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Things To Note When Managing Allergic Rhinitis

Did you know that allergic rhinitis affects up to 50 percent of children in Singapore aged four to 17 years old? Its symptoms are similar to the common cold, but unlike the latter, it is usually chronic and will persist as long as the allergen is present. Allergens like house dust mites, cigarette smoke and the haze can cause the mucous lining of the nose to be inflamed.

In our interview with him, Dr. Leong Jern-Lin, Consultant Ear Nose and Throat Surgeon at ASCENT Ear Nose Throat Specialist Group revealed that in Asia, the prevalence of allergic rhinitis was found to have increased from 5% to 45%[1]. Specifically in Singapore, 71% of all rhinitis patients visited a primary care physician, and it is one of the top 10 reasons for a visit to primary care clinics[2]

In a comprehensive adult allergy cohort study conducted in Singapore involving close to 8,000 participants, allergic diseases can be caused by a number of common allergens that are present in considerable concentrations in Singapore – and it turns out, 70-80% of the population reacted against the house dust mite[3]

Read on as Dr Leong gives more insight into managing allergic rhinitis.

  1. How is allergic rhinitis different in adults and children?

    Allergies are similar for both children and adults. When they suffer from allergic rhinitis, typical symptoms such as itchy eyes and noses, sneezing, runny nose and block nose are present.

    Parents should pay special attention to how their child expresses the condition – the child is likely to experience constant sneezing, an itchy nose, allergic shiners (dark circles), watery and itchy eyes that may become red and swollen, and may begin to breathe through the mouth. If the condition is severe, parents should seek proper medical help

  2. What are some ingredients to look out for when choosing suitable medication to alleviate allergy symptoms in children?

    To alleviate allergic symptoms in children, parents should look out for medicines that are:

    – Safe, effective in providing 24-hour relief, and non-drowsy to avoid affecting performance in school.
    – Newer generation, or what is termed second generation antihistamines. One example is Zyrtec Solution/Drops that can be bought from pharmacies.

  3. What ingredients should parents avoid when using allergy medication for children and babies?

    Parents should avoid using older generation, or what we term the first generation antihistamines due to its sedative effect. Induced sedation may adversely affect a child’s learning ability in school.

  4. How can parents tell if the allergy is bad enough that a visit to the doctor is warranted? When is the use of over-the-counter medication sufficient?

    If the child often suffers from runny and blocked nose, accompanied intermittently by itchy eyes and nose, (i.e. less than four times a week or each recurrent episode is less than four weeks), your child might be suffering from allergic rhinitis. If nasal symptoms interfere with child’s sleep or daily activities, they will need help from the doctor.

    Second generation antihistamines such as Zyrtec Solution/Drops can be bought from the pharmacist, and can be used to treat the allergic rhinitis symptoms. If the child’s symptoms last more than four times a week and for more than four weeks, professional medical attention is needed.

  5. What other things should parents do to create a home environment that is kinder to those with allergies?

    Common triggers of allergies in a home environment includes dust mites, pet hair and air conditioning. In Singapore, during haze and monsoon periods, I tend to see a spike in patients seeking treatment for their allergic rhinitis symptoms.[4]

    To create a home environment void of allergy triggers, parents should identify what the allergens are, and encourage allergen avoidance as a first step towards treatment. Common allergy triggers in Singapore include house dust mites – so constant cleaning and vacuuming will help. Parents are also encouraged to reduce the number of stuffed toys and change bed sheets and curtains on a weekly basis. Some children are also allergic to pet dander, so in those situations, avoiding contact with animals is a good idea.

    Apart from avoidance, managing allergic symptoms is key. Parents should keep allergy medication within reach – opt for a safe second generation antihistamine such as Zyrtec Solution/Drops that can be purchased from the pharmacist.

  6. Do childhood allergies last forever?

    Children hardly outgrow their allergic rhinitis symptoms. 8 in 10 children diagnosed with allergic rhinitis will still have trouble 10 years later.[5]

    Hence it is important to actively manage the child’s allergic rhinitis symptoms to have a better quality of life. Apart from over-the-counter medication, other treatment options such as immunotherapy (desensitization) are available for the parents’ consideration.

    It is important to highlight however that this treatment takes time (at least 3 years) and patience to conduct, and dedication from the parent to follow through with their children, in order for it to be effective.

    [1] Henley, Karen. “State Of World Allergy Report 2008: Allergy And Chronic Respiratory Diseases”. World Allergy Organization Journal 1.Suppl 1 (2008): S3. Web. Available at: http://waojournal.biomedcentral.com/articles/10.1186/1939-4551-1-S1-S4. Last accessed 19 Oct. 2016.
    [2] Clinical and Experimental Allergy Reviews, 10 July 2008, D Y Wang, B R Gordon, Management of persistent allergic rhinitis in the tropics: Singapore experiences.
    [3] Allergy, European Journal of Allergy and Clinical Immunology, 24 January 2014, Page 506, A.K. Andiappan, K.J. Puan, B. Lee, A. Nardin, M. Poidinger, J. Connolly, F.T. Chew, D.Y. Wang, O. Rotzschke. ‘Allergic airway diseases in a tropical urban environment are driven by dominant mono-specific sensitization against house dust mites’
    [4] GSK Zyrtec Consumer Survey, February 2016

    [5]
    “Common Myths About Allergy And Asthma Exposed”. Australasian Society of Clinical Immunology and Allergy (ASCIA). N.p., 2016. Web. Available at: http://www.allergy.org.au/patients/about-allergy/common-myths-about-allergy-and-asthma-exposed. Last accessed 18 Oct. 2016.
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