What is Allergic Rhinitis in Children?
Allergic rhinitis is an inflammation of the mucous membranes in the nose that occurs as a result of contact of the mucosa with allergens-irritants. Common symptoms of the disease are: itchy nose, redness of the eyes, watery nasal discharge, lacrimation, nasal congestion and sneezing. There are two types of allergic rhinitis: seasonal allergic rhinitis (known as hay fever) and year-round allergic rhinitis.
Causes of Allergic Rhinitis in Children
Allergic rhinitis is hereditary. Therefore, if a family has a family member with bronchial asthma, neurodermatitis, allergic urticaria, then most likely the disease will be transmitted to the child, and as a result he will experience allergic rhinitis, which is a secondary disease of the above-mentioned diseases.
Children with perennial allergic rhinitis are often susceptible to allergens that are in their environment or at home, including dust, wool and dander of domestic animals, mold. Year-round rhinitis lasts throughout the year, may worsen regardless of the season. This type of allergic rhinitis is often observed in young children.
Bleeding from the nose is often caused by allergic rhinitis, because the mucous membrane is irritated, which causes itching, and children try to rub the nose and scratch it.
Seasonal allergic rhinitis, or hay fever, is caused by allergens from herbs (cereals, complex flowers, etc.) and trees. In rare cases, rhinitis causes fungal spores. Seasonal allergic rhinitis, as a rule, develops only after 6 years.
Pathogenesis during Allergic Rhinitis in Children
During an allergic reaction, the immune system releases histamine, which triggers the cascade effect of allergy symptoms. Selected histamine can lead to narrowing of the airways and dilation of blood vessels (resulting in swelling or swelling), after which histamine seeps into soft tissues. The effect of histamine in tissues provokes the appearance of itching, which is associated with many allergic reactions.
Symptoms of Allergic Rhinitis in Children
The following are the most common symptoms of allergic rhinitis. However, each child can tolerate the symptoms in different ways.
Studies have shown that children with allergic rhinitis may have difficulty sleeping, then children become irritable, they lack attention concentration. These problems may affect a child’s ability to cope with the daily tasks of normal daily life. In addition, if a runny nose is not treated, it can lead to serious consequences in the form of asthma.
Prolonged bouts of sneezing occur on contact with an allergen. A child can hurt itself due to constant itching in the nose, throat, eyes and ears. Children may have bleeding from the nose and ears due to regular itching. Congestion and nasal discharge bring significant discomfort to children.
Due to nasal congestion, children predominantly breathe through their mouths, thus the function of the nose (cleansing, heating the air) is not performed, and a dirty stream of air enters the body.
Children also have tearing, nasal mucous discharge, peeling of the skin around the nostrils, conjunctivitis, recurrences of infectious diseases of the ear, neurological disorders (fatigue, poor working ability in school or kindergarten), dark circles and folds under the eyes.
Diagnosis of Allergic Rhinitis in Children
The diagnosis is usually made on the basis of an analysis of the history of symptoms, examination and allergy tests. First of all, the doctor must determine the cause of the disease. He can ask parents about what time of day and season of the year the child has rhinitis attacks. After he sets the type of rhinitis (seasonal or year-round). There are also other studies:
- Examination – the doctor will examine the inside of the nose with the help of special devices. This painless procedure allows the doctor to determine whether the patient has redness, signs of inflammation, swelling of the eyes, swelling of the mucous membranes in the nose, polyps in the nose, skin rashes. The doctor usually checks the eyes, ears and chest.
- Endoscopy – allows you to study the nasal cavity for the presence of inflammation and abnormalities.
- Differential diagnosis. Symptoms of allergic rhinitis are similar to signs of other diseases.
- Computed tomography – to be carried out with suspected acute and chronic sinusitis, polyps in the nose, which are associated diseases of allergic rhinitis.
- Allergen test – determines the body’s response to allergens. Skin tests are rarely necessary for the diagnosis of seasonal allergic rhinitis, since the causes are usually obvious. The skin test is not suitable for children under 3 years of age. The procedure is as follows: patients should not take antihistamines for at least 12 – 72 hours before the start of the study. Otherwise, an allergic reaction may not occur. A small amount of potential allergens is injected under the skin with a needle. If allergies are present, the area of the injection becomes swollen and reddened for approximately 20 minutes.
- Nasal smear – studies of nasal secretion indicate the cause of the disease, for example, an increase in the number of white blood cells indicates an infectious origin, a high number of eosinophils indicates an allergic origin.
- General blood analysis.
Treatment of Allergic Rhinitis in Children
Treatment is prescribed by a doctor based on the child’s age, general health, and medical history. Medications for allergic rhinitis are very effective and are essential in improving the quality of life of the child.
Drug therapy is aimed at blocking the allergic response, reducing inflammation. The treatment is as follows:
Elimination and restriction of allergens causing problems. With the help of allergic tests, the doctor determines the type of allergen, and accordingly the causes of rhinitis. Avoiding some allergens is quite simple, for example, pets can be given to close relatives or friends (many families do not want to give their pets to the wrong hands). Dust mite and mold in the house can be eliminated by frequent cleaning with special household tools. It is necessary to abandon the carpet, where dust mites accumulate.
It is more difficult to avoid exposure to natural allergens, such as plant pollen. But still, there are ways to limit children from their impact: if possible, you should try not to walk with your child on windy days or after a thunderstorm, children need to wear sunglasses, not go out when there is freshly mowed grass there, close the windows of the house if around blooming plants, closing the windows of the car during the trip, a picnic in the parks should stay away during the flowering season. Wet cleaning in the house where there is an allergy should be daily. Go on holiday with your children when the flowering season comes.
Antihistamines are probably the most well-known and affordable treatment. Antihistamines block the release and action of histamine, and eliminate symptoms such as itching, sneezing, or runny nose. Antihistamines include: diphenhydramine, hydroxyzine, cetirizine, loratadine, fexofenadine. A side effect of antihistamine drugs is drowsiness. In such cases, you need to consult a doctor so that he changed the dosage. Antihistamines are safe and available without a prescription. Young children are prescribed antihistamines in the form of syrup, older children in the form of tablets.
Also, antihistamines are produced in the form of nasal sprays and eye drops. They soothe irritated nose and eyes during hay fever or outbreaks of allergic rhinitis. Nasal sprays are used for children over the age of six to clean the nasal passages. Nasal antihistamines help fight the symptoms of itching and sneezing, while steroids are used to control inflammation in the nose and help relieve eye symptoms. Note that they should be used only for a short period of time, otherwise they may aggravate the symptoms.
Steroids can be administered in the form of sprays or drops. Their effectiveness in reducing symptoms can only appear after a couple of days. They are suitable for children with seasonal rhinitis, so it’s best to use them for preventive purposes a few weeks before the start of the flowering season. Sprays should be used every day to control the symptoms. Spray needs to be sprayed in a nose, having inclined a head. In some children, nose bleeding begins with the use of sprays. It is not caused by the spray of the drug, it is the result of the inflammatory process. The drugs are aimed at reducing inflammation. If the bleeding is abundant and long-term, then it is necessary to consult a doctor and replace the prescribed remedy.
Eye drops are especially effective if eye problems are one of the main symptoms of allergic rhinitis. Like nasal sprays, they work best with regular use. Starting the application is necessary before the start of the flowering season. Many eye drops contain cromoglycate that blocks cells that release histamine. In order to drip the drops, the child must put it on the bed, gently pull down the lower eyelid and carry out the procedure. It is better to place the head of small children on the lap of one of the parents in order to control the effectiveness of the procedure. Older children may sit with their heads thrown back during the instillation.
Anti-leukotrienes. This is a relatively new type of medication used to control asthma symptoms. These drugs help reduce lung constriction and reduce the likelihood of fluid accumulation in the lungs. They are usually assigned inside.
Immunotherapy is used to improve the action of the above drugs and strengthen the body in the fight against the disease. The goal of immunotherapy is to change the immune system so that it no longer responds to allergens as a threat. Subcutaneous immunotherapy is the most common type of immunotherapy treatment, and includes the introduction of an injection with an allergen to a child. The introduction of injections can reduce the reaction to allergens or completely eliminate the symptoms of allergic rhinitis. But with subcutaneous immunotherapy during treatment, an allergic reaction may increase, so this type of treatment should be under the supervision of a physician. Due to the possible severe allergic reaction, this treatment is carried out only in adolescents, in preschool and older children it is not used. Also, immunotherapy may consist of drugs in the form of tablets and spray. There is a risk of some mild allergic reactions, but they usually disappear over time, and in general, treatment is rated as successful in reducing the severity of symptoms. This type of treatment allows patients to control their allergies.
Prevention of Allergic Rhinitis in Children
Preventive measures to prevent allergic rhinitis include the following:
- Environmental control – the use of air conditioning during the flowering season. Windows should be closed, especially in the morning and in windy weather.
- Do not visit the area where there is heavy dust, mites.
- Refusal of pets.
- Control of diseases such as asthma, sinusitis, which are closely associated with allergic rhinitis.
- Air humidification.
- Taking antihistamines on a regular basis. Some drugs are not suitable for younger children, so it is important that parents discuss the choice of drugs with a doctor.
- Perform prescribed treatment.
- Limit walks and visits to parks during the flowering season.