Nasal Wash

For mild allergic rhinitis, a nasal wash can be helpful for removing mucus from the nose. A saline solution can be purchased at a drug store or made by mixing one teaspoon of salt and one pinch of baking soda in a pint of warm water. The patient leans over the sink head down, pours some solution into the palm of the hand, and inhales it through the nose one nostril at a time. The patient spits the remaining solution out and blows the nose gently. The solution may also be inserted into the nose using a large rubber ear syringe, available at a pharmacy. Leaning over the sink head down, the patient inserts only the tip of the syringe into one nostril. He or she gently squeezes the bulb several times to wash the nasal passage and then presses the bulb firmly enough so that the solution passes into the mouth. The process should be repeated in the other nostril. A nasal wash should be performed several times a day.

Drug Treatments for Allergic Rhinitis

Most cases of mild allergic rhinitis require little more than reducing exposure to allergens, using a nasal wash, and taking mild over-the-counter remedies. Decongestants relieve nasal congestion and itchy eyes. Antihistamine tablets relieve sneezing and itching, and can prevent nasal congestion before an allergy attack. Because seasonal allergies generally last only a few weeks, most physicians do not recommend more powerful treatments for children with this condition. One study noted, however, that if such children also have asthma, intense treatments for allergic rhinitis may also improve asthmatic symptoms. It is important for parents to determine if the child is actually under severe distress and that they are not simply responding to their own anxiety when they hear the child snorting or snoring. In only some cases are prescription drugs required. Corticosteroid and cromolyn nasal sprays reduce inflammation and are effective in treating allergic rhinitis symptoms. Newer-generation antihistamines are also available by prescription. All have side effects, some very unpleasant and, in rare cases, serious. Patients may need to try different drugs until they find one that relieves symptoms without producing excessively distressing side effects.

Immunotherapy (Allergy Shots)

Immunotherapy (allergy shots) may be given to people over seven whose allergies are severe and do not respond to medication. They are also safe for pregnant women with allergies. The object of these shots is to make the immune system tolerant to the allergen. The most common allergens for which shots are given are house dust, cat dander, grass pollen, and mold. Injections of diluted extracts of the allergen are given on a regular schedule, usually twice a week to weekly at first in increasing doses until a maintenance dose has been reached. At that time, intervals between shots can be two to four weeks, and the treatment is continued for up to five years. It usually takes several months and may take up to three years to reach a maintenance dose. Patients can experience some relief within six months; if there is no benefit within 18 months, the shots should be discontinued. Side effects usually occur within 20 minutes although some can develop up to two hours after the shot is given. In rare cases, particularly because of excessive doses or if a patient has a serious lung problem, severe reactions can occur, which can be life threatening. Injections for ragweed and, possibly, excessive doses of dust mites, have higher risks for side effects than other allergy shots. Extreme responses to skin tests may predict who will have more severe reactions to the shots. People who are wheezing should not be given immunotherapy. Premedicating patients with antihistamines and corticosteroids helps reduce the risk of reactions to immunotherapy. Patients must be monitored closely during this period.Allergy shots are not a cure but are effective in preventing symptoms of allergic rhinitis. Some experts believe that immunotherapy for allergic rhinitis may help prevent the development of asthma in some children.

Surgery

Surgery may be needed for certain cases of mechanical obstruction, such as deviated septum or polyps.