Allergic Rhinitis

Rhinitis is characterized by inflammation of the mucosal soft tissue with clinical symptoms of nasal discharge, blocked nose and itch-triggered sneeze occurring for more than one hour on most days. It is a common ailment (about 40% of the population) which may significantly interfere in the patient’s quality of life, by causing fatigue, headache and cognitive impairment. In general 85% of rhinitis sufferers have sleep disturbance, are physically limited, have reduced concentration at work and show significant changes to social life. In the majority the treatment of rhinitis requires effective management of coexisting or complicating respiratory conditions, such as asthma. Sinusitis and chronic otitis media are other complicating conditions.


Causes

Rhinitis may be caused by allergic or non-allergic factors but some individuals may suffer from both types. Allergic rhinitis is always associated with elevated levels of IgE antibody. Allergy is the major cause (80%) of rhinitis in childhood and the middle-aged sufferers but in older individuals about half are allergic rhinitis and the rest being non-allergic disorders. Risk factors for allergic rhinitis include: (1) family history of allergy, (2) serum IgE levels greater than 100 kU/L in adults and 10 to 100 kU/L in children, (3) high exposure to indoor allergens such as, dust mites, pet dander (cat, dog, hamster, rabbit), pollens, pest mammalian-epithelium (rats), insect pests (cockroach), mould spores, and (4) positive reaction noted clinically or by CAP RAST blood tests, to specific allergen in foods and aeroallergens. Allergic rhinitis tends to be persistent and chronic in Malaysia. The most important allergens associated with allergic rhinitis include house dust mites (85%), cockroach (66%), cat or dog dander (30%), pollens (e.g. oil palm, Acacia) (25%), mould spores (20%) and foods (22%). The foods most important in children are egg white, milk, shrimp and banana but in adults it may be shrimps and garlic.

Prevention

Mold spores are everywhere. You can reduce your exposure to mold by following these steps:
• Keep rooms dry, and use a dehumidifier, if necessary.
• Throw out moldy or mildewed articles (such as books, toys, and shoes).
• Use synthetic fabrics for clothing and household furnishings whenever possible. Disinfect bathrooms, basement walls, and furniture with diluted bleach or other disinfectant solutions.

You can take several steps to limit exposure to dust mites.
• Wrap mattresses, box springs, and pillows with mite-proof covers.
• Wash bedding and pillows once a week in hot water (60° C).
• If you can, get rid of upholstered furniture. Try to use wooden, leather, or vinyl.
• Keep indoor air dry. Try to keep the humidity level lower than 50%.
• Wipe dust with a damp cloth and vacuum once a week. Use a vacuum cleaner with a HEPA filter.
• Replace wall-to-wall carpet with wood or other hard flooring.
• Keep stuffed toys off the beds, and wash them weekly.
• Replace slatted blinds and cloth draperies with pull-down shades. They will not collect as much dust.
• Keep closets clean, and keep closet doors closed.

People who are allergic to animals may need to avoid keeping pets. If not, keep pets outside, if possible. If pets are allowed indoors, keep them out of bedrooms, off upholstered furniture, and off carpets. Frequent bathing and grooming of the pet (preferably by someone who is not allergic to the animal) may help.

Allergy to animals may also include wool, which may contain tiny amounts of dander (skin).