Introduction
Nasal allergy or allergic rhinitis is the most common symptom of allergy. It occurs in almost all people regardless of gender, age or race. Happening mostly due to external factors, climate changes play a very important role in allergic rhinitis. It is seen most predominant in rainy and cold seasons. In most cases, nasal allergy does not imply a life-threatening condition. But this disease or rather symptom causes a big discomfort in daily life and socialising. As some types of the common cold can be spread by droplet infection, sneezing, spitting or coughing in public may cause shame and guilt. In severe cases, the discomforts like sneezing are so evident that the person’s daily life is affected.
Signs & symptoms
Sneezing
Running nose
Stuffed nose
Itching in the nose
Cough
Sore throat or feeling of scratching in the throat
Itching and watering of eyes
Dark circles around the eyes
Headache
Excessive fatigue
Itchy skin rashes like eczema may be present
Causes
Pollen from trees, grasses and weeds in the air.
dust
mites,
mould,
cold or snow
animal dander
cockroach debris.
Some external factors can trigger or worsen this condition, including:
- cigarette smoke
- chemicals
- cold temperatures
- humidity
- wind
- air pollution
- hairspray
- perfumes
- colognes
- wood smoke
- fumes
Pathophysiology
Allergy is a hyper reaction of the body to any external factor. In nasal allergy, the site of this hyperactivity is the upper respiratory tract, mainly the nose. When the body comes into contact with an allergen, it releases histamine, which is a natural chemical that defends your body from the allergen. This chemical can cause allergic rhinitis and its symptoms, including a runny nose, sneezing, and itchy eyes.
Diagnosis
History taking
Physical examination
Skin prick test
Blood testes like ESR, TC, DC or RAST (RadioAllergoSorbent Test)
Treatments
There are many medications and therapies to control nasal allergy and associated discomforts.
Antihistamines
They work by stopping the body from making histamine.
Some popular over-the-counter (OTC) antihistamines include:
- fexofenadine
- diphenhydramine
- desloratadine
- loratadine
- levocetirizine
- cetirizine
Decongestants
Decongestants can be used to relieve a stuffy nose and heavy sinuses for a short period. Using them for a longer time can cause some adverse effects. Popular OTC decongestants include:
- oxymetazoline
- pseudoephedrine
- phenylephrine
- cetirizine with pseudoephedrine
Eye drops and nasal sprays
Eye drops and nasal sprays relieve itchiness and other allergy-related symptoms for a short time.
Corticosteroids
They can help with inflammation and immune responses. Immunotherapy
Immunotherapy
Also known as allergic shots, it is used in severe allergies. It can be prescribed with medications to control the symptoms. They decrease the immune response to particular allergens over time. They do require a long-term commitment to a treatment plan. An allergy shot regimen begins with a build-up phase to let the body get used to the allergen in the shot. During the maintenance phase, it’s possible that the allergy symptoms will fade or disappear altogether. Some people can experience severe allergic reactions to an allergen in their shot. It is important after a shot to ensure that the patient doesn’t have an intense or life-threatening response to it.
Sublingual immunotherapy (SLIT)
SLIT involves placing a tablet containing a mixture of several allergens under the tongue. It works similarly to allergy shots but without an injection. Currently, it is effective for treating rhinitis and asthma allergies caused by grass, tree pollen, cat dander, dust mites, and ragweed. Like allergy shots, the medication is taken frequently over a period of time.
Possible side effects include itching in the mouth or ear and throat irritation. In rare cases, SLIT treatments can cause a fatal condition called anaphylaxis.
Prognosis
Nasal allergy is body nature rather than a disease with a long-term prognosis. Control of symptoms can be possible but a complete relief is not common.
Complications
- Loss of sleep due to symptoms
- development or worsening of asthma symptoms
- frequent ear infections
- sinusitis or frequent bouts of headache
- absences from school or work because of reduced productivity
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.
Disease & Ayurveda
Kshavathu-bhramsathu
Nidana
Smelling or tasing hot, pungent and spicy things
Very closely smelling allergens like pollens
Looking at sun
Tingling inside the nose with threads etc.
Purvaaroopa
Not mentioned
Samprapti
Due to the causative factors, vitiated Kapha and Vaata get lodged in the cartilages of nose & nasal cavity and manifests as the disease.
Lakshana
Sneezing
Running nose
Nasal discharge
Divisions
Not mentioned
Prognosis
Sadhyam in new
Yaapyam in chronic
Chikithsa
Samana
Lepanam with Rookshana dravyas
Sodhana
Virechananasyam
Naadeeswedam
Snigdha dhoomam
Pradhamana nasyam
Commonly used medicines
Dasamoolakaduthrayam kashayam
Amruthotharam kashayam
Taleesapatradi choornam
Haridrakhandam
Koosmandarasayanam
Vyoshadi vatakam
Rasnadi choornam
Brands available
AVS Kottakal
AVP Coimbatore
SNA oushadhasala
Vaidyaratnam oushadhasala
Home remedies
Using a dehumidifier or a high efficiency particulate air (HEPA) filter
Washing sheets and blankets in hot water can remove dust mites
Avoid the usage of carpet at home
Steam bath
Nasal saline drops/sprays
Diet
- To be avoided
Heavy meals and difficult to digest foods – cause indigestion.
Junk foods- cause disturbance in digestion and reduces the bioavailability of the medicine
Carbonated drinks – makes the stomach more acidic and disturbed digestion
Refrigerated and frozen foods – causes weak and sluggish digestion by weakening Agni (digestive fire)
Milk and milk products – increase kapha, cause obstruction in channels and respiratory tract disorders
Curd – causes vidaaha and thereby many other diseases
- To be added
Light meals and easily digestible foods
Green gram, soups, honey
Freshly cooked and warm food processed with cumin seeds, ginger, black pepper, ajwain etc
Behaviour:
Protect yourself from cold climate.
Follow a regular schedule for headbath
Better to avoid exposure to excessive sunlight wind rain or dust.
Maintain a regular food and sleep schedule.
Avoid holding or forcing the urges like urine, faeces, cough, sneeze etc.
Avoid sedentary lifestyle. Be active
Yoga
Regular stretching and cardio exercises are advised to improve immunity and respiratory health. Also, specific yogacharya including naadisuddhi pranayama, bhujangaasana, pavanamuktasana is recommended.
Regular exercise helps improve bioavailability of the medicine and food ingested and leads to positive health.
Yoga can maintain harmony within the body and with the surrounding system.
Pavanamuktasana
Nadisudhi pranayama
Bhujangasana
Simple exercises for lungs and heart health
All the exercises and physical exertions must be decided and done under the supervision of a medical expert only.
Research articles
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6107993/