Spring - a time of joyful is not for everyone. Together with flowering gardens and scented herbs to many come snot, nasal congestion, itching and other unpleasant symptoms. "Allergies!" - We say in such a situation. So what is this disease - allergic rhinitis?
Allergic diseases - the scourge of our time, and runny nose of allergic nature - one of the most frequent pathologies in the world: they suffer from 10 to 25% of the population around the world.
Previously, physicians were divided into two nasal allergiesform: seasonal (the so-called spring hay fever - it is about him and discussed earlier in this article) and permanent (or year-round). Now apply a slightly different classification, which are distinguished by:
- intermittent - Periodic - form of the disease (symptoms occur no more than 4 days per week or more than 4 weeks in a year). It corresponds to the seasonal runny nose on the old classification.
- persistent - Continuous - form in which, respectively, the patient is suffering from a cold for more than 4 days per week or more than 4 weeks in a year - a year-round analogue form of allergic rhinitis.
And depending on the severity of symptoms and, most importantly, from the inconvenience, delivered his "master", allergic rhinitis is divided into three levels of severity:
- light - in which the patient is not disturbed sleep, and, in general, a cold little effect on its ordinary and professional activities;
- moderate - when there are sleep disturbances, decreased daily activity, problems with work or with sports training;
- heavy - at which compounded existing disorders and disease gives patients severe torment.
Where does it come from: the causes of disease
The cause of allergic rhinitis can be designatedone word: allergen. What it is known to all - a certain substance that is perceived by the body as foreign, dangerous agent found out that, the body begins to fight.
at seasonal allergies provocateurs diseases are the pollen of flowering plants more often (birch, walnut, cereals, poplar fluff, ragweed, and so on. d.).
The main allergen at permanent form of the disease - House dust (more precisely contained thereinmites kind Dermatophagoideus). In second place in importance - animal hair. Also, often provoking factors include paper dust, food for aquarium fish, molds, certain foods, medicines and more.
The most important thing - the right diagnosis, and for this it is necessary to know the symptoms of the disease.
For allergic rhinitis is characterized by nature:
- profuse watery discharge from the nose. They often do not even look like snot and more like ordinary water;
- difficulty breathing through the nose. This is due to swelling of the nasal mucosa;
- itching, tickling in the nose, sudden attacks of sneezing.
In addition to these three "classic" signs mayobserved: watery eyes, itching and redness of the eyes, itching, decreased sense of smell, headache and fatigue. Full "set" of symptoms often is typical for seasonal variants of allergic rhinitis and its permanent shape may be anemic, without itching, sneezing and manifest only mild nasal discharge and obstruction of nasal breathing.
How is it diagnosed?
For accurate diagnosis is not enough tofind the above symptoms. They will help to suspect the nature of allergic rhinitis, but confirm the suspicions can only be through a survey. So, what should I do?
Refer to the ENT doctor. With the help of a special nasal mirrorotolaryngologist will examine the nasal cavity, appreciate the color, degree of swelling, the overall condition of the mucous membrane, the nature of discharge from the nose and compare it with the painting, typical of allergic rhinitis.
Then you need to get tested:
- general blood analysis. In allergic reactions in blood test increases the level of eosinophils (OK, this figure does not exceed 5). At a cold as, for example, bacterial, detected increase in blood leukocytes. However, the increase in the number of eosinophils in the general analysis of blood - a sign not mandatory and is found only in 30% of patients with allergic rhinitis.
- swab from the nose all the same eosinophils(This study is much more informative). Normally, in the nasal secretions of these blood cells are not found, but in allergic rhinitis, they found more than 70% of patients. In addition, this analysis is very simple, it can (and should) be repeated several times, which greatly increases the probability of a correct diagnosis.
Once the nature of allergic rhinitisestablished and there is no doubt you need to try to find out what the substance causes a similar reaction. To do this already should consult an allergist.
So, allergist consultation and, according to testimony, conducting skin tests. To do this, the patient's skin of the forearm is applied to a set of different allergens, then make small punctures, and after a certain time measured the dimensions of the formed blisters.
But, unfortunately, to identify "harmful" substanceIt is not always possible. First, the sample is made only to the most common allergens (and this is the maximum - a few hundred agents), while the number of potential provocateurs tens of thousands. Secondly, the determination of allergen sensitization difficult with several substances simultaneously.
Is it really?
Allergic rhinitis: trifle or a dangerous disease? We are accustomed to the fact that the "snot" do not deserve serious consideration, but in relation to the nature of the allergic rhinitis, this rule does not work. Firstly, allergic rhinitis can cause the development of other diseases, especially asthma. Studies have shown that 90% of patients with asthma, rhinitis begins. And secondly, painful and persistent symptoms common cold severely impair the quality of life of patients.
How to treat allergic rhinitis?
Treatment of allergic rhinitis - employment is quite difficult, in spite of what has to be treated, according to the opinion of the patients, "just snot."
The first - and most important: eliminate the cause! It is necessary to limit the contact of the patient and his "enemy" - the allergen.
With increasing sensitivity to pollen allergens is recommended:
- during flowering cause significant plant temporarily move to another region;
- home to use special air purifiers, respirators, masks, etc.
- not to commit at this time country trips;
- not to take herbal medicines and not to use cosmetics made from herbs;
- lead "allergic" blog allowing to assess the dynamics of the disease and the efficacy of treatment in a single season or over several years;
- observe the hypoallergenic diet:
- by reaction to the pollen of trees, it is desirableexclude from its menu, fruit and berries that grow on bushes or trees (peaches, plums, cherries, cherries, apples), nuts, kiwi, birch juice, celery, parsley and carrots;
- at Allergy to pollen cereals need to be careful with kvass and beer,not recommended the use of cereals cereals, bread, pasta and other products made from flour and cereal, sorrel, peanuts, beans, soybeans, corn, coffee, cocoa and smoked sausages;
- if the allergy is caused by pollen of weeds, it is besteliminate from the diet of sunflower (oil, halva, sunflower seeds), mustard and mayonnaise, watermelons, melons, chicory, spices and herbs, spinach, beets and drink, which is used in the manufacture of wormwood (vermouth, absinthe).
When an allergy to molds is desirable:
- Avoid contact with cut grass and hay musty, damp fallen leaves;
- limit time spent in the basement, damp houses, and other places with high humidity;
- exclude yeast dough, sour (sauerkraut) cabbage, cheese, beer, wine, liquors, kvass, sugar and various sweeteners: xylitol, sorbitol, fructose from the diet.
At home allergies It recommended:
- remove all the "dust collectors": carpets, stuffed toys;
- regularly (preferably twice a day) carry out wet cleaning of the apartment, often wash clothes;
- All bedding made of down, feathers and wool to synthetic change things or objects made from non-animal materials (eg, buckwheat husk);
- storing books behind glass;
- not to keep indoor plants;
- not to have seals, dogs, fish, birds and other animals.
We draw the attention of readers our website that people with allergies are not suitable household work in dusty and damp areas, the work associated with the care of animals.
Those who are allergic to dander horse contraindicated introduction of products manufactured on the basis of horse serum.
Specific immunotherapy - SIT.
It's quite popular and effective methodtreatment of allergic rhinitis, but it is suitable, unfortunately, not all patients. Sessions SIT conducts allergist and the essence of this method of treatment is as follows: in the patient's body gradually introduce small doses of allergen substances. At the same time people like to "get used" to the provoking agent, and shaped the response of the immune system, blocking the allergic process.
Perhaps SIT and shows you if:
- you can not limit the contact with the allergen;
- exactly proved the role of a specific allergen in rhinitis development;
- pathological reaction caused by the limited (no more than 3) the number of allergens;
- the disease is in an inactive phase - the phase of remission;
- your age is in the range from 5 to 50;
- the effect of the drug treatment is not available or it is insignificant.
SIT - a rather dangerous procedure, because it can cause choking (angioedema), so the question of its necessity and admissibility is decided individually.
Drugs - basic (and well-known) way to treat allergic rhinitis. What are the main groups of drugs used by doctors today:
- Histamine blockers. Now mainly used in the H1-blockers secondgeneration, as they provide long-lasting effect and does not cause sleepiness: Claritin (loratadine), Tsetrin, Zyrtec (cetirizine), Tavegil (Clemastine). These drugs do not affect the cause of the disease, but to effectively relieve swelling, redness, itching, and other painful symptoms.
- Local decongestants - In other words, nose drops. The pharmaceutical industry offers a huge selection of different tools in this group, but most of the drugs manufactured on the basis of one of the four substances: nafazolina, oxymetazoline, xylometazoline and phenylephrine. The latter is considered the safest and most often used in pediatric practice.
Local decongestants help to cope with nasal congestion and profuse watery discharge.
Just remember that for a long period (more than 4-5 days) application of drops can cause drug dependence!
Of course, no one proposes to use all 5 groups of drugs at the same time. There are approximately regimens allergic rhinitis, depending on its severity:
- mild severity of disease: Inside designate histamine blockers, locally - vasoconstrictor drops and Cromones. When treatment failure Cromones replaced by local corticosteroids;
- the average severity of allergic rhinitis. Therapy has to begin steroid sprays parallel with vasoconstrictor and histamine blockers, if necessary;
- and finally, in severe disease in the treatment regimen may be added to systemic corticosteroids in the minimum dosage and short courses.
If the patient has irreversible changes of the nasal mucosa, nasal turbinate hypertrophy, cysts, polyps and other abnormalities, surgical treatments are applied.