2008 – Allergen avoidance is the first step in treating chronic rhinitis
Exposure to house dust mites is a major cause of perennial rhinitis. Steps for treating allergic rhinitis begin with taking the patients clinical history combined with skin prick testing/serum specific IgE blood tests and allergen/irritant avoidance along with nasal douching. If symptoms continue selected medication should be prescribed as listed in the published Guidelines.
Allergic rhinitis is predominant among children and accounts for about a third of rhinitis cases in adults. It significantly reduces quality of life and interferes with both attendance and performance at school and work. Allergy to house dust mites or cats is a risk factor for both asthma and rhinitis. Rhinitis is diagnosed by history and examination backed up by specific allergy tests. Standardized allergy education improves disease specific quality of life. Treatment of rhinitis is associated with benefits for asthma. Most asthmatics have rhinitis. Skin prick tests should be carried out routinely in all cases and must be interpreted with a clinical history. This is important as the tests are known to have a high negative predictive value and 15% of patients with positives outcomes do not develop symptoms upon exposure to allergens.
House dust mite avoidance for clinical benefits is most likely achieved with multiple interventions such as mite proofing beds, removing carpets and upholstered furniture.
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BSACI* Guidelines for the Management of Allergic and non-Allergic Rhinitis, G.K. Scadding et al; Clinical and Experimental Allergy, 2008, 38, p19-42 (* British Society for Allergy and Clinical Immunology)
Of the 22 recognised allergens from dust mites 7 are active enzymes, one of which is similar to a tenderiser used in the food industry.
