The triggering factors of allergic rhinitis are the same as those of bronchial asthma. They include food, animals, dust mites, drugs and chemicals, although inhalant factors are primarily responsible for allergic rhinitis.

Special care should be taken with the following factors:

• dust found at home, especially on carpets and curtains, rich in mites;

• inhalation of pollen present in air, grass or trees and air pollutants (mainly ozone and sulfur dioxide);

• infections of the respiratory tract by viruses (especially adenovirus) and bacteria;

• pet hair (cats, dogs);

• fungal spores present in the soil (dust) and suspended in atmospheric air;

• inspiration of cold air;

• emotional state;

• cigarette smoke;

• inhalation of hair sprays and deodorants;

• aspirin;

• physical exercises

• occupational factors: flour (for bakers), animal hair or their feces (for people working in a zoo, for example), steamers etc.;

• foods such as milk, chocolate, tomatoes, crustaceans, etc.

The clinical status of allergic rhinitis is characterized by the following signs and symptoms:

• Sneezing: often the only symptom of rhinitis. It occurs soon after contact with the allergens, happen in "saves" and can last for several minutes.

• Pruritus (itching): sneezing is usually accompanied by nasal itching, which may extend into the ocular conjunctiva, the external auditory canal and even the upper lip. The presence of itching in nasal symptomatology is a positive diagnosis of nasal allergy in most cases. Both sneezing and pruritus or itching occur due to an irritation of the nerve endings of the local mucosa, the presence of edema and inflammation present in the region.

• Rhinorrhea (runny nose): this is the abundant secretion of mucus fluid from the nose. There may even be spontaneous dripping of the secretion. It occurs as a result of increased secretion of the glands of the nasal mucosa. When the allergy is prolonged, this secretion becomes presenting itself as greenish or, with associated infections, yellowish.

   

• Nasal obstruction: is a very common symptom. More rarely, it may be the only symptom the patient presents. It can affect one or both of the nasal cavities and is the symptom that most disturbs the patient, as it forces him or her to breathe through the mouth, besides significantly disturbing his/her sleep (worsening nasal obstruction occurs when the patient lies down, due to the accumulation of secretion).

The pharmacological treatments of allergic rhinitis are divided into:

• Antihistamines – the first-line treatment for the control of allergic rhinitis. These drugs block histamine binding to the H1 receptor, thereby blocking most of the symptoms associated with this disease.

• Inhalation or topical corticosteroids – the use of this highly effective therapeutic class is aimed at reducing the inflammatory response of the allergic reaction. The result is a regression of all inflammatory and allergic symptoms.

• Decongestants – these are nasal vasoconstrictors commercially available for use in rhinitis. They cause a contraction of the smooth muscle of the vessels in the nasal mucosa. These medications reduce nasal obstruction related to allergic or non-allergic factors but do not affect the inflammatory process or promote improvement in rhinorrhea, nasal pruritus, or sneezing.

   

• Anticholinergics – these may assist in the treatment of allergic rhinitis, especially in the control of rhinorrhea (presence of mucus and secretions). They treat this symptom alones.

• Specific immunotherapy (vaccines) – can be applied subcutaneously or intradermally by administering gradually increasing doses of the main antigens that may be causing rhinitis in the patient with variable results. The goal, in this case, is to promote the formation of antibodies.

• Saline solutions – are used as coadjutants in nasal lavage, in addition to reducing the viscosity of the mucus.

As with asthma, the patient should be informed about the various measures that may reduce exposure to triggering or aggravating factors. Below there are some environmental control measures that can effectively assist in the treatment of patients with allergic rhinitis:

• exposure to allergens and triggers should be avoided, such as dust, strong odors, wool blankets, mildew, etc.;

• The sleeping area should preferably be well ventilated and sunny;

• Mold and moisture must be kept in check, especially in the bedroom;

• Beds and cribs should not be adjacent to the wall;

• Animal hair and feathers should be avoided, especially in the patient's bedroom and bed;

• Stuffed animals, bookshelves, magazines, cardboard boxes, or any other place where mite colonies can be formed in the bedroom should be avoided;

• Rugs, carpets, curtains and cushions should not be used.

Non-allergic rhinitis may present the same symptoms as allergic rhinitis. However, rhinitis caused by known factors, such as drugs (aspirin), irritants (gases and chemicals), and physical factors such as very cold or dry air and excessive exposure to light come under this category. Idiopathic rhinitis (vasomotor) has no known causes or triggering factors.