Suffering from nasal blockage, sneezing, runny nose, or irritation in the eyes & throat? You might be suffering from Allergic Rhinoconjunctivitis (AR)!

This disease affects about 15-20% of the adult population and 40% of the pediatric population, symptoms of which are runny nose, sneezing, nasal congestion, burning and watering of eyes, and itching of the nose, eyes, palate, throat, and ears. Depending on the causative allergen, these symptoms can be seasonal, perennial (year-round), or episodic. Allergic Rhinoconjunctivitis (AR) can disturb daily activities and sleep patterns leading to reduced concentration, daytime fatigue, irritability, and hyperactivity. Children can have low exam scores, express low self-esteem, impaired athletic performance, and also have been found to be suffering from ADHD.

This disease is associated with complications and co-morbidities. Nasal inflammation caused by rhinitis can contribute to the development of Acute and Chronic Sinusitis, can lead to Eustachian tube dysfunction, and cause Serous Otitis Media (SOM), symptoms of which are aural fullness, and deafness. SOM can lead to speech delay in children and craniofacial abnormalities due to chronic mouth breathing.

AR should be differentiated from Non-Allergic Rhinitis (NAR) which is mostly seen after 20 years of age, more in females and there is no evidence of a familial pattern.

AR is triggered by allergens but NAR is triggered by strong smells, irritants, smoke, changes in weather, hormonal fluctuations, and ingestion of alcohol and food. Many of the symptoms of AR and NAR are similar but NAR patients will have more of nasal congestion and rhinorrhea and rarely have sneezing. AR patients will have more troublesome eye symptoms like watering and redness of eyes, pruritis, sneezing, nasal itch, post-nasal drip (clearing of throat), cough, irritability, and fatigue.

Diagnosis is made by an ENT Surgeon on clinical examination. It is confirmed by doing the Skin Prick Test which is considered the gold standard test for diagnosis.

The allergens responsible for AR are Tree and Grass pollens, House dust mites, molds, insects like cockroaches, and pets like cats and dogs.

Treatment- This consists of Pharmacotherapy, Allergen avoidance, and Allergen Immunotherapy. Pharmacotherapy consists of oral and nasal Antihistamines, Nasal corticosteroids, Leukotriene inhibitors, and oral and nasal decongestants which should be used only for a very short period.

These drugs suppress the allergy symptoms temporarily. Allergen avoidance measures should be undertaken according to the causative agent. Allergen Immunotherapy is the only disease-modifying therapy in AR. It develops long-term immune tolerance.

The causative allergen is given through various routes( SLIT-sublingual, SCIT- subcutaneous) in increasing doses till a tolerance level dose is reached.