Rhinitis has a significant impact on quality of life for 50% of people with the condition.
There are several conditions that can be associated with rhinitis that are very important to consider, says Dr Jessica Tattersall, an allergist and medical rhinologist at the Sydney Allergy Clinic.
“With rhinitis, the nose is just the tip of the iceberg,” says Dr Tattersall.
Adults with allergic rhinitis may present to a GP clinic roughly four or five times a year when they have acute infective rhinosinusitis with the typical symptoms of discharge and pressure build up, she says.
“What they’re not coming to you for is the periods in between this when they’re going through packets of anti-histamines to control their allergic disease,” she says.
“So, these patients have what I like to call ‘bad plumbing’. Their nose isn’t working very functionally, they get a secondary insult like a viral infection and the plumbing backs up and they’re left with their symptoms of acute pain and pressure and discharge.”
“In kids, they can get hypertrophy of their tonsils and adenoids, as well as many ENT infections, including in the middle ear. Obviously, ocular symptoms can be quite troublesome.”
This is an excerpt from a lecture that Dr Tattersall will deliver at the upcoming 16 August webcast; click here to register.
Disordered breathing during sleep, including snoring and obstructive sleep apnoea, is also common in this group of patients with allergic rhinitis.
These conditions in turn can cause dental malocclusions and hypo-growth of the maxillary bone, she says.
“Due to the sleep disordered breathing, they do present often from their dentist with a high arch palate requiring to spreading of their teeth due to this ongoing mouth breathing that they’ve had overnight,” says Dr Tattersall.
“This is very important to pick up, as well as the cognitive issues that are associated with chronic allergic rhinitis.
“There’s loss of function both with work and schooling, concentration, poor sleep, and fatigue. And this obviously can generally have a great impact on their quality of life.”
For “persistent and mild”, “intermittent and moderate-severe” and “persistent and moderate-severe” rhinitis, ASCIA recommends combination treatments (intranasal corticosteroid and antihistamine sprays). Dymista and Ryaltris are the two products available on the market for people aged over 12 years.
This is an excerpt from a lecture that Dr Tattersall will deliver at the upcoming 16 August webcast; click here to register.
