02 Mar Allergic rhinitis: more than just a runny nose

• The immune system classifies pollen, house dust mites, animal dander or mould as a threat.
• It forms specific antibodies against these substances.
• On renewed contact, the body releases histamine and other inflammatory messengers.
• The nasal mucosa swells and produces more secretions. Other characteristic signs of allergy (see below) are also present.

• Frequent sneezing fits
• Constantly runny nose with clear, watery secretion
• Restricted breathing due to swollen nose
• Itching in the nose, throat or around the eyes
• Watery, reddened eyes
• Sometimes coughing or a feeling of pressure in the head area

• Seasonal: symptoms occur mainly during the pollen season
• All year round: symptoms are permanent, for example in the case of a house dust mite or animal hair allergy

• Allergic rhinitis usually starts suddenly after contact with a specific trigger, e.g. after spending time outdoors during the pollen season. The nasal secretions remain clear and watery. Itching in the nose and eyes and repeated sneezing attacks are also common.
• One Cold often develops gradually and is accompanied by a general feeling of illness. The nasal secretions often become thick as the disease progresses. It usually also turns yellowish or greenish in colour. Fever, aching limbs or sore throat are also typical of an infection.
• Allergic symptoms last as long as there is contact with the trigger. A cold usually subsides within seven to ten days.

• The term allergic rhinitis describes allergy-related inflammation of the nasal mucosa, regardless of the trigger. It can occur all year round.
• Hay fever on the other hand, is a special form of allergic rhinitis. In this case, only pollen from trees, grasses or herbs trigger the symptoms. It therefore typically occurs seasonally, especially in spring and summer during the respective pollen season.
• All hay fever therefore counts as allergic rhinitis, but not every allergic rhinitis is automatically hay fever.

We enquire about the type, duration and frequency of your symptoms. The temporal correlation with seasons, places of residence or animal contact provides us with important information. Familial allergies, asthma or neurodermatitis also play a role.

We assess your nasal mucosa by means of an ENT examination. A pale to bluish discoloured, clearly swollen nasal mucosa indicates an allergic cause. In the case of an acute cold, the mucous membrane usually appears reddened, as there is an infectious inflammation. If necessary, an endoscopy of the nose and paranasal sinuses is performed to identify other causes such as Nasal polyps to be excluded.

If an allergic rhinitis is suspected following a medical history and examination, specific test procedures are carried out. These help to clearly identify the triggering substances and categorise the symptoms. The combination of test result and clinical symptoms is always important. At our ENT clinic in Frankfurt, we use tried and tested procedures that are based on international standards.

• Skin test
  Here we apply special allergen extracts to the skin of your forearm. We use a fine lancet to lightly scratch the top layer of skin so that the various allergens can penetrate the skin. If a wheal with redness appears within 15 to 20 minutes, the immune system is already reacting to this substance with specific antibodies.
• Blood test
  As part of a blood test, the laboratory determines the amount of specific IgE antibodies. The immune system produces these antibodies in response to certain allergens. An elevated value shows that the body is sensitised to this substance. The blood test is particularly useful if a skin test is not an option, e.g. in the case of pronounced skin diseases or if certain medications could falsify the test result. It also provides additional information for the precise categorisation of symptoms in the case of unclear findings.

As soon as we have clearly identified the triggering allergen, you should reduce your contact with this substance as much as possible. Only if it is clear what is causing the symptoms can you effectively reduce the stress in your everyday life.

If you are allergic to house dust mites, for example, special protective covers for mattresses and bed linen as well as a low-dust bedroom design can provide noticeable relief. Regular ventilation and the avoidance of „dust traps“ also support this effect.

If your body reacts to animal hair, giving up the animal often leads to a significant improvement in symptoms.

If you are allergic to pollen, adjusting ventilation times, pollen screens on the windows or nasal rinsing after spending time outdoors can help. Changing your clothes after returning home can also reduce the pollen load.

Complete avoidance is not possible in every case. Nevertheless, a conscious and consistent reduction in allergens makes a decisive contribution to alleviating symptoms and reducing the need for medication.

If contact with the allergen cannot be completely avoided or your symptoms are more severe, drug treatment can help to reduce the symptoms. The aim of this so-called symptom therapy is to weaken the excessive immune reaction and quickly improve your quality of life.

Antihistamines inhibit the effect of the neurotransmitter histamine, which is largely responsible for sneezing, itching and a runny nose. As a result, these symptoms often subside noticeably. Nasal sprays containing cortisone reduce the inflammatory reaction in the nasal mucosa and facilitate nasal breathing. They act directly at the site of the problem and are particularly suitable for persistent nasal congestion.

If necessary, anti-allergic eye drops or temporary decongestants supplement the treatment.

However, it is important to note that these medications effectively alleviate the symptoms, but they do not change the underlying allergic cause.

In contrast to pure symptom treatment, hyposensitisation directly addresses the cause of your allergy. It aims to gradually acclimatise the immune system to the triggering allergen and permanently reduce the excessive reaction.

We recommend this type of therapy in particular if your symptoms are still very pronounced despite consistent allergen avoidance and drug treatment or if you would like to take less medication in the long term.

At the beginning, you will receive the identified allergen in a very low dosage. We increase the amount at regular intervals up to the so-called maintenance dose. Subsequently, the dose is administered at fixed intervals over a longer period of time, usually several years. In this way, the immune system learns to tolerate the allergen.

The therapy is particularly suitable for pollen, house dust mite, animal hair and insect venom allergies. Many patients report significantly reduced symptoms and a reduced need for medication over the course of the treatment.