Allergic Rhinitis

Throughout the year most of us suffer from some form of runny or stuffed up nose.  Have you ever asked yourself, is this seasonal allergies or am I developing a sinus infection?  Have you ever wondered if you are in need of an antibiotic or will an antihistamine or nasal steroid spray do the trick?   Hopefully this blog will help you understand the difference between these two common medical ailments.

Allergic rhinitis is either seasonal (often occurring during a certain time of the year) or perennial (occurring year round). 

Each season brings different allergens:

In spring:  Trees like elm, maple, birch, ash, sycamore and oak

Late spring/summer:  Grass pollens and some weeds

Fall:  Most weeds including ragweed

Winter, as well as year round:  Molds

Any of these allergens, when they come in contact with our nasal mucosa, are possible culprits to elicit an allergic response to those unfortunate sufferers.  Basophils, a particular type of white blood cell in our bodies, release histamines which give us our symptoms of allergies such as repetitive sneezing, itchy eyes, ears, nose, throat, runny nose, fatigue; watering eyes, post nasal drip, impaired smell, sinus headaches and ear plugging.

Treatment for allergic rhinitis:

·         Avoidance of the allergen

·         Antihistamines and decongestants

·         Nasal sprays: steroid sprays or saline solutions

·         Allergy shots

·         Note: that antibiotics will not treat allergies

Skin testing by an allergist is the best way to confirm allergic rhinitis.

Sinusitis

Sinusitis is Infection or inflammation of the sinuses, which are cavities within our skull that are lined with the same mucosa as our nasal passages.  There are 4 pairs of sinuses in the head.  The same allergens that affect our nasal mucosa also can cause inflammation within our sinuses.   However, the most common cause of sinusitis is typically due to a virus.  The difficulty comes when the mucosa becomes so congested and inflamed that the sinuses become blocked over a long period of time.  Bacteria that are present in our upper respiratory tract can cause a secondary infection when the sinuses are unable to drain properly. 

Typically your provider can diagnose sinusitis when the following symptoms are present:

·        Allergy or viral symptoms that generally improve & then worsen with unilateral (one sided) pain

·        Increasing of sinus pressure or pain with leaning forward

·        Thick green or yellow nasal discharge

·        Maxillary tooth pain

·        Poor response to antihistamines or decongestants

·        Fever

·        Bad breath

Treatment for acute sinusitis include

·         Decongestants (over the counter)

·         Nasal rinses (over the counter)

·         Nasal vasoconstrictors:   Neosynephrine/Afrin (over the counter)

·         Nasal steroid sprays

·         Steroid injections and/or tapering steroid packs

·         Antibiotics: Typically started if symptoms have persisted for 10 days or greater