Comorbidities of Allergic Rhinitis

Allergic rhinitis is an increasingly common condition with typical symptoms of itchy and runny nose, sneezing, nasal congestion, and postnasal drainage. Frequently brushed off as “a pesky runny nose”, it has been shown that allergic rhinitis is often not an isolated disorder, but coincides with a multitude of other conditions including asthma, sinusitis, conjunctivitis, chronic otitis media, tonsillar and adenoid hypertrophy, sleep apnea, snoring, pharyngitis, laryngitis and disordered sleep. Allergic rhinitis and related comorbidities often negatively impact quality of life.

Allergic rhinitis results from an abnormal immune response to substances encountered in the environment such as pollens, pet dander, mold, and droppings from dust mites and cockroaches. The incidence of allergic rhinitis is estimated at 10-30% of the world’s population and symptoms are often under-recognized and undertreated. It has also been shown that poorly controlled allergic rhinitis is an exacerbating factor for asthma based on a shared common inflammatory pathway and the concept of “one airway”. Controlling allergic rhinitis is a key to maintaining asthma control. Recurrent sinus infections and worsening conjunctivitis are also often related to uncontrolled allergic rhinitis.

Identifying specific allergens with allergy testing allows customization of a treatment plan to include avoiding allergens, medications, and immunotherapy. Immunotherapy is the only therapy that treats the underlying cause, hence not only reducing pesky nasal symptoms, but significantly impacting eye symptoms, asthma and all the other associated disorders. Studies have shown that treating allergic rhinitis with immunotherapy not only improves allergic asthma, but can prevent it from occurring by eliminating the immune system response to potential triggers.
Don’t brush off a runny nose. Likely there are many other related symptoms that can be influenced by adequately treating allergic rhinitis.

Madeline Dillon, MD
Allergy Partners of Charlottesville

References:
Hadley JA, Derebery MJ, Marple BF. Comorbidities and allergic rhinitis: not just a runny nose. J Fam Pract. 2012 Feb;61(2 Suppl):S11-5.

Meltzer EO, Gross GN, Katial R, Storms WW. Allergic rhinitis substantially impacts patient quality of life: Findings from the Nasal Allergy Survey Assessing Limitations. J Fam Pract. 2012;61(suppl 1):S5-S10.
World Health Organization. White Book on Allergy 2011-2012 Executive Summary. By Prof. Ruby Pawankar, MD, PhD, Prof. Giorgio Walkter Canonica, MD, Prof. Stephen T. Holgate, BSc, MD, DSc, FMed Sci and Prof. Richard F. Lockey, MD.
Summary Health Statistics for U.S. Adults: National Health Interview Survey, 2010. By Jeannine S. Schiller, M.P.H., Jacqueline W. Lucas, M.P.H., Brian W. Ward, PhD and Jennifer A. Peregory, M.P.H., Division of Health Interview Statistics.
Bachert C, Vignola AM, Gevaert P, Leynaert B, Van Cauwenberge P, Bousquet J. Allergic rhinitis, rhinosinusitis, and asthma: one airway disease. Immunol Allergy Clin North Am. 2004;24(1):19-43.