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How does your GP diagnose allergic rhinitis?

To diagnose allergic rhinitis, your healthcare provider will ask you a range of questions, perform a physical exam, and some may also offer specific tests to diagnose the condition (depending on the availability of the materials in their office). Your provider may also refer you to a specialist for additional testing, but this is usually only needed when the diagnosis is not clear or when treatment fails.
To feel optimally prepared for your first consultation, check out our PDF guide here.

What your GP might do/propose:

  • Ask about your symptoms and triggers: Your doctor will talk with you to understand what symptoms you’re experiencing and whether you’ve noticed anything that might be triggering them. They may ask where you were and what you were doing when the symptoms began, and whether they follow a seasonal pattern or occur all year round.
  • Observe: In addition to listening to your description of symptoms, the doctor will also look at your face for physical signs that may suggest allergic rhinitis or allergic conjunctivitis. They may check for watery or red eyes, a runny nose, dark circles under the eyes (“allergic shiners”), and other visible features that can help them understand what’s going on.
  • Test for allergies: This can be done via a blood test or via skin prick testing, depending on availability. Both look for IgE antibodies to specific allergens. For a skin prick test, your healthcare provider places small drops of different allergens on your forearm and lightly pricks the skin beneath each drop. After 15 minutes, they check for a reaction. If you’re allergic to a particular allergen, the skin around that spot will typically become red, itchy, and slightly swollen. If you take oral antihistamines, your healthcare team will let you know how many days before your appointment you need to stop them. If antihistamines are not stopped in time, the skin prick test may not work properly.
  • Look inside your nose: sometimes your doctor will use a special tool to check the front part of your nose. This is called an anterior rhinoscopy. It helps them see if the thin layer of tissue inside your nose (called the lining) is swollen, irritated, or damaged. They will also check for growths, like nasal polyps.
  • Check your ears: sometimes the GP uses an otoscope (a small lighted device for looking inside the ears) to check the ear canal, the eardrum, and the middle ear. This helps the doctor see signs of problems such as eustachian tube dysfunction (which can be triggered by allergies) or ear infections

How does a specialist diagnose allergic rhinitis?

Specialists, like an allergist or ear-nose-throat (ENT) doctor may perform more advanced tests to confirm your diagnosis and find out what’s causing your symptoms. They may also repeat some tests already done by your GP.

  • Test for allergies: This can be done via a blood allergy test or via skin prick testing (see above).
  • Nasal allergen challenge: This is a test used to find out whether your nose reacts to certain allergens. It can help diagnose seasonal allergies, year round allergies, “local allergic rhinitis” (a type of allergy that doesn’t show up on skin or blood tests but only inside the nose), and allergies related to your workplace. Sometimes it is also done before starting allergen immunotherapy when someone is allergic to many different things. During this test, small amounts of allergens are placed inside your nose, and your symptoms and reactions are closely monitored.

Your provider may also explore whether you also have one or more other diseases that frequently occur alongside allergic rhinitis. This can be done by asking you specific questions and by performing or ordering additional tests. These may include:

  • Nasal endoscopy: A thin camera is used to look further up inside your nose and sinuses.
  • Other tests to check whether you have chronic rhinosinusitis: learn more here
  • Test how your lungs are working: there are several breathing tests to evaluate how well your lungs are working. The most commonly performed lung function tests are spirometry and peak flow measurements. Spirometry tests measure the amount of air you can blow out in one forced breath. A peak flow test is performed to measure how fast you can blow air out of your lungs.
  • Other tests to check whether you have asthma: learn more here

Disclaimer

This website does not provide medical advice.

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Overview

How does your GP diagnose allergic rhinitis?
How does a specialist diagnose allergic rhinitis?
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