Respiratory allergies are increasing worldwide. Around 20% of people in Europe suffer from allergic rhinitis (15%- 20% of whom are affected by a severe form of the disease [+ info]) , whereas asthma is estimated to affect 5%-12% of people in Europe [+ info]. These diseases are the first cause of loss of work days [+ info]. and may even impair school performance [+ info]. Despite their significant social and personal impact, respiratory allergies are neglected and underestimated, with many people unaware that they are real diseases.
What is allergic rhinitis?
The World Health Organization (WHO) describes allergic rhinitis, or hay fever, happening when you breathe in something to which you are allergic and the inside of your nose becomes inflamed and swollen.
Sinusitis is an inflammation of the lining inside the sinuses, which can be acute or chronic. When the sinuses become blocked and fill with fluid, germs can grow and cause symptoms such as headache and yellowish nasal secretions. Blocked sinuses can be caused by the common cold, hay fever or nasal polyps (small lumps inside the nose).
Allergic rhinitis and sinusitis are linked to each other, because allergic rhinitis causes your nose to become blocked, and in turn blocks the sinuses.
Allergic rhinitis is triggered by allergens. Allergens can be found both outdoors and indoors. When allergic rhinitis is caused by outdoor allergens like mould or trees, grass and weed pollens, it is often referred to as seasonal allergies, or ‘hay fever'. Allergic rhinitis may also be triggered by allergens found in the home, such as animal dander, indoor mould, or house dust mites. The current classification of allergic rhinitis takes into consideration the intensity of symptoms and the impact on quality of life. According to these characteristics, it may be mild or moderate/severe.
Some people are more likely to develop IgE antibodies to allergens because it runs in their family. If this is the case, you are said to be ‘atopic' or to have ‘atopy'. People who are atopic are more likely to develop allergies, because their body produces more IgE antibodies than normal.
Environmental factors also play a part in the development of allergic disorders. The exact role of the environment is unknown, but studies have shown that a number of factors seem to increase the chance of a child developing atopy, such as:
- Growing up in a house with smokers.
- Using antibiotics unnecessarily.
- A certain level of exposure to dust mites*.
- A certain level of exposure to pets*.
* However, exposure may result in the development of tolerance to house dust mite and pet allergens among children.
Boys are more likely to develop atopy than girls, as are babies who have a low birth weight. The reasons for this are unclear.
Respiratory allergies in a nut-shell
A common and distressing inflammatory condition affecting the upper airways and the membranes of the nose and eyes, caused by an allergic reaction to an allergen. Conjunctivitis often accompanies this condition. In this case, it is known as allergic rhinoconjunctivitis. This condition is often associated with asthma.
Blocked or running nose, sneezing, itching and watering eyes and inflamed eyelids. Symptoms may be seasonal (hay fever) or year-round.
A form of asthma caused by exposure of the bronchial mucosa to an inhales airborne allergen. Asthma is a commonly occurring and potentially life-threatening illness where the respiratory airways become inflamed and swollen. This inflammation also causes an increase in airway responsiveness to a variety of stimuli.
Shortness of breath, tight chest, cough or bronchospasm, wheezing. These symptoms are usually associated with widespread but variable airflow limitation that is at least partly reversible with medication.
THE PREVALENCE OF ALLERGIES (NOT ONLY RESPIRATORY) IN THE COUNTRY SUR
ALLERGIC RHINITIS: THE ARIA CLASSIFICATION
Traditionally, allergic rhinitis was divided into seasonal and perennial, however some allergens are present throughout the year (e.g. Parietaria in Mediterranean countries, pets and house dust mites). To address this issue, the Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines, the first evidence-based guidelines on allergic rhinitis, proposed a new classification, namely "intermitent rhinitis" and " persistent rhinitis", which is subdivided in mild and moderate-severe disease based on the severity of symptoms and quality of life outcomes.. This classification is useful for the implementation of treatment°. However, there are no widely agreed measures of allergic rhinitis control/treatment objectives, as there are for asthma.
> 4 DAYS PER WEEK > 4 WEEKS
MILD All of the following
- Normal sleep
- No impairment of daily
- No impairment of work and school
- Symptoms present but not or work troublesome
MODERATE-SEVERE One or more items
- Sleep disturbance
- Impairment of daily activities, activities, sport, leisure sport, leisure
- Impairment of school
- Troublesome symptoms intermittent
4 DAYS PER WEEK < 4 WEEKS
An accurate and early diagnosis should be made by a doctor, so the allergy can be managed and exacerbations avoided. Respiratory allergies are diagnosed based on clinical history, physical examination and specific questions. Allergic rhinitis is classified mild or moderate/severe, depending on the intensity of symptoms and the impact on quality of life.
Depending on severity, your doctor may do skin prick tests and blood tests to measure specific IgE. These tests reveal which allergens are the most important causes of the symptoms. Your doctor can then decide on the appropriate treatment, while you should avoid exposure.
It is important to identify and avoiding the allergens that affect you. However, there are also medical treatments available that your doctor might prescribe in your case:
- Nasal antihistamine
- Oral antihistamines
- Topical intranasal steroids
- Nasal decongestants (only in certain situations)
- Oral steroids (only in certain situations)
- Surgical treatment
Some of those treatments above might be non-prescription products in your country, so you should seek the advice of your pharmacist before buying any medicine.