Options for Treating Allergic Rhinitis
I actually couldn’t believe it when my doctor told me many years ago that I have allergic rhinitis. After all, my sinuses didn’t bother me that much, probably because I’d been mild-to-moderately stuffed up for so long that I didn’t exactly notice I couldn’t breathe through my nose. I have what’s known as perennial allergic rhinitis, which means my symptoms are continual (likely linked to my dust mite allergy), whereas some people have seasonal allergic rhinitis in response to allergies like pollens and moulds at certain times of year only, and as such, they may only need to treat their rhinitis during problematic times of year. Oddly, it seems this year my rhinitis is unrelenting, beginning to annoy me more after things have frozen over! For the last three weeks, since I returned from Zurich, however, has been a different story.
Allergic (and non-allergic) rhinitis are common among people with asthma—in fact, it can be referred to jointly as “united airway disease”.1 I’m unsure how I feel about the unity of my lungs and sinuses for hijinks having a name of its own! Around 80% of people with asthma also have rhinitis—and 40% of people with rhinitis also have asthma.2 While sinus problems do not always have an impact on asthma control (as is apparently my case!), in many cases, getting rhinitis under control can help.
How is Allergic Rhinitis Treated?
The first line of therapy against allergic rhinitis is typically intranasal corticosteroids. Just like inhaled steroids reduce inflammation locally in the lungs for asthma, nasal steroids work similarly in the sinuses. Often, it is recommended to use nasal steroids alongside saline rinses to clear the nasal passages of any gunk to allow the steroids to better adhere inside the nasal cavity.
If nasal corticosteroids aren’t enough, there are many other add-ons that can help control this common—and annoying—condition. Beyond, you know, eating hot peppers as Kat recommended to me. (But hey, that works for the short term, too!). Treatment is based on symptoms—namely, what type of symptoms are associated with your rhinitis.3
- Oral antihistamines - Most often over-the-counter antihistamines are recommended
- Intranasal antihistamines - Treats histamine reactions more locally than do oral antihistamines.
- Oral decongestants - Such as pseudoephedrine (Sudafed)
- Intranasal cromolyn - Available over the counter in the US and Canada.4
- Intranasal anticholinergics - A mast-cell stabalizer which may have antileukotriene type benefits. A drawback is that it must be used 3-6 times per day.5
- Leukotriene receptor antagonists - Such as montelukast—Singulair, used to inhibit leukotriene responses that are common causes of allergy symptoms.
- Immunotherapy - In the case of significant allergic-mediated rhinitis, immunotherapy treatment (allergy desensitization) may be recommended.
More to investigate
As you can see, there are a lot of different ways to treat the annoying symptoms of allergic rhinitis. The best first step is to chat with your asthma or allergy specialist about your symptoms, so they can provide the best options possible. At my upcoming asthma clinic appointment I’m going to ask about having my allergy tests re-done as it’s been a good number of years, and if going back on Singulair might help—after all, I don’t think my rhinitis was really noted until after I was off Singular and felt it did nothing. I know that I have no side effects on Singulair, which is what makes it worthwhile to try again for me. I didn’t have great results with Singulair for my asthma, but maybe I’ll have better results using it for my rhinitis? As always your asthma—and mileage with any treatment—may vary, and there is often more to investigate!
Do you have rhinitis symptoms alongside your asthma? How do you treat them?
Do you prefer to use a spacer or no spacer?