What Is Perennial Allergic Rhinitis?

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Perennial allergic rhinitis is a chronic allergic condition that doesn't subside throughout the year and causes nasal congestion and a runny nose. You may feel like you have a permanent cold that won't go away. Dust mites are the most common cause of perennial allergic rhinitis but it can be caused by any allergy that is present year round. The other most common causes are cats and dogs.

Prevalence

The actual prevalence of perennial allergic rhinitis may be understated, as this condition can often be undiagnosed. In childhood, boys are more likely than girls to experience perennial allergic rhinitis, however, in adulthood, differences by gender tend to disappear. While the prevalence varies depending on the study some research shows it could be quite high (up to 23 percent of the population).

You may also find that you have other disorders if you suffer from perennial allergic rhinitis. Asthma is one of the most common problems that you may experience. These other conditions may often co-exist with perennial allergic rhinitis:

If left undiagnosed or untreated perennial allergic rhinitis can lead to other conditions such as chronic sinusitis, deviated septum, or abnormal growths such as polyps in the nasal cavities or sinuses.

Symptoms

Nasal inflammation is the hallmark symptom of perennial allergic rhinitis. You may have some or a combination of the following symptoms:

  • nasal obstruction or stuffiness
  • itching
  • runny nose
  • congestion

In order to truly be considered perennial allergic rhinitis these symptoms must be present for an hour or more each day for most of a 12-month period. If your condition has progressed to sinusitis or the growth of abnormal tissue you may also experience the following symptoms:

  • headaches
  • facial pain or fullness
  • fatigue
  • bad breath
  • toothaches
  • your runny nose may be foul smelling or an abnormal color
  • postnasal drip
  • decreased sense of smell

Diagnosis

Perennial allergic rhinitis can be diagnosed by a primary care physician but may be best diagnosed by a doctor who specializes in disorders of the ear, nose, and throat (an otolaryngologist). Your doctor will talk to you about your medical history and ask you about the symptoms you are experiencing. You may also be questioned about things that you think might trigger your symptoms, as well as your family's medical history.

This may be followed by a physical exam, specifically, your ears, nose, and throat will be examined for conditions such as deviated septum or fluid in the ears. If, after your history and physical, your doctor suspects perennial allergic rhinitis some of the following diagnostic tests may be ordered:

  • blood or skin testing to diagnose specific allergies
  • CT or MRI scans to look for chronic sinusitis, nasal polyps, etc...

Treatment

Several treatment options exist for the management of perennial allergic rhinitis. If a specific allergy has been identified, avoiding the substance you are allergic to may be helpful in managing your symptoms. You may want to work on decreasing the prevalence of allergens in your home. To do this, you may want to try:

  • adding a dehumidifier (if you are allergic to dust mites)
  • get rid of pets or limit their access to bedrooms
  • regular cleaning
  • occasional deep cleaning with carpet cleaning, steam cleaning, or dry cleaning or better yet replace carpet with another type of flooring

If you are unable to eliminate allergens from your home or environment, medications or immunotherapy may be options for treating allergies. Medications commonly used for controlling allergy symptoms include the following antihistamines:

  • diphenhydramine
  • cetirizine hydrochloride
  • loratadine
  • fexofenadine

While these medications are available over-the-counter they should only be used under the direction of your doctor. Make sure your doctor or pharmacist knows all medications you are taking to avoid interactions and inform them of any medication allergies you might have. Older antihistamines such as diphenhydramine are known to cause drowsiness.

Immunotherapy, or allergy shots, may be an option for some people with perennial allergic rhinitis. Immunotherapy is a long-term treatment option that involves giving you small amounts of the substance you are allergic to and gradually increasing the amount you are given over time. This can change your body's immune response to that substance. It is not available for all types of allergies and can be a time-consuming process since at least the first dose, and commonly subsequent doses, need to be given under medical supervision.

Allergy shots are generally not used in children under the age of 5. Your response to allergy shots may vary and could range from a complete cure of your symptoms to no response at all. In general, studies show this treatment to be beneficial and cost-effective.

In addition to antihistamines for controlling your allergies, other medications may be used to control symptoms. Many of these medications are available over-the-counter and may include decongestants and nasal sprays.

Intranasal steroids are often used in addition to antihistamines. Steroid nasal sprays, including oxymetazoline, can be associated with a condition called rebound congestion (also referred to as nasal spray addiction) when used longer than three days. Some prescription nasal sprays are less likely to cause rebound congestion. It is a good idea to talk to your doctor about rebound congestion and your options for nasal decongestants.

Nasal irrigation using a neti pot may be helpful in controlling nasal symptoms including congestion. A humidifier may also be beneficial in helping with congestion, however, if you are allergic to dust mites you should be aware that high humidity levels can increase the number of dust mites in your environment.

If your condition has progressed to chronic sinusitis or if you have structural abnormalities such as deviated septum or nasal polyps additional treatments may be necessary. While antibiotics are sometimes used to treat chronic sinusitis this condition often requires surgery. This is especially true if you have a deviated septum, enlarged turbinates, or nasal polyps. Nasal sinus surgery is common in the United States and is usually done endoscopically in a same day surgery setting.

A Word From Verywell

Perennial allergic rhinitis is a chronic condition that left untreated may cause a variety of side effects. The first step in your treatment should be to try and eliminate the allergens from your home. If you are still unsuccessful in having a resolution from your allergies, then the treatments described above may be very helpful in reducing your symptoms.

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