Allergic Rhinitis is a disorder which ischaracterized by sneezing; rhinorrhea; obstruction of the nasal passages; conjunctiva,nasal, and pharyngeal itching; and lacrimation, all occurring in a temporal relationship to allergen exposure. Perennial allergic rhinitisoccurs in response to allergens that are present throughout the year such as housedust (containing dust mite antigens) and animal dander.2 It may be seasonal or perennial.1
Aetiology
Allergic Rhinitis is due to an immediate hypersensitivity reaction in the nasal mucosa. The antigens concerned in the seasonal form of the allergic rhinitis disorder are pollens from grasses, flowers, weeds or trees. Grass pollen is responsible for hay fever (pollenosis), this disorder is at its peak between May and July.1
Perennial allergic rhinitis may be a specific reaction to antigens derived from house dust, fungal spores or animal dander but similar symptoms can be caused by physical orchemical irritants, for example, pungent odors or fumes including strong perfumes, cold air and dry atmospheres. The term vasomotor rhinitis is often used for this type of nasal problem because in this context the term ‘allergic’ is a misnomer.1
Clinical Features
In the seasonal type there are frequent sudden attacks of sneezing with profuse watery nasal discharge and nasal obstruction. These attacks last for a few hours and are often accompanied by smarting and watering of the eyes and conjunctiva injection. In the perennial variety the symptoms are similar but more continuous and generally less severe. Skin hypersensitivity tests with the relevant antigen are usually positive in seasonal allergic rhinitis and are thus of diagnostic value; but these tests are less useful in perennial rhinitis.1
Deposition of pollens and other allergens on nasal mucosa of sensitized individualsresults in IgE-dependent triggering of mast cells with subsequent release of mediatorsthat cause development of mucosal hyperemia, swelling, and fluid transudation.2
Diagnosis
Accurate history of symptoms correlated with time of seasonal pollination of plantsin a given location; special attention must be paid to other potentially sensitizing antigenssuch as materials associated with pets, e.g., dander.2
- Physical examination: nasal mucosa may be boggy or erythematous; nasal polypsmay be present; conjunctivae may be inflamed or edematous; manifestations ofother allergic conditions (e.g., asthma, eczema) may be present.
- Skin tests to inhalant and/or food antigens.
- Nasal smear may reveal large numbers of eosinophils; presence of neutrophils maysuggest infection.
- Total and specific serumIgE (as assessed by immunoassay) may be elevated.2
Risk factors for Allergic Rhinitis
- History of allergies
- Having asthma
- Atopic eczema
- Cigarette smoke
- Cold temperatures
- Humidity
- Wind
- Air pollution
- Perfumes
- Wood smoke
- Fumes
Bad effects or complications due to Allergic Rhinitis: Some complications that can arise from hay fever include
- Sleeplessness due to allergy symptoms
- Development or worsening of asthma symptoms
- Frequent ear infections
- Sinusitis or frequent sinus infections
- Absences from school or work because of reduced productivity
- Frequent headaches
- Complications can also arise from antihistamine side effects. Most commonly, drowsiness can occur. Other side effects include headache, anxiety, and insomnia. In rare cases, antihistamines can cause gastrointestinal, urinary, and circulatory effects.
Tips to prevent Allergic Rhinitis:
- Stay indoors when pollen counts are high
- Avoid exercising outdoors early in the morning
- Take showers immediately after being outside
- Keep your windows and doors shut as frequently as possible during allergy season
- Keep your mouth and nose covered while performing yard work
- Try not to rake leaves or mow the lawn
- Bathe your dog at least twice per week to minimize dander
- Remove carpeting from your bedroom if you’re concerned about dust mites
Homeopathic Management of Allergic Rhinitis:
Acute rhinitis can be treated by Homeopathy but the acute episodes as well as chronic tendency fall under the scope of Homeopathy. For acute attacks there are various remedies which can be prescribed based on symptoms of the case. Some examples are given below. For complete treatment of chronic or recurrent Allergic Rhinitisone must see a homeopathic practitioner. A homeopath in such a case will prescribe a holistic remedy covering the physical symptoms and emotional attributes of patient so as find the remedy based on totality which will boost immunity and reduce or remove the tendency to allergic rhinitis.
Some acute remedies are given below but shall be taken in consultation with a homeopathic practitioner.
Aconitum Napellus
Coryza caused by cold, dry winds; dry at first with violent headache, roaring in ears, fever, thirst, sleeplessness; heat and sense of fullness in nares, and muscles sore all over body so that sneezing forces him to support chest; fluent coryza with frequent sneezing and dropping of a clear, hot water; inner nose red, swollen, interfering with breathing, amel. In cool room and open air.
Ammonium Carbonicum
Cold commences in head, nose stopped up at night, can only breathe with mouth open (with mouth shut, awakes as if smothering); followed by profuse discharge of sharp burning water in daytime, which is apt to run down in throat; frequent sneezing with epistaxis, when blowing nose; aggr. Towards morning, 3 A. M.; dry and tickling cough with much oppression of mucus in chest and rawness down trachea and bifurcation of bronchi; sensitive to cold air, amel. In warm room.
AntimoniumTartaricum
Stoppage of nose, alternating with fluent coryza, sneezing; fluent coryza and chilliness, with loss of taste and smell; epistaxis, followed by fluent coryza, with sneezing.
Argentum Nitricum
Pain and swelling of right ala; left nasal bones painful, bleeding pimples on septum; violent itching in nose, compelling rubbing till it looked raw; ulcers in nose, with yellow scabs; scurf’s in nose exceedingly painful, bleeding if detached; bloody and purulent discharge in open air, stopped in-doors, and at night smell of pus; catarrh with constant chilliness.
Arsenicum Album
Fluent coryza, with frequent sneezing without relief; hoarseness and sleeplessness, with swollen nose; stoppage of the nose, with copious discharge of watery mucus and burning in the nose, with soreness of the adjacent parts; buzzing in the ears; headache, with beating in the forehead and nausea; relief by warmth; prostration, sneezing in cool air, after leaving a warm room; generally aggr. -from cold, except headache, which is temporarily relieved by cold washing andpermanently by walking in cold air.
ArumTriphyllum
Nostrils raw and bloody, the left discharges c-continuously; discharge of burning, chorus fluid from nose, excoriating nostrils, upper lip and corners of mouth; nose stuffed, can only breathe with mouth open, bores and picks in nose, aggr. Mornings; sneezing, aggr. at night; can hardly talk on account of phlegm in back part of throat. Snuffles of babes.
Belladonna
Smell acute, at other times dull; smell as of herring-brine or sour beer; frequent sneezing when dry, with tickling, especially in left nostril; one side of nose stopped up; suppressed catarrh with maddening headache.
Bryonia Alba
Severe dry coryza with catarrh of the frontal and maxillary cavities and severe drawing-tearing, twitching and stitching pains in affected parts; or fluent coryza, beginning with violent and frequent sneezing, accompanied by stitching headache when stooping, hoarseness and altered tone of voice; profuse nosebleed, catarrh extending to chest.
Calcarea Phosphoric
Fluent coryza in a cold room; stopped in warm air and out-doors.
Camphora Officinalis
Fluent coryza on sudden change of weather; violent stitching or crawling, from the root of the nose almost to the tip; stopped coryza;
Allium Cepa
Acrid watery discharge from the nose, it drops from the tip of the nose; the tears mild; cough increases in the evening, sometimes with a pain in the larynx as if it would be torn; cold after damp northeasterly winds; cold begins mostly on left side and goes to the right; catarrh, with epiphora and smarting of the eyes, with violent sneezing; he must take a long breath and then sneeze accordingly; spring coryza; tingling and itching in right nostril, with burning acrid discharge; aggravation evenings and in a warm room; feels better in fresh air; violent, laryngeal cough; temporarily relieved by eating apples.
Cimicifuga Racemosa
Dry coryza, with stinging sensation in the evening; fluent coryza of whitish mucus, during the day; abundant watery coryza with sneezing and aching pains in the head and eyeballs; great sensitiveness to cold air, as if every inhalation brought the cold air in contact with the brain. Severe pains in the face, with general lassitude.
Dulcamara
Dry coryza, aggr. During rest and in cold air; amel. during motion, renewed by the least exposure, skin hot and dry, limbs cold, stiff, numb and painful; offensive sweat; discharge suppressed from least contact with cold, damp air, or from changes from hot to cold weather; rough and hoarse voice.
Kalium Bichromicum
Catarrh of fauces and trachea; great accumulation of ropy mucus and expectoration of solid chunks from posterior nares; hoarseness; cough; suppressed voice; burning of the mucous membrane, extending up into the nostrils; enlarged tonsils causing dullness of hearing; ulceration in pharynx and larynx; oppressed breathing; coryza, with pressure and tightness at root of nose, aggr. Evenings and in the open air, amel. in warm weather; in the morning, obstruction and bleeding from right nostril; fluent coryza, excoriating nose and lip; nostrils sensitive and ulcerated, round ulcer or scabs on septum, foul tongue, showing involvement of digestive tract; catarrh alternating with rheumatism.
Euphrasia Officinalis
Burning coryza; increasing in the evening, with flow of tears and cough; the discharge of the nose mild, the tears acrid, and the cough worse during the day (opposite to Cepa) after windy weather; profuse bland coryza, with scalding tears and aversion to light; aggr. at night while lying down.
Fagopyrum Esculentum
Each exposure is sure to increase the cold, with formation of dry crusts and granular-like appearance of the posterior nares, with intolerable itching; nose hot, swollen inside and outside, stinging and gnawing.
Gelsemium Sempervirens
Catarrh from warm, moist, relaxing weather, with excoriating discharge from the nose, making the nostrils and wings of nose raw and sore; frequent sneezing and sore throat, tonsils red and somewhat tumefied; difficulty of swallowing from paretic state of the muscles; great prostration; violent morning paroxysms of sneezing; fullness at root of nose, pains extending to neck and clavicles; difficulty swallowing, with pain shooting up into ear; coryza and neuralgia in spring and summer weather; fever, but very little thirst; chilliness, especially up and down the back.
Hepar Sulphur
Every breath of cold air causes a new attack of catarrh or headache, or when it remains confined to one nostril and headache gets worse by motion; nose swollen and sore to touch, especially inside of alae or wings of nose; sensation when swallowing as of something sticking in throat.
Kalium Bichromicum
Catarrh of fauces and trachea; great accumulation of ropy mucus and expectoration of solid chunks from posterior nares; hoarseness; cough; suppressed voice; burning of the mucous membrane, extending up into the nostrils; enlarged tonsils causing dullness of hearing; ulceration in pharynx and larynx; oppressed breathing; coryza, with pressure and tightness at root of nose, aggr. Evenings and in the open air, amel. in warm weather; in the morning, obstruction and bleeding from right nostril; fluent coryza, excoriating nose and lip; nostrils sensitive and ulcerated, round ulcer or scabs on septum, foul tongue, showing involvement of digestive tract; catarrh alternating with rheumatism.
Kalium Carbonicum
Dull smell, especially from catarrh; fluent coryza, excessive sneezing, pain in back, headache and lassitude; dry coryza, with loss of voice; hoarseness; mucus or sensation of a lump in throat; obstruction in the nose, making breathing through the nostrils impossible; goes off when walking in the open air, but returns in the room; burning itching in the nose; nosebleed; aggr. at every exposure to fresh air.
Lycopodium Clavatum
Catarrh of nose and frontal sinuses; discharge yellow and thick; frontal headache; yellow complexion; violent coryza; nose swollen; discharge acrid, excoriating; posterior nares dry; nose stopped up at the root; breathes with open mouth and protruding tongue, especially at night; burning headache when shutting eyes.
Mercurius Solubilis
Ordinary catarrh, whether epidemic or not; frequent sneezing, copious discharge of watery saliva; swelling, redness and rough, scraping soreness of the nose, with itching and pain in the nasal bones on pressing upon them; foetid smell of the nasal mucus; painful heaviness of the forehead; night-sweats, chills and feverish heat; great thirst; pains in the limbs, aggravated by warmth or cold, by dampness.
Natrium Carbonicum
Violent sneezing, profuse discharge of rather thin white mucus, aggr. From least exposure to air or when removing an article of clothing; loss of smell and taste; nose stopped up at night; aggr. on alternate days; amel. After sweat (Merc. aggr. after sweat); removes disposition to catch cold.
Natrium Muriaticum
Catarrh of frontal sinuses with neuralgic pains, involving the sinus and eye, often extending down to the cheek-bone, with puffiness of the eye, aggr. when moving the eye, especially when looking downward; squirming in right nostril as of a small worm; sneezing worse when undressing at night or when rising in the morning (Rum.); loss of smell and taste; great liability to catch cold; discharge of clear mucus alternating with stoppage of nose, with hoarseness and tickling cough; nose sore and interior of it swollen; fever-blisters.
Nux Vomica
During the first stage, dryness and obstruction of the nose, with heaviness in the forehead and impatient mood; catarrh fluent in the morning and dry in the evening and at night, with dryness of the mouth without much thirst; aggr. in warm air, amel. in cold air; sneezing early in bed; scraping in nose and throat; chills and heat alternate in the evening, with great heat of the face and head; acrid discharge from the obstructed nose; stoppage of the nose, particularly out-doors, but fluent indoors; aggr. From exposure to dry, cold air, sitting on cold stones, etc.
Phosphorus
Coryza fluent; dullness of head; sleepiness, especially during the day and after meals; blowing blood from the nose; alternating fluent and dry, with frequent sneezing; dry, forming crusts, adhering firmly; profuse discharge, flowing down into faucets; neck swollen; eyes staring; cold begins in chest and runs up nose (Ars., nose first, runs down chest).
Pulsatilla Pratensis
Coryza, fluid or dry, loss of taste and smell, nostrils sore, wings raw; later yellow-green discharge, aggr. In-doors; chilliness, face pale, head confused, frontal headache; chronic, thick, yellow, bland discharge or later yellow, green and offensive.
Rumex Crispus
Dull headache, worse by motion; sore feeling in eyes, without any external sign of inflammation; fluent coryza, with painful irritation in nostrils and sneezing; epistaxis; violent and rapid sneezing; feeling of dryness in posterior nares; cough excited by tickling in throat-pit and worse by least current of air; hoarseness.
Sabadilla
Hay fever; coryza, with severe frontal pains and redness of eyelids, violent sneezing, and copious watery discharge from nose and eyes.
Salicylicum Acidum
Incipient catarrh; the patients, especially children, sneeze the whole day.
Sambucus Nigra
Suitable to infants; nose obstructed by a tenacious, thick mucus, with sudden starting from sleep, as if suffocating; snuffles of children; nose seems perfectly obstructed; dryness of throat and mouth, with thirstlessness.
Sanguinaria Canadensis
Coryza, particularly of right nostril, accompanied by much sneezing, with dull, heavy pains over root of nose and stinging sensation in nose; copious, acrid, burning, watery discharge from nose, causing an indescribable rawness of the Schneider an membrane, with loss of sense of smell; conjunctiva often similarly affected; hay fever and subsequent asthma, sick and faint from perfume of flowers; polypi.
Silicea Terra
Alternately dry and fluent coryza; with every fresh cold stoppage and acrid discharge from nose; frequent but ineffectual sneezing; makes inner nose sore and bloody; dryness of throat, rough cough, itching in Eustachian tube; dryness and stoppage after checked foot-sweat; nose obstructed mornings, fluent during day; loss of smell and taste; frequent sneezing, especially in cold air; frequent chilliness, even while taking exercise; cold nose.
Squilla Maritima
Nasal discharge fluent and corrosive; absence of sweat; internal chilliness with external heat, or intense heat followed by chilliness as soon as patient uncovers; painful stitches in different parts of chest; loose morning cough more fatiguing than dry evening cough.
Sticta Pulmonaria
Premonitory symptoms of catarrh; excessive dryness of the nasal mucous membrane, which becomes painful; secretions dry rapidly, forming scabs difficult to dislodge; deglutition painful, from dryness in the throat, aggravated at night; incessant sneezing, burning in the eyes; dull frontal headache, with feeling of fullness at the root of nose; hard, dry, barking cough.
Sulphur
Profuse catarrhal discharge of burning water; fluent burning coryza out-doors; nose stopped up in-doors; frequent sneezing; discharge of blood from the nose on blowing it; loss of smell; soreness and ulceration of nostrils.
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References
- Ralston S.H., Penman I.D., Strachan M.W.J., Hobson R.P. Davidson’s, Principles and Practice of Medicine. 23rdrev.ed. Edinburgh; Churchill Livingstone/Elsevier; 2018. 1417p.
- Kasper D.L., Fauci A.S., Hauser S.L., Longo D.L.,Jameson J.L., Loscalzo J. Harrison’s Manual of Medicine. 19th rev. ed.United States: McGraw Hill; 2016. 1222p.
- Lilienthal, S. Homoeopathic therapeutics. Philadelphia: Boericke & Tafel; 1907
- Boericke W. New Manual of Homœopathic Materia Medica and Repertory. 9thReprinted Edition. New Delhi: B Jain Publishers (P) Ltd; 2005.