Allegric Rhinitis: Pearls of Wisdom

Statement of the problem: This provides an overview of Allergic Rhinitis and its management. It is very useful for students ofRhinology and clinicians managing this disease. It introduces them to a systematic approach of assessing allergic rhinitis patientswhich is very commonly found in most populations and causes considerably morbidity. Allergy per se is a very difficult subjectto master and it is with great perseverance one can treat patients suffering from this condition. The cornerstone of managing apatient of allergic rhinitis is first and foremost obtaining a good history. This is to be followed by a thorough examination andinvestigations. The general practitioner is the first expert to be involved in management of allergic rhinitis patient followed byspecialists in particular otorhinolaryngologists, and finally by allied healthcare personnel. Inflammation of nose and paranasalsinuses are characterized by two or more symptoms-namely, eithernasal blockage, obstruction, congestion or nasal discharge.Associated symptoms include facial pain, pressure and either reduction or loss of smell. Certain diagnostic endoscopic signsof nasal polyps and or mucopurulent discharge and or mucosal oedema in the middle meatus and or CT changes of mucosawithin the ostoemeatal complex, and or sinuses are seen. Definitions, aetiologies, clinical presentations, diagnosis, prognosisand management of allergic rhinitis is dealt with. Common allergens causing the disease are mentioned, pathophysiology andclassification of allergic rhinitis is discussed in detail. Different types of allergen testing are highlighted along with their specificrole and uniqueness. Principles of immunotherapy in treatment of allergic rhinitis are discussed here. Health effects of allergicrhinitis along with its impact on physical quality of life is mentioned. The basic idea of this presentation is to improve diagnosticaccuracy by promoting appropriate use of ancillary tests like nasoendoscopy, allergy testing, computed tomography etc. and reduceinappropriate antibiotic use. The basic treatment plan of allergic rhinitis is according to the severity and duration. It consists ofallergen avoidance, pharmacotherapy, allergen immunotherapy and surgery which has limited role.