ABSTRACT
Allergic rhinitis is a common disorder that is usually a long-standing condition that often goes undetected in the primary-care setting. The classical manifestation of the disorder are nasal congestion, nasal itch, rhinorrhea and sneezing. A thorough history, physical examination and allergen skin testing are important for establishing the diagnosis of allergic rhinitis. Rhinitis is classified into one of the following categories according to etiology: IgE-mediated (allergic), autonomic, infectious and idiopathic (unknown). Although the focus of this article is allergic rhinitis. This article provides an overview of the aetiology, diagnosis, and appropriate general & homoeopathic management of this disorder.
INTRODUCTION
Allergic rhinitis, also known as hay fever, is a type of inflammation in the nose which occurs when the immune system overreacts to allergens in the air. In the past, allergic rhinitis was considered to be a disorder localized to the nose and nasal passages, but current evidence indicates that it may represent a component of a systemic airway disease involving the entire respiratory tract .Common symptoms include sneezing, stuffy nose, watery eyes, and a sore, scratchy throat. An allergen is a normally harmless substance that causes an allergic reaction. Allergic rhinitis, or hay fever, is an allergic response to specific allergens. Pollen is the most common allergen. People with allergic rhinitis generally experience symptoms after breathing in an allergy-causing substance such as pollen or dust. In the fall, a common allergen is ragweed. In the spring, the most common triggers are grasses and pollen.
AETIOLOGY
An allergen is something that triggers an allergy. When a person with allergic rhinitis breathes in an allergen such as pollen, mold, animal dander, or dust, the body releases chemicals that cause allergy symptoms. Plants that cause hay fever are trees, grasses, and weeds. Their pollen is carried by the wind. Flower pollen is carried by insects and does not cause hay fever. Types of plants that cause hay fever vary from person to person and from area to area. The amount of pollen in the air can affect whether hay fever symptoms develop or not. Hot, dry, windy days are more likely to have a lot of pollen in the air. On cool, damp, rainy days, most pollen is washed to the ground.
Hay fever and allergies often run in families. If both of parents have hay fever or other allergies, child is likely to have hay fever and allergies, too. The chance is higher if mother has allergies.
RISK FACTORS
Allergies can affect anyone, but you’re more likely to develop allergic rhinitis if your family has a history of allergies.
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
CLINICAL MANIFESTATIONS
Common symptoms of allergic rhinitis include: sneezing, a runny nose, a stuffy nose,
an itchy nose, coughing, a sore or scratchy throat, itchy eyes, watery eyes, dark circles under the eyes, frequent headaches, eczema-type symptoms, such as having extremely dry, itchy skin that often blisters, hives, excessive fatigue
Usually feel one or more of these symptoms immediately after coming into contact with an allergen. Some symptoms, such as recurrent headaches and fatigue, may only happen after long-term exposure to allergens. Fever isn’t a symptom of hay fever.
Some people experience symptoms only rarely. This is highly likely when you’re exposed to allergens in large quantities. Other people experience symptoms all year long.
INVESTIGATIONS
Allergy testing may reveal the pollen or other substances that trigger your symptoms. Skin testing is the most common method of allergy testing.
If your doctor determines you cannot have skin testing, special blood tests may help with the diagnosis. These tests, known as IgE RAST tests, can measure the levels of allergy-related substances.
A complete blood count (CBC) test, called the eosinophil count, may also help diagnose allergies.
PREVENTION
Stay indoors when pollen counts are high, Avoid exercising outdoors early in the morning, Take showers immediately after being outside, Keep windows and doors shut as frequently as possible during allergy season, Keep mouth and nose covered while performing yard work, Try not to rake leaves or mow the lawn, Bathe dog at least twice per week to minimize dander, Remove carpeting from your bedroom if you’re concerned about dust mites.
MANAGEMENT
The conventional treatment of allergic rhinitis is to keep giving anti-allergic medicines or antihistaminics like Cetrizine or Levocitrizine. In fact these anti allergic medicines are used to treat all sorts of allergies, whether nasal or skin. They tend to provide temporary relief. Anti histaminic may be fine for some hours. The sneezing stops and the running nose stops. The itching in the nose and eyes disappears. But the effect lasts only for some hours. Once the effect wears off, the problem returns in full force. These anti histaminics are sleep inducing and often people tend to feel sleepy or dizzy during the daytime, which can be dangerous at times. The easy availability and low cost makes these anti allergic medicines easily accessible. In fact they have become sort of home remedies for allergies and people just keep taking them without even a prescription from a qualified doctor.
Home Managements
· A high intake of soy and isoflavones may be associated with a reduced prevalence of allergic rhinitis.
· Intake of eicosapentaenoic (EPA) and docosahexaenoic acids (DHA) from fish may be associated with a reduced prevalence of allergic rhinitis.
· Black cumin alleviates symptoms of allergic rhinitis.
· Peppermint may be clinically effective in alleviating the nasal symptoms of allergic rhinitis.
· High dietary intake of seaweed, calcium, magnesium, and phosphorus may be associated with a decreased prevalence of allergic rhinitis.
· Raw milk consumption (relative to boiled) is inversely associated to asthma, atopy and hay fever.
· Rose extract exhibits antiinflammatory, antiallergic and painkilling activities.
· Butterbur exhibits protection against chemically induced nasal responsiveness in seasonal allergic rhinitis.
· Lactobacillus acidophilus can alleviate the symptoms of perennial allergic rhinitis.
· Propolis may be effective in the relief of symptoms of allergic rhinitis through inhibition of histamine release.
· An extract of the medicinal mushroom Agaricus blazei Murill can protect against allergythrough reducing Th2 relative to Th1 cytokine levels.
· Supplementation of mothers and their babies with the probiotic Lactobacillus reuteri reduces IgE associated eczema and may reduce respiratory allergic disease later in life.
· Curcumin attenuates the development of allergic airway inflammation and hyperresponsiveness.
· Vitamin D deficiency is higher among children with asthma, allergic rhinitis, atopic dermatitis, acute urticaria, and food allergy.
· Onion exhibits antiallergic, antihistaminic, antiinflammatory, and antioxidant properties.
· Indian Oyster mushroom may be effective in the relief of symptoms of allergic rhinitis through inhibition of histamine release.
· Peach extract inhibits mast cellderived allergic inflammation.
· Spirulina consumption significantly improves the symptoms of allergic rhinitis.
· Exclusive breastfeeding during the first 3 months after birth protects against allergic rhinitis in children, both with and without a family history of atopy.
HOMOEOPATHIC MANAGEMENT
Homoeopathy treats the person as a whole and tries to find a constitutional remedy with the aim of strengthening the organism generally. This means looking at not only the patient’s symptoms, but also his or her general health and way of reacting to the environment, as well as what drives him or her on an emotional level. But homoeopaths can also treat symptomatically, meaning treating the rhinitis symptoms specifically. Usually aim for constitutional treatment but sometimes combine the two approaches, giving a more symptomatic nasal remedy for flare ups, while treating the person as a whole with a constitutional remedy.
There is a special mention about allergic diseases in Homoeopathic literatures under the heading IDIOSYNCRASY. Dr Samuel Hahnemann, founder of Homoeopathic system of medicine defined idiosyncrasy 200 years ago in his famous book Organon of Medicine as “Idiosyncrasies by which are meant peculiar corporeal constitutions which although otherwise healthy, posses a disposition to be brought into a more or less morbid state by certain things which seem to produce no impression and no change in many other individuals”.
Manifestations of allergic reactions and idiosyncracies are same. Both are hypersensitive reaction. An idiosyncratic individual is oversensitive to one or few things which doesn’t require treatment as the person in healthy, but allergic disorders are due to morbid susceptibility.
Successful Homoeopathic prescribing demands a detailed case taking to find out the evolution of disease, relation with life situation, also to find out characteristic symptoms. According to Hahnemann it is the constitution of an individual that becomes sick first. The objective of treatment should be the improvement of the constitution, so that sensitivity, which has gone bad, is corrected or brought within normal range. It has been proved, verified and confirmed that if a proper indicated constitutional treatment is given to the child for sometime, it improves the constitution. In due course, the attacks become lesser in frequency and severity.
By constitutional approach we can prevent the recurrence of the complaint by modifying the altered susceptibility. Miasmatic remedy can help to remove any miasmatic block obtained from the familial background, past history of patient and also the presentation. Acute prescriptions are required during acute flare-ups.
Thus the concept of totality of symptoms and principle of individualization together enables the homoeopathic physician to perceive the disease in its whole content to make a suitable prescription
Indicated Remedies | Indications |
Allium cepa.
| For frequent sneezing, a lot of irritating nasal discharge and tearing eyes. This candidate tends to feel thirsty |
Arsenicum album.
| For stuffiness with copious, burning nasal discharge and violent sneezing. An appropriate candidate for Arsenicum feels restless, anxious, and exhausted. |
Apis mellifica | stuffy nose due to a pink edema of the nasal mucous membranes, swollen eyelids. Fresh air unblocks the nose. A reliable homeopathic nasal decongestant. |
Arsenicum iodatum | sneezing and excoriating watery rhinitis, nighttime asthma attacks during peak pollen season. Hay fever symptoms are improved by moderate temperatures. |
Dulcamara | stuffy nose in rainy and foggy weather, followed by postnasal drip; hay fever at the end of August and in the fall. Dry cough and asthma in damp weather. |
Euphrasia.
| For nasal discharge, with stinging, irritating tears. A suitable person for this remedy has worse nasal symptoms when lying down. |
Galphimia | burning discharge from eyes and nose, swollen itchy eyelids, sneezing, skin rash. Its efficacy in allergic rhinitis is proven by many scientific studies. That is why it is a common ingredient in most complex medicines for hay fever. |
Kalium iodatum | very profuse watery discharge from nose and eyes, swollen red eyes and nose; constricting pain at the root of the nose. The copious coryza blocks the sinuses, triggering a frontal headache and allergic sinusitis. |
Nux vomica.
| For stuffiness with nasal discharge, dry, ticklish, and scraping nasal sensations with watery nasal discharge and a lot of sneezing. An appropriate person for this remedy is irritable and impatient. |
Arundo | There is a lot of burning and itching in the nose, the eyes and the roof of the mouth. Sense of smell becomes diminished. the episode begins with intense itching in the palate and the nose, |
Merc Sol | There is a lot of sneezing and watery discharge from the nose. The patient is worse even in damp or wet weather. Increased sweating is another indication for this medicine. There is profuse salivation in the mouth. At times the salivation is so much that it keeps the mouth wet most of the time. Despite this increased salivation, the patient keeps on feeling thirsty. There may be foul smell from the mouth. |
Natrum Mur | there is a lot of sneezing and in fact, the symptoms start with sneezing only, There is intense dryness of the mouth and the mucous membranes. The discharge from the nose is thin and watery and resembles the white of an egg. There is an increased desire to eat salt or salty food. |
Conclusion
Homoeopathic medicines stimulate the immune power to act against the disease. So homoeopathic medicines acts well in cases of Allergic rhinitis. Homoeo medicine helps to reduce the symptoms without producing any side effect. Homoeopathic medicines stimulate the immune power to act against the disease. So homoeopathic medicines acts well in cases of Allergic rhinitis. Homoeo medicine helps to reduce the symptoms without producing any side effect. Homoeopathy is highly effective in the treatment of allergies and fully capable of stimulating the organism to heal to the point of complete relief from all allergy symptoms.
