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Back Typical symptoms Symptoms of allergic rhinitis (AR) vary from person to person and may fluctuate over time, even in the same individual. The term ‘rhinitis’ refers to nasal problems, but many people are also affected by symptoms of the eyes, mouth, throat, and ears. Nasal symptoms: nasal congestion sneezing, often in sudden bouts of repeated sneezing runny and/or itchy nose mucus dripping down the back of the throat (postnasal drip) Eyes: itchy, watery, and/or red eyes: In some people, allergens also cause reactions in the eyes, causing an inflammatory reaction, referred to as allergic conjunctivitis. “allergic shiners”: Some people also experience discolorations of the skin beneath the eyes. When you have allergies, your nose gets blocked and inflamed. This slows down normal blood flow in the small veins under your eyes. Because the skin there is very thin, the blood shows through and makes the area look dark, bluish, or purple, medically referred to as “allergic shiners”. Mouth – Throat: itching of the tongue, roof of the mouth, and/or throat rarely, sore throat Ears: the Eustachian tube joining the back of the nose to the middle ear (the air-filled chamber located directly behind the eardrum, acting as a bridge between the outer ear and the inner ear) is often involved in the allergic inflammation, particularly in children. This makes it difficult to equalize pressure in the ears, for example when a plane descends. This leads to ear discomfort and popping. Glue ear (temporary deafness due to middle ear fluid) is also more common in children with AR and is helped by effective AR treatment. Sinuses: the sinus linings can also swell with allergen exposure, leading to facial discomfort and making infection more likely. This happens because congestion reduces the normal drainage of mucus from the sinuses, allowing viruses or bacteria to become trapped, potentially leading to infection. Chest: AR can make the lining of the lower airways more irritable, leading to symptoms such as coughing, wheezing, and shortness of breath. Effective treatment of AR helps prevent this and stops nerve signals that can trigger irritation in the lower airways. Allergic rhinitis also occurs in many people with asthma, where inflammation is already present in the lower airways. In this situation, both the upper and lower airways require treatment. Speak with your healthcare provider if you experience any chest symptoms. Impact of symptoms Although allergic rhinitis is sometimes brushed off as a minor nuisance, it is a medical condition that can greatly affect daily life. Symptoms are often described by patients as bothersome, and they can disturb sleep, leaving people feeling tired during the day and making it harder to concentrate or think clearly. Many people find that their work or school performance suffers. Seasonal AR is associated with reduced grades in adolescents taking major examinations. Allergic rhinitis can have a major impact on overall quality of life if it is not well controlled with medical treatment. Moreover, when not properly treated, allergic rhinitis can increase the risk of related conditions, including ear infections, sinus infections, and asthma. Poorly controlled allergic rhinitis may worsen asthma symptoms and increase exacerbations. VIDEO HERE : testimonial videos by AR patients recorder at GAD/PEARL Classification of symptoms Healthcare professionals often classify allergic rhinitis based on how often symptoms occur and how much they affect daily life. This classification helps guide decisions about the most appropriate treatment. Although this classification system has its merits, it has also been criticised by the scientific community. For example, someone with symptoms 3 days a week all year round would technically be “intermittent”, even though their symptoms act more like persistent ones. When allergen contact is intermittent the initial nasal symptoms can be dramatic with sneezing, itching and runny nose. When allergen exposure is persistent the major symptom is often nasal blockage, with mucus dripping down the back of the throat (post-nasal drip), and the diagnosis can be sometimes be missed. What to do? A. When you first notice symptoms: self-management Allergic rhinitis is often self-managed with the support of a pharmacist, though you can always see your GP early on if you’d like a confirmed diagnosis and treatment guidance. The pharmacist can help determine whether your symptoms are likely caused by allergic rhinitis or another condition and guide you toward appropriate self-management options. Pharmacists are also trained to recognize when a referral to a GP is needed. “Red-flag” symptoms that warrant a doctor’s visit: NOSE: one-sided nasal symptoms isolated nasal obstruction or isolated rhinorrhoea (especially when only occurring on one side and worse when bending over) pain loss of smell recurrent nose bleeds EYES: symptoms affecting only one eye burning rather than itchy eyes sensitivity to light, swelling, decreased vision. If severe this could be orbital cellulitis, which needs emergency treatment CHEST: new-onset wheezing in the absence of a cold shortness of breath persistent cough poor symptom control of known asthma If none of the above-mentioned “red flag symptoms” are present then you could self-treat, using the EUFOREA Patient Journey algorithm as a guide. Step 1:Important first steps are to avoid as far as possible those things that you find cause your symptoms. This could be an allergen or another non-specific trigger, like cigarette smoke. Find out more about these strategies in the Lifestyle and Prevention module. Step 2: Nasal saline rinsing helps keep your nose clean and reduce symptoms, making this a useful daily support in your allergic rhinitis self management. Step 3: If these avoidance measures and rinsing with nasal saline are insufficient to control your symptoms, you could add a medicine from the list below. They are available over-the-counter in most countries. Treatment options are:– nasal corticosteroid sprays– non-sedating antihistamine tablets– nasal antihistamine sprays In the self-management of allergic rhinitis: AVOID decongestants and sedating antihistamines. Find out more information about each of these treatment options in our dedicated Treatment module. All treatments for allergic rhinitis — including for people with intermittent symptoms — work best when taken consistently on a daily basis, starting before your symptoms