RHINITISDr

muaid I . AzizFIMCS

Rhinitis or Rhinosinusitis Definition: its an inflammation of the lining of

the nose characterized by two or more of the following symptoms

nasal obstruction Facial pain Rhinorrhoea sneezing hyposmia or anosmia nasal congestion itching headache

Rhinosinusitis

allergic infectious other

Allergic Rhinitis

Definition:Clinically defined by a combination of 2 or more

of nasal symptoms Running Blocking Itching sneezing

pathogenesis

Ig E ( TYPE 1 HSR)

Risk factors

Genetics & family hx . Environment Co – morbidities ( asthma , sinusitis ,

om ,sleep disorders, LRTI) Patients with persistent AR should be

evaluated for asthma , the converse is also true

How you classify allergic rhinitis?

persistant

Allergic Rhinitis

Intermittant

Classification of allergic rhinitis Intermittent Allergy The allergy appears at certain times of year when the

pollens are carried by the wind. Examples are: tree pollen in the spring grass pollen in early to mid summer weed pollen and mold spores in autumn Persistent Allergy Perennial or “all year round” allergens give persistent

symptoms that are similar to the seasonal variety or hay fever but they are there all the time. The most important allergens are the house dust mite and animal dander . Perennial allergy can also be worse in the hay fever season if the person is also sensitive to pollen.

Clinical presentation

Seasonal ( intermittent ) Sneezing rhinorroea Itching Perennial ( continous) Nasal obstruction Poor sense of smell Chronic inflammatory rhinosinusitis

Diagnosis

History Examination investigation

HISTORY

Presenting sx. , sx of co-morbidities , general medical , past ,family , ocupational , enviromental , dietry &drug hx.

As rhinorrhoea & conjunctivitis ( seasonal) While nasal obstruction is more common in (perennial rhinitis)

Frequency, severity, duration , persistance or intermittent, affecting quality of life or not

Examination

Normal mucosa Swollen oedematous

pale or bluish color

investigation

Allergy diagnosis 1. skin prick test (SPT)

How you can control allergic rhinitis?

avoidance diet

Medical therapy

immunotherapy

Control of allergic rhinitis

Allergen avoidanc

e

Outdoor

triggers

Indoor trigger

s

Indoor allergens

Dust mites

Animal dander

Cockroach

Mold

Dust mite

Mold

dust & dust mites

Dusting

Washing w hot water

Animal dander& other pet allergens

By restricte

d location

Get arid of it

molds

Cleaning bath tube

showers

Measures to control indoor allergens

Outdoor triggers

MoldPollen

pollen

Avoid pollen

Stay inside Closed windows & doors Avoid fan w open window Avoid bringing pollen back into your

home

Avoid mold

Avoid going outside on rainy or windy days

Avoid activity as gardening Remove excess leaves from surrounding Keep rain gutters & drains clear of leaves Anti mold for car air conditioner.

Natural allergy relieve

Antihistamines OR Decongestants

Steroids Leukotrienes modifiers

Natural allergy relieve: saline nasal spray

How to prepare it ? When to use it ? How to use it ? How its effect or help allergy relieve?

How to prepare it ?

Mix 2-3 tsp of non iodized salt + 500 cc H2O + one tsp of packing soda.

When to use it?

Exposed to pollen outdoors ( at the end of the day)

For moisturing in dry nose in winter Pre steroid application

How to use it?

Neti pot Syringe Cupped hands

How to effect?

Remove the pollens Thining the mucous & relieve the

obstruction Keeping cilia healthy.

Antihistamines

For relieving running ,itching ,& sneezing. Little effect on nasal obstruction Non sedative (2nd generation)

Topical steroids

Reduce inflammation , nasal sx. , Eye sx , improve sense of smell

Systemic steroids

For unblock of the nose at the start of treatment or for very sever sx ,

thanks