Allergic Rhinitis :: Nationwide Children's Hospital

Allergic Rhinitis

What is allergic rhinitis?

Allergic rhinitis is a common condition caused by an abnormal reaction of the body’s immune system response to various particles (allergens) in the environment. In this condition, the nasal lining can become inflamed and swollen from the over-response of the body. The lining of the nose often over-secretes excessive amounts of mucus when exposed to allergens. This condition can be worse in some seasons or can be present throughout the entire year. Common examples of allergens for children include dust, grasses, pollens, mold, trees, and dog and cat dander. Children with allergic rhinitis also may have conditions like asthma or eczema of the skin. It is common for allergic rhinitis to be passed from parents to their children.

What are the symptoms of allergic rhinitis?

Allergic rhinitis typically presents as difficulty breathing through the nose (nasal congestion/obstruction), as well as mucus drainage from the front of the nose or down the back of the throat (post-nasal drip). Postnasal drip can occur during the day and at night, and can contribute to frequent coughing in children. Allergies also can cause itchy, watery eyes and increased mucus secretion from the eyes.

What should I expect after a referral?

Your child may be referred to an allergist, a medical professional specializing in the diagnosis and management of allergies and allergic rhinitis. The allergist may perform an allergy test on your child to determine what exactly he or she is allergic to. This is often done during a standard appointment, and can be used to determine the best treatment for your child.

What treatment options are available for allergic rhinitis?

Allergy testing can help to determine which allergens cause the most problems. Treatment of allergic rhinitis primarily involves avoiding exposure to the things that cause symptoms. Your child’s doctor can discuss avoidance measures with you depending on the things your child is allergic to.

Medical treatments for allergic rhinitis include a trial of a medicated nasal spray. These sprays help to decrease the inflammation of the nasal lining by acting locally in the nose. This means that almost all of the steroid spray works only in the nose and little gets into the body. This type of medication needs to be used every day and can take up to one month of chronic daily usage to notice a difference in nasal breathing, nasal congestion or obstruction.

Allergies also may be treated with oral anti-histamine medications. Antihistamines usually work very quickly compared to nasal steroid sprays. Most children notice an improvement in runny nose and nasal congestion within 30-60 minutes of taking these medications. Your child’s doctor may recommend other types of medications for treatment as well.

Allergy shots, or immunotherapy, also may be recommended for your child depending on results of an allergy test. If successful, the allergy shots may allow your child to stop taking allergy medications.

There is no surgical cure for allergic rhinitis. However, there might be surgical options to help improve airflow through the nose. Surgery is typically not offered to children with seasonal allergies and nasal congestion/obstruction unless the child has first tried using allergy medications. Should your child have persistent nasal obstruction/congestion despite being on allergy medications, your child’s ENT surgeon may recommend surgical treatments, such as adenoidectomy, inferior turbinate reduction, sinus surgery or other procedures.

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