Q (Nov 21) Both my children have runny noses in the morning and blocked noses at night. I took them to a GP and was told that they both have allergic rhinitis. The GP said that I had to cope with it by keeping the house clean and changing their bed sheets every day.
I have tried to keep my home clean and dust-free but it seems impossible as there is always so much dust in the air. I want to avoid giving them long-term medication as I am afraid of side effects like retarded growth. My husband and I have sensitive noses too.
Will air purifiers or supplements help? Is it true that people with sensitive noses also have sensitive eyes, lower immunity to diseases and are generally prone to skin and food allergies?
A Allergic rhinitis is an inflammation of the membranes lining the nose. It is a result of an immune response to certain allergens such as dust mites, moulds, animal dander (shed skin) and pollen.
One or more of the following symptoms may be present: sneezing, nasal congestion, itching or rhinorrhoea ('runny nose'). The eyes, ears, sinuses and throat can also be affected. The tendency to develop these allergic symptoms has a genetic component, and often there may be other family members with similar symptoms.
As many patients with allergic rhinitis have house dust mite sensitivity, controlling the environment will help improve symptoms.
Measures include the weekly washing of bed linen like sheets and pillow cases at a temperature of 60???C or more. This is necessary to kill the dust mites.
It is also advisable to remove soft toys from the bed, as these trap house dust mites. And prolonged exposure to them while sleeping will worsen symptoms.
There are house dust mite-proof covers on the market. Air purifiers are often not helpful, as only those with HEPA (High Efficiency Particulate Air) filters can remove the extremely small and light dust mite particles.
Children with allergic rhinitis often benefit from medications such as oral antihistamines and nasal corticosteroids to control symptoms and improve their quality of life.
These medications have few side effects - as nasal corticosteroids act locally, the risk of growth retardation is minimal. For selected patients with severe, persistent allergic rhinitis despite medication and environmental control, immunotherapy may be considered.
While there has been a great deal of interest in the role of probiotics in reducing allergic disease, more research needs to be done and, to date, there are no health supplements that have been proven to effectively improve allergic rhinitis.
While it is not true that patients with allergic rhinitis have lower immunity, many often have other associated allergic diseases such as allergic conjunctivitis ('sensitive eyes'), eczema, asthma and environmental or food allergies.
Skin prick testing can screen for common environmental and food allergies. It is important to treat allergic rhinitis as it may be a risk factor for asthma.
DR WONG MUN YEE, REGISTRAR, DEPARTMENT OFGENERAL AND AMBULATORY PAEDIATRICS SERVICE, KK WOMEN'S AND CHILDREN'S HOSPITAL
