Treatment of allergic rhinitis can improve nasal and ocular symptoms

Nov 10 2009

The treatment of allergic rhinitis is shown to improve co-existing conditions including conjunctivitis, asthma, sinusitis, otitis media with effusion (fluid in the middle ear) and sleep disorders according to an international expert at the annual meeting of the American College of Allergy, Asthma and Immunology (ACAAI) in Miami Beach, Fla.

"Allergic rhinitis often co-exists with numerous co-morbid disorders and should be treated in the context of systemic allergic disease," said Prof. Ruby Pawankar, M.D., Ph.D, Nippon Medical School ,Tokyo, Japan.

"Allergic rhinitis is a global health problem that causes major illness and disability worldwide. Impairment of quality of life is seen in both adults and children with allergic rhinitis. It affects them at school and work. Patients also have sleep disorders, emotional problems, decreased cognitive functioning impairment in activities and social functioning," Dr. Pawankar said.

Current estimates indicate that more than 50 million people in the United States suffer from allergic rhinitis - allergies that are characterized by sneezing, nasal congestion, runny nose and watery eyes. It is the most prevalent chronic condition in patients under age 18.

As many as 70 percent of patients with allergic rhinitis reported they suffer from nasal and ocular symptoms. In a study performed in patients with moderate to severe allergic rhinitis, both nasal and ocular symptoms were often moderate-to-severe in intensity. Some 20 percent to 23 percent of patients were extremely bothered by ocular symptoms.

"Allergic rhinitis has been shown to increase the risk of asthma three-fold, and investigators found that when rhinitis began in the first year of life, the development of asthma by age 6 was twice as high as when it started after the first year," Dr. Pawankar said.

Patients with allergic rhinitis and asthma had an increased risk of Emergency Department visits and increased risk of hospitalization for asthma. Treating allergic rhinitis in asthma patients with co-existing allergic rhinitis resulted in 61 percent fewer hospitalizations.

In a study comparing the prevalence of sinusitis in patients with perennial allergic rhinitis (PAR) versus normal controls, an increased prevalence of sinusitis (67.5 percent) was reported in patients with PAR versus in non-allergic controls (33.4 percent).

Allergic rhinitis interferes with sleep and leads to increased daytime sleepiness, Dr. Pawankar said. Investigators found this to be as high as 57 percent of adult patients and 88 percent of pediatric patients. Allergic rhinitis patients reported difficulty falling asleep, nocturnal awakening, early awakening, non-restorative sleep, lack of sleep, and snoring.

"Treating the underlying inflammation is key to relieving symptoms and reducing consequences and co-morbidities in patients with allergic rhinitis," Dr. Pawankar said.

An allergist, an expert in the diagnosis and treatment of allergies and asthma, can perform allergy testing to identify the specific causative allergen that triggers the allergic reactions and determine the most appropriate and effective treatment.