep rain gutters & drains clear of leaves Anti mold for car air conditioner.
Natural allergy relieve Antihistamines OR Decongestants Steroids Leukotrienes modifiers
How to prepare it ? When to use it ? How to use it ? How its effect or help allergy relieve?
Mix 2-3 tsp of non iodized salt cc H2O + one tsp of packing soda.
Exposed to pollen outdoors ( at the end of the day) For moisturing in dry nose in winter Pre steroid application
Neti pot Syringe Cupped hands
Remove the pollens Thining the mucous & relieve the obstruction Keeping cilia healthy.
For relieving running,itching,& sneezing. Little effect on nasal obstruction Non sedative (2 nd generation)
Reduce inflammation, nasal sx., Eye sx, improve sense of smell
For unblock of the nose at the start of treatment or for very sever sx,