All you need to know about allergic rhinitis

Written by: Professor Helen Brough
Published:
Edited by: Conor Lynch

Allergic rhinitis occurs as a result of the lining of one’s nose becoming inflamed. It can, in some cases, be an extremely serious medical condition, but, fortunately, the condition can be treated in a variety of different ways.

 

In our latest article, revered consultant paediatric allergist, Dr Helen Brough, tells us how allergic rhinitis is caused, outlines what the main symptoms are, and explains how it can be most effectively treated.

Can you detail what exactly allergic rhinitis is?

Allergic rhinitis is an allergic inflammation of the lining of the nose. It can also cause lots of other symptoms, such as allergic rhinoconjunctivitis, which can also lead to inflammation of the lining of the eyes.

 

Allergic rhinitis can also affect inside one’s ears, it can make you feel itchy at the back of your throat and tongue, can also cause a bit of a cough and make your nose feel very congested. In patients who suffer from asthma, we often see that they suffer from an allergic cough as a result of allergic rhinitis.

 

Allergic rhinitis normally occurs due to an inhalant allergen, such as seasonal allergens like grass and pollen, as well as perennial allergens (all year round) such as house dust mite, cat dander or dog dander if the family lives with that animal.

 

What is the most common cause of allergic rhinitis?

The most common cause of allergic rhinitis in the UK is grass palynology, which leads to itching, sneezing, congestion, and patients having to constantly rub their eyes and nose. People generally suffer from this from May to the end of August.

 

This allergic condition can be particularly severe if, on that day, the pollen count is high. Fortunately, today, there are numerous amounts of applications that can tell you when the pollen count is high.

 

The second most common cause of allergic rhinitis then is house dust mite, which can cause worsening symptoms in the winter, when there is more dust mite around in the house. Often, house dust mite allergy causes a lot of congestion, feeling that you just can’t seem to get rid of a cold, headaches, and can also lead to dark circles under the eyes.

 

What are the main warning signs and symptoms?

The main symptoms to watch out for are red, swollen eyes, clearing of one’s throat due to the presence of mucus, itchy nose, itching inside the ears, and a dry, irritated cough at the back of the throat.

 

How is allergic rhinitis treated?

There are three aspects to the treatment of allergic rhinitis. The first is allergen avoidance. So, once patients know what they are allergic to, they can avoid those allergic triggers. The second is symptomatic treatment. This usually comprises of an antihistamine, which should be a non-sedative one.

 

The gold standard for symptomatic treatment for allergic rhinitis is nasal steroid sprays, because they not only treat the itching and the runny nose, but also the nasal congestion. There are also some very effective eye drops that contain antihistamines.

 

The final aspect of treatment is immunotherapy. People can effectively take drops or tablets under the tongue in order to change the way their immune system responds to any given allergen that is causing allergic rhinitis. This produces tolerant antibodies.

 

When is the condition considered serious?

It is very serious, especially in situations where children are affected in school, when one’s sleep is affected, and when children find it difficult to go outside and enjoy activities because they have such severe symptoms. The condition can also lead to sinusitis.

 

Dr Helen Brough is a highly esteemed consultant paediatric allergist who specialises in conditions such as allergic rhinitis. Visit her Top Doctors profile today and consult with her if you are concerned about your child’s allergies. 

By Professor Helen Brough
Paediatric allergy & immunology

Professor Helen Brough is a consultant in paediatric allergy and clinical immunology and was the head of service at the Evelina London Children’s Hospital, Guy’s and St. Thomas’ Hospital between 2015 and 2023 where she led the largest Children’s Allergy Service in the UK.

She has specific interests in food allergy prevention, diagnosis and treatment, immunotherapy, asthma, eosinophilic gastrointestinal disorders and eczema. She jointly runs the joint asthma and allergy service at the Evelina London.

She co-authored two landmark studies on the prevention of food allergy, is the lead investigator for the Pronuts study (assessing peanut, sesame and tree nut allergy) and is an investigator for the oral and patch peanut desensitisation trials at the Evelina London.

She is the President of the Royal Society of Medicine Allergy and Immunology and was the chair of the Paediatric Section for the European Academy of Allergy and Clinical Immunology (EAACI) between 2022 to 2024. She organised the Annual National Allergy Meeting for the British Society of Allergy and Clinical Immunology from 2013 to 2016 and the European Allergy (EAACI) Congress in 2020. She was awarded the 2020 Distinguished Clinician Award by the American Academy of Allergy, Asthma and Immunology, the Barry Kay award for excellence in Paediatric Allergy research from the British Society for Allergy and Clinical Immunology in 2013, and ‘Health Professional of the Year’ runner-up in 2010 by Coeliac UK.

As a parent herself, Professor Brough knows how distressing and concerned a parent can be when dealing with their child’s condition. All consultations are child-centred and we will always give you and your child enough time to fully discuss all concerns, guiding and supporting you both through treatment plans. We pride ourselves that a common thread across all our reviews is that we are thorough and take time to explain conditions and treatments with all our patients.

Sometimes, parents can find it hard to remember all the information that is discussed during their child’s consultation. So, we always follow up every appointment with a consultation letter, detailing everything that was discussed during your consultation. Our team At Children’s Allergy Doctors, we make it easy for you to select an appointment with us, and at a time that suits you. All appointments can be directly booked online, or by telephone.

We have an experienced practice manager and a medical secretary who manage the secretarial, billing and administration of my practice. From appointment booking, communicating with parents, assisting with queries, or taking payments, they are dedicated to providing an excellent, friendly service to every patient and will be able to answer any queries that you may have.

Professor Brough graduated from King’s College, Cambridge University, with double honours in medicine and Experimental Psychology, before completing her clinical training at the Royal Free and University College London Medical School. She trained in Paediatrics in South London Paediatric training rotation, and was then awarded one of the few recognised Higher Specialist Training posts in Paediatric Allergy and Immunology. Professor Brough trained in some of the UK’s leading teaching hospitals: Guy’s and St. Thomas’ Hospital, King’s College Hospital, and Great Ormond Street Hospital.

She is also certified by the European Academy of Allergology and Clinical Immunology (EAACI) as a European Paediatric Allergist. She has also completed an MSc in Allergy, gaining a distinction at the University of Southampton and was subsequently awarded a PhD in determining routes of developing peanut allergy, at King’s College London University. Clinical studies and publications: Professor Brough co-authored two landmark studies on the prevention of food allergy, and is the lead investigator for the Pronuts study (assessing peanut, sesame and tree nut allergy), and an investigator for the oral and patch peanut desensitisation trials, which are currently running at the Evelina London.

She has published multiple original research articles as well as published a textbook, Rapid Paediatrics. Professor Brough regularly presents her research; both nationally and internationally and is an honorary senior lecturer at King’s College London. She has written reviews on the active management and prevention of food allergies, dietary management of peanut allergy and risks of exposure to food in the environment in allergic patients, and is also at the forefront of research on desensitisation to nuts.

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