If your child sneezes a lot or if the nose is often stuffy or running , or if their eyes, mouth or the skin often feels itchy, then they might be having allergic rhinitis. Allergic rhinitis is commonly known as Hay Fever.
But don’t think that exposure to hay is needed to start this, or you need to have fever to get Hay Fever.
Why does the child get allergic rhinitis?
A child develops this when the body's immune system becomes sensitized and over reacts to something in the environment that typically cause no problems in most people.
What are the different forms?
1. Seasonal – symptoms occur in spring, summer or early fall. Usually caused by allergic sensitivity to airborne mold spores or to pollen from grass and so on.
2. Perennial - symptoms occur year round. Generally caused by dust, pet hair or dander, cockroach or mold.
One should also remember that there are non allergic causes for rhinitis.
What are the symptoms?
Running nose, itchy eye, mouth or skin, sneezing, stuffy nose and fatigue.
What else can trigger the symptoms?
Irritants like, cigarette, smoke , strong odors, cosmetics, detergents, car exhaust and other air pollutants.
What problems can children have due to this?
Can be associated with decreased concentration and focus, limited activities, irritability, sleep disorders, fatigue and missed days of school. Many parents tell that their children are moody during allergy season.
What should you do for your child ?
Meet an allergist at the earliest. Allergist can dig out a detailed history and look out for clues in the life style that will pinpoint the cause of symptoms. Also allergist will perform a detailed physical examination to look for nasal septum, nasal polyps etc.
Is there any test for the diagnosis?
The allergist may recommend a skin test, were small amounts of suspected allergens are applied on the skin of the child's arm. It is easy, sensitive and least expensive way of identifying allergens.
What is the treatment for allergic rhinitis?
Avoid allergens that trigger the symptoms
Outdoor exposure: Most important for seasonal allergic rhinitis.
Stay indoors when pollen counts are at their peak.
Try not to rub the eyes as pollen can make symptoms worse when the eyes are rubbed and irritated.
Keep windows closed especially if you are living near the road side.
Keep the air conditioner unit clean.
Reduce exposure to dust mites, especially in the bedroom. Use mite covers for pillows and mattresses.
Limit exposure to mold.
Floors should be wet mopped instead of dusting or sweeping.
Exposure to Pets- Wash the hands immediately after playing with the pet.
If the allergy is severe avoid pets.
If, in spite of avoiding triggers, if the child's symptoms are not well controlled, then the allergist will recommend medication.
Intranasal Corticosteroid is the single most effective drug for treating allergic rhinitis. This reduces nasal congestion as well as sneezing, itching and running nose.
The doctor will give the child antihistamines, which will counter the effects of histamine, the irritating chemical released in the body when an allergic reaction takes place. Now a day the doctors prefer to give less sedative antihistamines.
If the child has associated asthma also, the doctor may prescribe montelukast, which block the action of leukotriene, a substance in the body that can cause allergic symptoms.
What if your child won’t respond to these medicines and symptoms are still prevalent?
Immunotherapy is the future for allergic rhinitis treatment. There are two types of immunotherapy. One is the allergy shots, were subcutaneous injection of diluted allergen extract administered in increasing doses, until maintenance dose is reached. The other is the sublingual, where diluted allergen extract given sublingually. This is a promising therapy for the future.
Demystifying certain myths
Antibiotics will not affect the cause of rhinitis and hence it is needed only if associated bacterial infection is there.
Surgery is not the treatment for rhinitis, but will help if the patient has nasal polyps or chronic sinusitis.
So, parents please get to your nearest allergist to understand and treat your child's allergic rhinitis. The child deserves quality life without missing school and fun in life. Let the children not suffer in silence. Let us together control the allergic rhinitis and let our children breathe free.
(The author is the Deputy Medical Superintendent of Kerala Institute of Medical Sciences, Thiruvananthapuram)