What are the symptoms of allergic rhinitis?

From the Guidelines

Allergic rhinitis symptoms include sneezing, runny nose, nasal congestion, itchy nose, itchy or watery eyes, postnasal drip, and sometimes fatigue, and the most effective treatment approach is to recommend intranasal steroids for patients whose symptoms affect their quality of life, as stated in the clinical practice guideline 1.

Key Symptoms

The symptoms of allergic rhinitis occur when the immune system overreacts to allergens like pollen, dust mites, pet dander, or mold, and can be classified by the temporal pattern of exposure to a triggering allergen, such as seasonal, perennial/year-round, or episodic 1.

• Sneezing
• Runny nose
• Nasal congestion
• Itchy nose
• Itchy or watery eyes
• Postnasal drip
• Fatigue

Treatment Approach

For mild symptoms, over-the-counter antihistamines like cetirizine (Zyrtec), loratadine (Claritin), or fexofenadine (Allegra) can provide relief, typically taken once daily, while nasal corticosteroid sprays such as fluticasone (Flonase) or triamcinolone (Nasacort) are effective for moderate to severe symptoms, usually used as 1-2 sprays per nostril daily 1.

• Over-the-counter antihistamines for mild symptoms
• Nasal corticosteroid sprays for moderate to severe symptoms
• Saline nasal rinses to flush allergens from nasal passages
• Decongestant sprays like oxymetazoline for immediate relief of congestion, but only for up to 3 days to avoid rebound congestion

Reducing Exposure to Triggers

Avoiding known allergens, keeping windows closed during high pollen seasons, using air purifiers, and washing bedding regularly in hot water can help reduce exposure to triggers, as suggested in the clinical practice guideline 1.

• Avoiding known allergens
• Keeping windows closed during high pollen seasons
• Using air purifiers
• Washing bedding regularly in hot water

Diagnosis and Testing

The diagnosis of allergic rhinitis is based on a history and physical exam consistent with an allergic cause, and may include specific IgE (skin or blood) allergy testing for patients who do not respond to empiric treatment, or when the diagnosis is uncertain, or when knowledge of the specific causative allergen is needed to target therapy 1.

• History and physical exam consistent with an allergic cause
• Specific IgE (skin or blood) allergy testing for patients who do not respond to empiric treatment or when the diagnosis is uncertain.

From the FDA Drug Label

The primary outcome variable was mean change from baseline in daytime nasal symptoms score (the average of individual scores of nasal congestion, rhinorrhea, nasal itching, sneezing) as assessed by patients on a 0-3 categorical scale Symptoms of allergic rhinitis may include: stuffy, runny, and/or itchy nose sneezing

Allergic Rhinitis Symptoms:

• Nasal congestion
• Rhinorrhea
• Nasal itching
• Sneezing The drug label for montelukast 2 and 2 indicates that the medication is used to treat symptoms of allergic rhinitis, which include nasal congestion, rhinorrhea, nasal itching, and sneezing.

From the Research

Allergic Rhinitis Symptoms

• Allergic rhinitis typically presents with symptoms of nasal congestion, rhinorrhea, postnasal drainage, sneezing, and itching of the eyes, nose, and throat 3
• The most common symptoms of allergic rhinitis are rhinorrhea (90.38%) and nasal congestion (94.23%) 3
• Patients with seasonal allergic rhinitis typically have physical examination findings of edematous and pale turbinates, while patients with perennial allergic rhinitis typically have erythematous and inflamed turbinates with serous secretions 3
• Main symptoms defining allergic rhinitis are: sneezing, itchy nose, rhinorrhoea and nasal congestion 4

Classification of Allergic Rhinitis

• Intermittent allergic rhinitis is defined as symptoms occurring less than 4 consecutive days/week or less than 4 consecutive weeks/year 3
• Persistent allergic rhinitis is defined as symptoms occurring more often than 4 consecutive days/week and for more than 4 consecutive weeks/year 3

Treatment of Allergic Rhinitis

• First-line treatment for mild intermittent or mild persistent allergic rhinitis may include a second-generation H1 antihistamine or an intranasal antihistamine 3
• Patients with persistent moderate to severe allergic rhinitis should be treated initially with an intranasal corticosteroid either alone or in combination with an intranasal antihistamine 3, 5, 6
• Combination therapy of an intranasal corticosteroid and an oral antihistamine may be considered for patients with moderate to severe allergic rhinitis 6, 4
• A fixed combination of intranasal corticosteroid and intranasal antihistamines may be considered to be most beneficial, particularly in monotherapy and AR resistant to previous treatment 4