Alergiczny nieżyt nosa – Zapobieganie i profilaktyka

Alergiczny nieżyt nosa
Zapobieganie i profilaktyka

Alergiczny nieżyt nosa (ANN) jest przewlekłą chorobą immunologiczną, której profilaktyka opiera się na trzystopniowym podejściu: pierwotnym (eliminacja czynników środowiskowych i zawodowych), wtórnym (unikanie alergenów i czynników drażniących) oraz trzeciorzędowym (zapobieganie zaostrzeniom i poprawa kontroli choroby). Kluczowe jest ograniczenie ekspozycji na najczęstsze alergeny, takie jak roztocza kurzu domowego, pyłki roślin, sierść zwierząt i zarodniki pleśni, poprzez stosowanie pokrowców przeciwalergicznych, utrzymanie wilgotności powietrza na poziomie 30-50%, częste pranie w temperaturze ≥60°C, używanie odkurzaczy z filtrem HEPA oraz unikanie aktywności zwiększających kontakt z alergenami. W farmakoterapii profilaktycznej skuteczne są leki przeciwhistaminowe II generacji (np. cetyryzyna 10 mg/dobę) oraz donosowe kortykosteroidy stosowane regularnie i długoterminowo, zgodnie z wytycznymi ARIA. Alternatywnie stosuje się kromoglikan sodowy, antagonistów receptorów leukotrienowych oraz kombinacje leków donosowych u pacjentów z opornymi objawami.

Profilaktyka alergicznego nieżytu nosa

Alergiczny nieżyt nosa (ANN) to przewlekła choroba immunologiczna, która dotyka znaczącą część populacji i może istotnie wpływać na jakość życia pacjentów. Skuteczna profilaktyka tej jednostki chorobowej opiera się na kilku kluczowych strategiach mających na celu zmniejszenie ekspozycji na alergeny oraz zapobieganie wystąpieniu i nasileniu objawów¹.

Stopniowa profilaktyka ANN

Współczesne podejście do zapobiegania alergicznemu nieżytowi nosa obejmuje profilaktykę stopniowaną, składającą się z trzech poziomów¹:

Profilaktyka pierwotna – polega na eliminacji przyczyn kluczowych dla rozwoju choroby, w tym modyfikacji czynników środowiskowych i zawodowych
Profilaktyka wtórna – koncentruje się na unikaniu klinicznie istotnych alergenów i czynników drażniących
Profilaktyka trzeciorzędowa – ma na celu zapobieganie zaostrzeniom, poprawę kontroli choroby i zmniejszenie zapotrzebowania na leki, gdzie stosowne jest profilaktyczne podejście farmakologiczne oraz immunoterapia alergenowo-swoista u pacjentów z wczesnymi objawami

Unikanie alergenów jako podstawa profilaktyki

Najlepszym sposobem zapobiegania objawom alergicznego nieżytu nosa jest unikanie alergenów, które go wywołują¹². Chociaż całkowite wyeliminowanie alergenów z otoczenia jest często niemożliwe, ograniczenie ekspozycji może znacznie zmniejszyć częstotliwość i nasilenie objawów³.

Profilaktyka dotycząca roztoczy kurzu domowego

Roztocza kurzu domowego są jednym z najczęstszych alergenów wywołujących objawy alergicznego nieżytu nosa. Badania wykazały, że prawie 20% pacjentów z przewlekłym alergicznym nieżytem nosa stosuje środki zapobiegawcze przeciwko roztoczom kurzu domowego⁴. Do najczęściej stosowanych form profilaktyki przeciwroztoczowej należą pokrowce na materace oraz specjalne spraye przeciwroztoczowe⁴.

Aby ograniczyć liczbę roztoczy w domu, zaleca się⁵⁶:

Stosowanie pokrowców przeciwalergicznych na materace, kołdry i poduszki
Wybieranie drewnianych lub twardych winylowych pokryć podłogowych zamiast dywanów
Montowanie rolet, które łatwo można wyczyścić
Częste pranie poszewek, miękkich zabawek, zasłon i tapicerowanych mebli (w temperaturze co najmniej 60°C)
Stosowanie syntetycznych poduszek i akrylowych kołder zamiast wełnianych koców lub pościeli z piór
Korzystanie z odkurzacza z filtrem HEPA (High-Efficiency Particulate Air)
Używanie wilgotnej ściereczki do wycierania powierzchni (suche odkurzanie może rozprzestrzeniać alergeny)
Utrzymywanie wilgotności powietrza w domu poniżej 50%

Profilaktyka dotycząca alergenów zwierzęcych

W przypadku alergii na zwierzęta domowe, optymalnym rozwiązaniem jest nieposiadanie zwierzęcia⁷. Jeśli nie można usunąć zwierzęcia z domu, należy⁸⁹:

Trzymać zwierzęta na zewnątrz jak najdłużej lub ograniczyć ich przebywanie do jednego pomieszczenia, najlepiej bez dywanu
Nie wpuszczać zwierząt do sypialni
Kąpać zwierzęta co najmniej raz na dwa tygodnie
Często czyścić psy, najlepiej na zewnątrz
Regularnie prać posłania i miękkie meble, na których przebywało zwierzę
Używać filtrów HEPA w odkurzaczach i klimatyzatorach w celu zmniejszenia ilości sierści zwierząt w powietrzu
Myć ręce po kontakcie ze zwierzętami

Profilaktyka dotycząca pyłków roślin

Aby uniknąć ekspozycji na pyłki roślin, zaleca się¹⁰¹¹¹²:

Sprawdzanie prognoz dotyczących stężenia pyłków i pozostawanie w pomieszczeniach, gdy jest ono wysokie
Unikanie suszenia ubrań i pościeli na zewnątrz w okresach wysokiego stężenia pyłków
Noszenie okularów przeciwsłonecznych z ochroną boczną, aby chronić oczy przed pyłkami
Zamykanie drzwi i okien, szczególnie w południe i wczesnym wieczorem, kiedy stężenie pyłków w powietrzu jest najwyższe
Kąpiel, mycie włosów i zmiana ubrań po przebywaniu na zewnątrz
Unikanie terenów trawiastych, takich jak parki i pola, gdy to możliwe
Korzystanie z klimatyzacji z filtrami w samochodzie i domu
Unikanie aktywności takich jak koszenie trawy czy grabienie liści, które mogą wzbudzać alergeny

Profilaktyka dotycząca pleśni

Aby zapobiec rozwojowi zarodników pleśni, należy¹³¹⁴:

Utrzymywać dom w suchości i zapewniać dobrą wentylację
Podczas kąpieli lub gotowania używać wentylatorów wyciągowych lub otwierać okna, ale zamykać drzwi wewnętrzne, aby zapobiec rozprzestrzenianiu się wilgotnego powietrza
Unikać suszenia ubrań w pomieszczeniach, przechowywania ubrań w wilgotnych szafkach i zbyt ciasnego układania ubrań w szafach
Eliminować wszelkie zawilgocenia i skraplanie się wody w domu
Utrzymywać wilgotność w domu na poziomie 30-50%
Regularnie czyścić łazienki, kuchnię i piwnicę
Używać osuszaczy powietrza, szczególnie w piwnicy i innych wilgotnych miejscach

Farmakologiczna profilaktyka alergicznego nieżytu nosa

Oprócz unikania alergenów, ważnym elementem profilaktyki alergicznego nieżytu nosa jest odpowiednie stosowanie leków¹⁵¹⁶.

Profilaktyczne stosowanie leków przeciwhistaminowych

Badania wykazały skuteczność profilaktycznego stosowania leków przeciwhistaminowych drugiej generacji, takich jak cetyryzyna i terfenadyna, w zapobieganiu objawom sezonowego alergicznego nieżytu nosa¹⁷. Stwierdzono, że 10 mg cetyryzyny podawanej raz dziennie jest równie skuteczne jak 60 mg terfenadyny podawanej dwa razy dziennie w profilaktycznym leczeniu sezonowego alergicznego nieżytu nosa¹⁷.

Dla uzyskania optymalnych wyników, leki przeciwhistaminowe powinny być przyjmowane profilaktycznie 2-5 godzin przed ekspozycją na alergen lub regularnie, a nie doraźnie¹⁸. Amerykańska Akademia Alergii, Astmy i Immunologii (AAAAI) zaleca rozpoczęcie przyjmowania leków przed sezonem pylenia, aby zapobiec atakom alergicznym¹⁹.

Kortykosteroidy donosowe w profilaktyce

Donosowe kortykosteroidy są uznawane za najskuteczniejsze leki w kontrolowaniu objawów alergicznego nieżytu nosa²⁰²¹. Dla uzyskania najlepszych rezultatów, leki te powinny być stosowane regularnie i długoterminowo, podobnie jak leki zapobiegawcze w astmie²².

Wytyczne ARIA (Allergic Rhinitis and its Impact on Asthma) zalecają donosowe kortykosteroidy jako najlepszą opcję zarówno w łagodnym, jak i umiarkowanym do ciężkiego alergicznym nieżycie nosa, zarówno u dzieci, jak i dorosłych²³. Kortykosteroidy donosowe hamują wczesną i późną fazę alergiczną w alergicznym nieżycie nosa, zapobiegając rekrutacji komórek immunologicznych i uwalnianiu mediatorów zapalnych²³.

Inne leki w profilaktyce ANN

Do innych leków stosowanych w profilaktyce alergicznego nieżytu nosa należą²⁴²⁵:

Kromoglikan sodowy donosowy – uważany za lek drugiego rzutu w leczeniu alergicznego nieżytu nosa; jest mniej skuteczny niż leki przeciwhistaminowe i donosowe kortykosteroidy
Antagoniści receptora leukotrienowego (LTRA) – blokują aktywność cysteinylowych leukotrienów (CysLTs), potężnych mediatorów zapalnych związanych z przekrwieniem błony śluzowej nosa, produkcją śluzu i rekrutacją komórek zapalnych
Kombinacja donosowego leku przeciwhistaminowego i kortykosteroidu – zalecana dla pacjentów, którzy nie reagują odpowiednio na same kortykosteroidy donosowe

Immunoterapia w profilaktyce alergicznego nieżytu nosa

Immunoterapia swoista alergenowo jest jedyną metodą leczenia, która może zmienić naturalny przebieg alergicznego nieżytu nosa i zapewnić długotrwałą ulgę od objawów²⁶²⁷.

Rodzaje immunoterapii

Dostępne są dwa główne rodzaje immunoterapii²⁸²⁹:

Immunoterapia podskórna (SCIT) – polega na podawaniu zastrzyków z alergenem w rosnących dawkach, aż do osiągnięcia dawki podtrzymującej. Program leczenia zazwyczaj trwa od trzech do pięciu lat i wymaga cotygodniowych wizyt w celu podania leku przez pierwsze 4-6 miesięcy.
Immunoterapia podjęzykowa (SLIT) – zatwierdzona przez FDA w 2014 roku, polega na codziennym rozpuszczaniu tabletki pod językiem, rozpoczynając kilka miesięcy przed sezonem alergicznym. Niektórzy pacjenci korzystają z całorocznego leczenia, które może trwać do trzech lat.

Wskazania do immunoterapii

Immunoterapię należy rozważyć w następujących przypadkach³⁰³¹:

Umiarkowany lub ciężki przetrwały alergiczny nieżyt nosa, który nie reaguje na standardowe leczenie
Pacjenci, którzy nie tolerują standardowych terapii lub chcą uniknąć długoterminowego stosowania leków
Pacjenci z alergiczną astmą
Gdy objawy są ciężkie
Gdy nie można uniknąć alergenu
Gdy leczenie farmakologiczne jest niewystarczające

Pierwsze próby odczulania powinny rozpocząć się wkrótce po zakończeniu sezonu pylenia, aby przygotować się na następny sezon. Niepożądane reakcje zwiększają się, gdy odczulanie rozpoczyna się w trakcie sezonu pylenia, ponieważ odporność alergiczna pacjenta jest już maksymalnie pobudzona³¹.

Specjalne grupy pacjentów w profilaktyce ANN

Profilaktyka u dzieci

Dla dzieci z alergicznym nieżytem nosa zaleca się³²³³³⁴:

Karmienie piersią przez pierwsze 4-6 miesięcy życia, co może wzmocnić układ odpornościowy dziecka i opóźnić lub zapobiec rozwojowi atopowego zapalenia skóry i alergii na mleko
W przypadku niemowląt z wysokim ryzykiem rozwoju alergii, gdy matka nie może karmić piersią, zaleca się stosowanie hydrolizowanych preparatów dla niemowląt jako hipoalergicznych zamienników mleka krowiego i sojowego
Podejmowanie kroków w celu kontroli roztoczy kurzu domowego, takich jak pokrywanie materaców, stosowanie pościeli hipoalergicznej i pranie jej regularnie w temperaturze 60°C
Redukcja liczby pluszowych zabawek i innych przedmiotów gromadzących kurz w pomieszczeniach, gdzie dziecko spędza dużo czasu
Bardzo ważne jest, aby nie narażać dzieci na dym tytoniowy przed i po urodzeniu

Profilaktyka u kobiet w ciąży

W przypadku kobiet w ciąży z alergicznym nieżytem nosa³⁵:

Jeśli alergiczny nieżyt nosa jest uciążliwy lub skuteczne leczenie pomaga kontrolować objawy astmy, lekarz może zalecić przyjmowanie leków w trakcie ciąży
Ograniczanie ekspozycji na znane alergeny jest szczególnie ważne
Najnowsze informacje wskazują, że nie ma znaczących korzyści w zapobieganiu alergiom pokarmowym u dziecka, jeśli matka unika wysoko alergennych pokarmów podczas ciąży i karmienia piersią³⁶

Profilaktyka u osób podróżujących

Dla podróżnych z alergicznym nieżytem nosa zaleca się³⁷³⁸:

Zakup ubezpieczenia podróżnego obejmującego usługi w nagłych wypadkach w miejscach podróży
Przegląd aktualnego poziomu kontroli objawów i schematu leczenia przed podróżą
Dostosowanie leków w celu maksymalnej kontroli objawów przed podróżą
Rozważenie zwiększenia dawki lub dodatkowej terapii profilaktycznej, jeśli podróżny będzie narażony na gorszą jakość powietrza lub inne aktywne sezony pylenia
Badanie zakwaterowania, które ogranicza ekspozycję na znane czynniki wyzwalające, takie jak pokrowce na pościel przeciw roztoczom kurzu, filtracja powietrza z klimatyzacją lub bez, pokoje bez zwierząt, pokoje dla niepalących i pokoje bez dywanów
Przechowywanie inhalatorów, innych leków, planu działania w astmie i karty z frazami medycznymi w apteczce lub przy sobie

Nowe kierunki w profilaktyce ANN

Mimo że unikanie alergenów jest powszechnie zalecane jako część strategii profilaktyki wtórnej i trzeciorzędowej alergicznego nieżytu nosa, dowody na skuteczność tych działań są niejednoznaczne³⁹.

Badania nad nowymi metodami profilaktyki

Niektóre obiecujące kierunki badań nad profilaktyką alergicznego nieżytu nosa obejmują⁴⁰⁴¹:

Kombinacje różnych środków zapobiegawczych – badania łączące wiele środków zapobiegawczych wykazały bardziej znaczące wyniki w porównaniu z badaniami oceniającymi tylko jeden rodzaj środka, co sugeruje, że różne sposoby radzenia sobie z ekspozycją lub stężeniem alergenów mogą być skuteczniejszym sposobem kontroli alergicznego nieżytu nosa
Strategie skupiające się na otaczającym środowisku – takie jak stosowanie akarycydów lub filtrów powietrza
Strategie skupiające się na jednostce – takie jak stosowanie filtrów donosowych lub mikroemulsji miejscowych
Probiotyki, prebiotyki i synbiotyki – chociaż obecnie nie ma silnych dowodów na zalecanie stosowania pro-, pre- lub synbiotyków w zapobieganiu astmie i alergicznemu nieżytowi nosa u dzieci, interwencja probiotyczna może mieć korzystną rolę w zapobieganiu i dodatkowym leczeniu alergicznego nieżytu nosa

Potrzeba dalszych badań

W przyszłości potrzebne są starannie zaprojektowane i przeprowadzone randomizowane badania, aby właściwie zmierzyć i zgłosić efekty wyżej wymienionych środków w zapobieganiu alergicznemu nieżytowi nosa oraz potencjalne skutki uboczne, aby zmniejszyć ogólne ryzyko błędu⁴². Ponadto prawidłowa ocena wszelkich długoterminowych skutków ubocznych będzie wymagać dużych badań obserwacyjnych⁴².

Na podstawie tych ustaleń należy przeprowadzić dalsze dobrze zaprojektowane badania obejmujące większą liczbę pacjentów z różnymi wrażliwościami na alergeny, aby poprzeć zalecenia dotyczące tych środków⁴³.

Praktyczne wskazówki profilaktyczne

Podsumowując, oto najważniejsze praktyczne wskazówki dotyczące profilaktyki alergicznego nieżytu nosa⁴⁴⁴⁵⁴⁶:

Unikaj dotykania twarzy i pocierania oczu lub nosa
Często myj ręce wodą i mydłem
Zamykaj okna w domu i samochodzie, szczególnie w okresie wysokiego stężenia pyłków
Używaj klimatyzacji z filtrem przeciwalergicznym
Stosuj pokrowce przeciwalergiczne na poduszki, materace i stelaże łóżek
Nie wpuszczaj zwierząt domowych do sypialni
Noś kapelusz z szerokim rondem i okulary przeciwsłoneczne, aby chronić oczy przed pyłkami
Myj się i zmieniaj ubrania po powrocie do domu
Utrzymuj dom w suchości i dobrej wentylacji
Używaj odkurzacza z filtrem HEPA i ścierki do kurzu
Regularnie pierz pościel w wysokiej temperaturze (min. 60°C)
Unikaj suszenia ubrań na zewnątrz w okresie wysokiego stężenia pyłków
Podczas sezonu pylenia pozostawaj w pomieszczeniach, gdzie jest klimatyzacja
Śpij przy zamkniętych oknach i jeźdź z zamkniętymi szybami

Warto podkreślić, że optymalne leczenie alergicznego nieżytu nosa obejmuje zarówno unikanie alergenów, jak i farmakoterapię⁴⁷. Leczenie powinno być zindywidualizowane w oparciu o częstotliwość i nasilenie dokuczliwych objawów⁴⁸.

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Materiały źródłowe

#1 Epidemiology, Prevention and Clinical Treatment of Allergic Rhinitis: More Understanding, Better Patient Care
https://pmc.ncbi.nlm.nih.gov/articles/PMC9605427/
With respect to prevention, graded prevention of AR has been proposed. Primary prevention involves eliminating causes that are critical to disease development, including changing causal or predisposing factors related to the environment and the workplace. Secondary prevention includes the avoidance of clinically relevant allergens and irritants. Tertiary prevention aims to prevent exacerbations, thereby improving disease control and reducing medication needs, where appropriate, pharmacological prophylaxis and allergen-specific immunotherapy for patients with early symptoms. […] In the future, carefully designed and executed randomized trials are needed to properly measure and report the effects of the above measures on AR prevention and potential adverse effects, so as to reduce the overall risk of bias. In addition, a correct assessment of any long-term adverse effect will require large observational studies.
#1
https://www2.hse.ie/conditions/allergic-rhinitis/allergic-rhinitis-prevention/
The best way to prevent allergic rhinitis is to avoid the allergen that causes it. […] To help limit the number of mites in your house: consider buying allergy-proof covers for mattresses, duvets and pillows; choose wood or hard vinyl floor coverings instead of carpet; fit roller blinds that are easy to wipe clean; clean cushions, soft toys, curtains and upholstered furniture often by washing or vacuuming them; use synthetic pillows and acrylic duvets instead of woollen blankets or feather bedding; use a vacuum cleaner fitted with a high-efficiency particulate air (HEPA) filter to remove more dust; use a clean damp cloth to wipe surfaces dry dusting can spread allergens further. […] If you cannot remove a pet from the house, you can try to: keep pets outside as much as possible or limit them to 1 room, preferably one without carpet; keep pets out of your bedroom; wash pets at least once a fortnight; groom dogs outside and often; wash bedding and soft furnishings your pet has been on often.
#2 Rhinitis, Nasal Allergy, Hayfever
https://aafa.org/allergies/allergy-symptoms/rhinitis-nasal-allergy-hayfever/
The first and best option is to avoid contact with allergens. Other prevention tips are: […] Don’t touch or rub your nose. […] Wash your hands often with soap and water. […] Use a Certified Asthma Allergy Friendly vacuum to reduce allergen exposure while vacuuming. […] Wash your bed linens and pillowcases in hot water and detergent to reduce allergens. […] Use dust-mite proof covers for pillows, comforters, duvets, mattresses and box springs. […] Keep pets out of the bedroom to reduce pet dander allergen in your bedding. […] Wear sunglasses and a wide-brimmed hat to reduce pollen getting into your eyes. […] Keep windows closed during high pollen and mold seasons. Use the air conditioner in your car and home (Certified Asthma Allergy Friendly filter).
#3 Allergic Rhinitis – What Is IT, Treatment and Prevention | MedPark Hospital
https://www.medparkhospital.com/en-US/disease-and-treatment/allergic-rhinitis
Two primary treatment modalities that can help you manage allergic rhinitis are allergen avoidance and medications. The combination of both modalities works effectively for most people. […] Once you identify your allergens, reducing exposure to them can help prevent you from having allergic reactions. You can do the following to prevent allergic rhinitis: […] Some allergens are difficult or impossible to avoid. Therefore, avoiding allergens may not be effective in controlling symptoms. Under this circumstance, medications are beneficial as they can relieve symptoms of allergic rhinitis. […] Immunotherapy commonly comes in the forms of subcutaneous immunotherapy or allergy shots and sublingual immunotherapy. Allergy shots contain a small amount of allergen you are allergic to, with the subsequent doses increasing gradually after each injection. The immune system continuously develops tolerance to the allergen until it stops the allergic reactions.
#4
https://www.archivesofmedicalscience.com/Prevention-of-perennial-allergic-rhinitis-in-the-conception-of-coordinated-healthcare,110155,0,2.html
Prevention of perennial allergic rhinitis in the conception of coordinated healthcare in Poland […] The purpose of this study was to assess the use of selected forms of secondary prevention by patients diagnosed with perennial allergic rhinitis. […] Nearly 20% of patients diagnosed with chronic allergic rhinitis used preventive measures against house dust mites; this is in contrast with 13% in the control group (p = 1.358e-07). […] The secondary preventive measures most commonly used in the study group were, in descending order of frequency, mattress protectors and anti-dust-mite spray. […] Undertaking preventive measures was most common among study participants with higher education and residents of large cities. […] Building, maintaining, and continual strengthening the doctors relationship with chronic allergy patients may shift the nature of healthcare services more towards preventive measures, for the implementation of which the patient will be co-responsible under the coordinated healthcare system.
#5
https://www2.hse.ie/conditions/allergic-rhinitis/allergic-rhinitis-prevention/
The best way to prevent allergic rhinitis is to avoid the allergen that causes it. […] To help limit the number of mites in your house: consider buying allergy-proof covers for mattresses, duvets and pillows; choose wood or hard vinyl floor coverings instead of carpet; fit roller blinds that are easy to wipe clean; clean cushions, soft toys, curtains and upholstered furniture often by washing or vacuuming them; use synthetic pillows and acrylic duvets instead of woollen blankets or feather bedding; use a vacuum cleaner fitted with a high-efficiency particulate air (HEPA) filter to remove more dust; use a clean damp cloth to wipe surfaces dry dusting can spread allergens further. […] If you cannot remove a pet from the house, you can try to: keep pets outside as much as possible or limit them to 1 room, preferably one without carpet; keep pets out of your bedroom; wash pets at least once a fortnight; groom dogs outside and often; wash bedding and soft furnishings your pet has been on often.
#6 Hay fever – Diagnosis and treatment – Mayo Clinic
https://www.mayoclinic.org/diseases-conditions/hay-fever/diagnosis-treatment/drc-20373045
Once someone knows their allergy triggers, a healthcare professional can help develop a treatment plan to reduce or get rid of hay fever symptoms. […] It’s best to limit exposure to substances that cause hay fever. […] Treatments for hay fever may include medicines, immunotherapy and nasal saline rinses. […] Saline nasal sprays can moisten dry nasal passages and thin nasal mucus. You don’t need a prescription, and you can use them as often as needed. […] Rinsing your nasal passages with saline, called nasal irrigation, is a quick and effective way to relieve nasal congestion. Rinsing flushes out mucus and allergens from your nose. […] It’s not possible to avoid allergens completely, but you can reduce your symptoms by limiting your exposure to these substances. If you know what you’re allergic to, you can avoid your triggers.
#7 Allergic Rhinitis – Immunology; Allergic Disorders – Merck Manual Professional Edition
https://www.merckmanuals.com/professional/immunology-allergic-disorders/allergic-autoimmune-and-other-hypersensitivity-disorders/allergic-rhinitis
Avoidance of triggers […] For perennial allergies, triggers should be removed or avoided if possible. Strategies include the following: Removing items that collect dust, such as knickknacks, magazines, books, and soft toys […] Using synthetic fiber pillows and impermeable mattress covers […] Frequently washing bed sheets, pillowcases, and blankets in hot water […] Frequently cleaning the house, including dusting, vacuuming, and wet-mopping […] Removing upholstered furniture and carpets or frequently vacuuming them […] Replacing draperies and shades with blinds […] Exterminating cockroaches to eliminate exposure […] Using dehumidifiers in basements and other poorly aerated, damp rooms […] Using high-efficiency particulate air (HEPA) vacuums and filters […] Avoiding food or medication triggers
#8
https://www2.hse.ie/conditions/allergic-rhinitis/allergic-rhinitis-prevention/
The best way to prevent allergic rhinitis is to avoid the allergen that causes it. […] To help limit the number of mites in your house: consider buying allergy-proof covers for mattresses, duvets and pillows; choose wood or hard vinyl floor coverings instead of carpet; fit roller blinds that are easy to wipe clean; clean cushions, soft toys, curtains and upholstered furniture often by washing or vacuuming them; use synthetic pillows and acrylic duvets instead of woollen blankets or feather bedding; use a vacuum cleaner fitted with a high-efficiency particulate air (HEPA) filter to remove more dust; use a clean damp cloth to wipe surfaces dry dusting can spread allergens further. […] If you cannot remove a pet from the house, you can try to: keep pets outside as much as possible or limit them to 1 room, preferably one without carpet; keep pets out of your bedroom; wash pets at least once a fortnight; groom dogs outside and often; wash bedding and soft furnishings your pet has been on often.
#9 Allergic Rhinitis (Hay Fever): Symptoms & Treatment
https://my.clevelandclinic.org/health/diseases/8622-allergic-rhinitis-hay-fever
Theres no way to prevent hay fever, but lifestyle changes can help you live with allergies. You can relieve hay fever symptoms by avoiding irritants as much as possible. To reduce symptoms, you should: […] Avoid touching your face and rubbing your eyes or nose. […] Close windows in your home and car during the spring, summer and early fall when pollen counts are higher. […] Put covers on pillows, mattresses and box springs to protect against dust mites. […] Keep pets off couches and beds, and close doors to bedrooms you dont want them to enter. […] Use filters in your vacuum cleaner and air conditioner to reduce the amount of allergens in the air. […] Wash your hands often, especially after playing with pets. […] Wear a hat and sunglasses to protect your eyes from pollen when youre outside. Change your clothes as soon as you come indoors.
#10
https://www2.hse.ie/conditions/allergic-rhinitis/allergic-rhinitis-prevention/
To avoid exposure to pollen: check weather reports for the pollen count and stay indoors when it’s high; avoid line-drying clothes and bedding when the pollen count is high; wear wraparound sunglasses to protect your eyes from pollen; keep doors and windows shut during the mid-morning and early evening. This is when there’s most pollen in the air; shower, wash your hair and change your clothes after being outside; avoid grassy areas, such as parks and fields, when possible; consider asking someone else to cut the grass for you if you have a lawn. […] To help prevent mould spores, you should: keep your home dry and well ventilated; when showering or cooking, use extractor fans or open windows but keep internal doors closed. This stops damp air spreading through the house; avoid drying clothes indoors, storing clothes in damp cupboards and packing clothes too tightly in wardrobes; deal with any damp and condensation in your home.
#11 Rhinitis, Nasal Allergy, Hayfever
https://aafa.org/allergies/allergy-symptoms/rhinitis-nasal-allergy-hayfever/
The first and best option is to avoid contact with allergens. Other prevention tips are: […] Don’t touch or rub your nose. […] Wash your hands often with soap and water. […] Use a Certified Asthma Allergy Friendly vacuum to reduce allergen exposure while vacuuming. […] Wash your bed linens and pillowcases in hot water and detergent to reduce allergens. […] Use dust-mite proof covers for pillows, comforters, duvets, mattresses and box springs. […] Keep pets out of the bedroom to reduce pet dander allergen in your bedding. […] Wear sunglasses and a wide-brimmed hat to reduce pollen getting into your eyes. […] Keep windows closed during high pollen and mold seasons. Use the air conditioner in your car and home (Certified Asthma Allergy Friendly filter).
#12 Patient education: Trigger avoidance in allergic rhinitis (Beyond the Basics) – UpToDate
https://www.uptodate.com/contents/trigger-avoidance-in-allergic-rhinitis-beyond-the-basics
Allergic rhinitis, also known as hay fever, affects approximately 20 percent of people of all ages. The most common symptoms include nasal itching, watery nasal discharge, sneezing, itchy red eyes, sore throat, or hoarse voice. […] One of the first steps in treating any allergic condition is to avoid or minimize exposure to the allergens that cause the condition. […] The first step in the treatment of allergic rhinitis is to reduce exposure to allergens. […] Once a person’s trigger(s) have been identified, the next step is to reduce exposure to those specific allergens. […] To reduce the growth of mold in the home, it is necessary to remove existing mold and also to reduce humidity to prevent future growth of mold. […] Allergic rhinitis symptoms that worsen when outdoors and at certain times of year are likely to be triggered by an allergy to pollen, other plant material, or molds. […] Affected individuals should close the windows of the car and home, stay indoors when possible, and use air conditioners to filter the air during times of peak symptoms.
#13
https://www2.hse.ie/conditions/allergic-rhinitis/allergic-rhinitis-prevention/
To avoid exposure to pollen: check weather reports for the pollen count and stay indoors when it’s high; avoid line-drying clothes and bedding when the pollen count is high; wear wraparound sunglasses to protect your eyes from pollen; keep doors and windows shut during the mid-morning and early evening. This is when there’s most pollen in the air; shower, wash your hair and change your clothes after being outside; avoid grassy areas, such as parks and fields, when possible; consider asking someone else to cut the grass for you if you have a lawn. […] To help prevent mould spores, you should: keep your home dry and well ventilated; when showering or cooking, use extractor fans or open windows but keep internal doors closed. This stops damp air spreading through the house; avoid drying clothes indoors, storing clothes in damp cupboards and packing clothes too tightly in wardrobes; deal with any damp and condensation in your home.
#14 Hay Fever (Rhinitis) | Symptoms & Treatment | ACAAI Public Website
https://acaai.org/allergies/allergic-conditions/hay-fever/
Wear glasses or sunglasses when outdoors to minimize the amount of pollen getting into your eyes. […] Donât hang clothing outdoors to dry; pollen may cling to towels and sheets. […] Try not to rub your eyes; doing so will irritate them and could make your symptoms worse. […] Keep windows closed and use air conditioning in your car and home. Make sure to keep your air conditioning unit clean. […] Reduce exposure to dust mites, especially in the bedroom. Use âmite-proofâ covers for pillows, comforters and duvets, and mattresses and box springs. Wash your bedding frequently, using hot water (at least 130 degrees Fahrenheit). […] To limit exposure to mold, keep the humidity in your home low (between 30 and 50 percent) and clean your bathrooms, kitchen, and basement regularly. Use a dehumidifier, especially in the basement and in other damp, humid places, and empty and clean it often. If mold is visible, clean it with mild detergent and a 5 percent bleach solution as directed by an allergist.
#15 Prophylactic treatment of seasonal allergic rhinitis – PubMed
https://pubmed.ncbi.nlm.nih.gov/1827615/
The prophylactic effectiveness of the new, second-generation antihistamines cetirizine and terfenadine was evaluated in a double-blind, multicenter study of 487 patients with seasonal allergic rhinitis. […] It is concluded that 10 mg of cetirizine once daily is as effective as 60 mg of terfenadine twice daily in the prophylactic treatment of seasonal allergic rhinitis. […] Rhinitis, Allergic, Seasonal / prevention control*
#16
#17 Prophylactic treatment of seasonal allergic rhinitis – PubMed
https://pubmed.ncbi.nlm.nih.gov/1827615/
The prophylactic effectiveness of the new, second-generation antihistamines cetirizine and terfenadine was evaluated in a double-blind, multicenter study of 487 patients with seasonal allergic rhinitis. […] It is concluded that 10 mg of cetirizine once daily is as effective as 60 mg of terfenadine twice daily in the prophylactic treatment of seasonal allergic rhinitis. […] Rhinitis, Allergic, Seasonal / prevention control*
#18
#19 Allergic Rhinitis: Symptoms, Treatment, and Home Remedies
https://www.healthline.com/health/allergic-rhinitis
The best way to prevent allergy symptoms is to manage your allergies before your body has a chance to respond to substances adversely. Consider the following preventive measures for the particular allergens you’re sensitive to: […] The AAAAI recommends starting medications before seasonal allergy attacks. For example, if you’re sensitive to tree pollen in the spring, you may want to start taking antihistamines before an allergic reaction has the chance to occur. Stay indoors during peak pollen hours, and take a shower immediately after being outside. You’ll also want to keep your windows closed during allergy season and avoid line-drying any laundry. […] To reduce dust mite exposure, you can take measures to make sure your home is not a friendly environment for dust mite development. Wet mop hard floors, rather than sweeping. If you have carpet, use a vacuum with a HEPA filter. You’ll also want to dust hard surfaces often, and wash your bedding weekly in hot water. Use allergen-blocking pillows and cases to decrease dust mite exposure while you’re sleeping.
#20 Treatment of Allergic Rhinitis | AAFP
https://www.aafp.org/pubs/afp/issues/2015/1201/p985.html
Allergic rhinitis is a common and chronic immunoglobulin Emediated respiratory illness that can affect quality of life and productivity, as well as exacerbate other conditions such as asthma. […] Patients should be educated about their condition and advised to avoid known allergens. […] Optimal treatment includes allergen avoidance and pharmacotherapy. […] Patients with allergic rhinitis should avoid exposure to cigarette smoke, pets, and allergens that are known to trigger their symptoms. […] Prevention has been a main focus in studies of allergic rhinitis, but few interventions have been proven effective. […] Although evidence does not support measures to avoid dust mites, such as mite-proof impermeable mattresses and pillow covers, many guidelines continue to recommend them. […] Other examples of proposed interventions without documented effectiveness include breastfeeding, air filtration systems, and delayed exposure to solid foods in infancy or to pets in childhood.
#21 Hay fever allergic rhinitis and your asthma – National Asthma Council Australia
https://www.nationalasthma.org.au/living-with-asthma/resources/patients-carers/brochures/hay-fever-allergic-rhinitis-and-your-asthma
Effective treatment for hay fever (allergic rhinitis) can help you keep your asthma under control. […] Nasal sprays that contain corticosteroids (a type of anti-inflammatory medicine) are the most effective treatments available for allergic rhinitis. […] People who have both asthma and allergic rhinitis should use both a preventer nasal spray and an asthma preventer inhaler regularly. […] Find out what triggers your allergic rhinitis and asthma. Try to avoid your allergy triggers if you can. […] Don’t smoke, and avoid other peoples cigarette smoke. Smoke can make allergic rhinitis and asthma worse, and can stop medicines from working effectively. […] Effective treatment for allergic rhinitis may reduce the chance of severe asthma attacks, and make the lungs work better. […] People with allergic rhinitis who are allergic to grass pollens (e.g. ryegrass) can have asthma attacks caused by springtime thunderstorms.
#22 Hay fever allergic rhinitis and your asthma – National Asthma Council Australia
https://www.nationalasthma.org.au/living-with-asthma/resources/patients-carers/brochures/hay-fever-allergic-rhinitis-and-your-asthma
Corticosteroid nasal sprays are effective for controlling itching and sneezing, runny nose, blocked nose, and eye symptoms (itching or wateriness). […] For best results, these medications should be taken regularly and long term, just like preventers for asthma. […] Your doctor can help you work out which allergens trigger your allergic rhinitis and asthma. Try to avoid your allergy triggers if you can. […] If your allergic rhinitis is troublesome, or if effective treatment for your allergic rhinitis helps control your asthma symptoms, your doctor might recommend that you take medicine while you are pregnant. […] Specific allergen immunotherapy (desensitisation) is an effective treatment for allergic rhinitis in some people and can achieve lasting relief from symptoms. […] If you have asthma and allergic rhinitis (hay fever) and you are allergic to ryegrass pollen, you could have an asthma attack caused by a thunderstorm.
#23 Towards definitive management of allergic rhinitis: best use of new and established therapies | Allergy, Asthma & Clinical Immunology | Full Text
https://aacijournal.biomedcentral.com/articles/10.1186/s13223-020-00436-y
ARIA guidelines recommend INCS as the best option for both mild and moderate to severe AR in both children and adults. INCS inhibit the early and late-phase allergic in AR by preventing the recruitment of immune cells, and the release of inflammatory mediators from cells involved in the pathophysiology of AR. […] The other major therapeutic class of drug indicated for AR therapy are the leukotriene-receptor antagonists (LTRAs). LTRAs block the activity of cysteinyl leukotrienes (CysLTs), a potent inflammatory mediator associated with nasal congestion, mucus production, and inflammatory cell recruitment responsible for AR symptoms. […] AIT is a treatment that provides the potential for long-term relief from AR. It includes subcutaneous and sublingual methods of administration. As a potentially disease-modifying therapy, it is surprisingly often the last treatment option for patients whose symptoms are ill-managed by the traditional pharmacologic therapies, despite showing evidence for primary use.
#24 Towards definitive management of allergic rhinitis: best use of new and established therapies | Allergy, Asthma & Clinical Immunology | Full Text
https://aacijournal.biomedcentral.com/articles/10.1186/s13223-020-00436-y
ARIA guidelines recommend INCS as the best option for both mild and moderate to severe AR in both children and adults. INCS inhibit the early and late-phase allergic in AR by preventing the recruitment of immune cells, and the release of inflammatory mediators from cells involved in the pathophysiology of AR. […] The other major therapeutic class of drug indicated for AR therapy are the leukotriene-receptor antagonists (LTRAs). LTRAs block the activity of cysteinyl leukotrienes (CysLTs), a potent inflammatory mediator associated with nasal congestion, mucus production, and inflammatory cell recruitment responsible for AR symptoms. […] AIT is a treatment that provides the potential for long-term relief from AR. It includes subcutaneous and sublingual methods of administration. As a potentially disease-modifying therapy, it is surprisingly often the last treatment option for patients whose symptoms are ill-managed by the traditional pharmacologic therapies, despite showing evidence for primary use.
#25
#26 Treatment of Allergic Rhinitis | AAFP
https://www.aafp.org/pubs/afp/issues/2015/1201/p985.html
Immunotherapy should be considered for moderate or severe persistent allergic rhinitis that is not responsive to usual treatments, in patients who cannot tolerate standard therapies or who want to avoid long-term medication use, and in patients with allergic asthma. […] Targeted immunotherapy, the only treatment that changes the natural course of allergic rhinitis, consists of administering a small amount of allergen extract subcutaneously or sublingually.
#27 Towards definitive management of allergic rhinitis: best use of new and established therapies | Allergy, Asthma & Clinical Immunology | Full Text
https://aacijournal.biomedcentral.com/articles/10.1186/s13223-020-00436-y
ARIA guidelines recommend INCS as the best option for both mild and moderate to severe AR in both children and adults. INCS inhibit the early and late-phase allergic in AR by preventing the recruitment of immune cells, and the release of inflammatory mediators from cells involved in the pathophysiology of AR. […] The other major therapeutic class of drug indicated for AR therapy are the leukotriene-receptor antagonists (LTRAs). LTRAs block the activity of cysteinyl leukotrienes (CysLTs), a potent inflammatory mediator associated with nasal congestion, mucus production, and inflammatory cell recruitment responsible for AR symptoms. […] AIT is a treatment that provides the potential for long-term relief from AR. It includes subcutaneous and sublingual methods of administration. As a potentially disease-modifying therapy, it is surprisingly often the last treatment option for patients whose symptoms are ill-managed by the traditional pharmacologic therapies, despite showing evidence for primary use.
#28 Hay Fever (Rhinitis) | Symptoms & Treatment | ACAAI Public Website
https://acaai.org/allergies/allergic-conditions/hay-fever/
Consulting an allergist is the most effective way to diagnose and treat allergic rhinitis symptoms and help you find relief. […] Immunotherapy may be recommended for people who donât respond well to treatment with medications or who experience side effects from medications, who have allergen exposure that is unavoidable or who desire a more permanent solution to their allergies. […] Immunotherapy can be very effective in controlling allergic symptoms, but it doesnât help the symptoms produced by nonallergic rhinitis. […] Two types of immunotherapy are available: allergy shots and sublingual (under-the-tongue) tablets. […] A treatment program, which typically continues for three to five years, consists of injections of a diluted allergy extract, administered frequently in increasing doses until a maintenance dose is reached.
#29 Hay Fever (Rhinitis) | Symptoms & Treatment | ACAAI Public Website
https://acaai.org/allergies/allergic-conditions/hay-fever/
Immunotherapy helps the body build tolerance to the effects of the allergen, reduces the intensity of symptoms caused by allergen exposure and sometimes can make skin test reactions disappear. […] As tolerance develops over several months, symptoms should improve. […] This type of immunotherapy was approved by the Food and Drug Administration in 2014. Starting several months before allergy season begins, patients dissolve a tablet under the tongue daily. […] Some patients benefit from year-round treatment. Treatment can continue for as long as three years. […] If your allergy symptoms appear at work, or seem to get worse there, ask your allergist to help you identify potential triggers and develop a treatment plan.
#30 Treatment of Allergic Rhinitis | AAFP
https://www.aafp.org/pubs/afp/issues/2015/1201/p985.html
Immunotherapy should be considered for moderate or severe persistent allergic rhinitis that is not responsive to usual treatments, in patients who cannot tolerate standard therapies or who want to avoid long-term medication use, and in patients with allergic asthma. […] Targeted immunotherapy, the only treatment that changes the natural course of allergic rhinitis, consists of administering a small amount of allergen extract subcutaneously or sublingually.
#31 Allergic Rhinitis – Immunology; Allergic Disorders – Merck Manual Professional Edition
https://www.merckmanuals.com/professional/immunology-allergic-disorders/allergic-autoimmune-and-other-hypersensitivity-disorders/allergic-rhinitis
Limiting pets to certain rooms or keeping them out of the house […] For people with severe seasonal allergies, possibly moving to an area that does not have the allergen […] Adjunctive nonallergenic triggers (eg, cigarette smoke, strong odors, irritating fumes, air pollution, cold temperatures, high humidity) should also be avoided or controlled when possible. […] Desensitization immunotherapy may be more effective for seasonal than for perennial allergic rhinitis; it is indicated when Symptoms are severe […] The allergen cannot be avoided […] Medication treatment is inadequate. […] First attempts at desensitization should begin soon after the pollen season ends to prepare for the next season; adverse reactions increase when desensitization is started during the pollen season because the persons allergic immunity is already maximally stimulated.
#32 Allergic Rhinitis: Types, Symptoms, Treatment Options and Testing
https://www.nationwidechildrens.org/conditions/allergic-rhinitis-hay-fever
Symptoms may improve by making small changes at home. […] If your child is allergic to pollens or outdoor molds: Keep windows closed at home and in the car when pollen counts are high. If possible, use a fan or air conditioning (windows closed) in the home and in the car. […] If allergic to things indoors: For dust mites: Cover the mattress, box spring and pillows with dust-mite-proof bedding. Reduce the number of stuffed animals and other dust collectors in rooms where your child spends a lot of time. Vacuum weekly or more often, if needed. Set humidifier to below 50%. […] For pet dander: Have your child avoid contact with pets. Wash hands after petting any animal. Consider finding a new home for the pet. […] Your child’s doctor may suggest medicines that are child-friendly and can be bought over-the-counter (OTC) or the doctor may prescribe medicines. They may be taken either orally (by mouth), or as eye drops or a nasal spray. Typically, the types of medicines include: Antihistamines, Corticosteroids, Decongestants.
#33 Prevention of Allergies and Asthma in Children
https://www.aaaai.org/tools-for-the-public/conditions-library/allergies/prevention-of-allergies-and-asthma-in-children
Prevention of Allergies and Asthma in ChildrenIt has long been known that allergies and asthma tend to run in families, making children where one or both parents have an allergic disease more likely to develop these conditions. Fortunately, there are steps that may delay or possibly prevent allergies or asthma from developing. […] Restricting a mother’s diet of specific allergens during pregnancy and while breast-feeding, when a child is otherwise well, is not routinely recommended as a means to prevent food allergies. […] Most recent information indicates there is no significant allergy prevention benefit to your baby if you avoid highly allergenic foods during this time. […] Especially recommended for the first four to six months, it may possibly reduce early eczema, wheezing and cows milk allergy.
#34 Prevention of Allergies and Asthma in Children
https://www.aaaai.org/tools-for-the-public/conditions-library/allergies/prevention-of-allergies-and-asthma-in-children
For infants at risk for food allergy where the mother is unable to breast feed, hydrolyzed infant formulas are recommended as hypoallergenic substitutes over cows milk and soy formulas. […] If your child is at high risk of developing allergies, there are steps you can take to control dust mites. […] If possible, carpets and upholstered furniture should be removed from your infant’s bedroom. […] It is very important not to expose your children to tobacco smoke before or after birth. […] Since breast-feeding for at least four to six months strengthens a child’s immune system, it is helpful in avoiding these infections and, in the long term, asthma. […] Breast-feeding exclusively for the first four to six months, or using a hypoallergenic formula, may strengthen the immune system while delaying or preventing atopic dermatitis and milk allergy. […] Reducing exposure to some allergens, such as dust mites, may delay or prevent allergy or asthma symptoms. […] Exposure to tobacco smoke before and after birth increases your infant’s risk of developing wheezing and asthma.
#35 Hay fever allergic rhinitis and your asthma – National Asthma Council Australia
https://www.nationalasthma.org.au/living-with-asthma/resources/patients-carers/brochures/hay-fever-allergic-rhinitis-and-your-asthma
Corticosteroid nasal sprays are effective for controlling itching and sneezing, runny nose, blocked nose, and eye symptoms (itching or wateriness). […] For best results, these medications should be taken regularly and long term, just like preventers for asthma. […] Your doctor can help you work out which allergens trigger your allergic rhinitis and asthma. Try to avoid your allergy triggers if you can. […] If your allergic rhinitis is troublesome, or if effective treatment for your allergic rhinitis helps control your asthma symptoms, your doctor might recommend that you take medicine while you are pregnant. […] Specific allergen immunotherapy (desensitisation) is an effective treatment for allergic rhinitis in some people and can achieve lasting relief from symptoms. […] If you have asthma and allergic rhinitis (hay fever) and you are allergic to ryegrass pollen, you could have an asthma attack caused by a thunderstorm.
#36 Prevention of Allergies and Asthma in Children
https://www.aaaai.org/tools-for-the-public/conditions-library/allergies/prevention-of-allergies-and-asthma-in-children
Prevention of Allergies and Asthma in ChildrenIt has long been known that allergies and asthma tend to run in families, making children where one or both parents have an allergic disease more likely to develop these conditions. Fortunately, there are steps that may delay or possibly prevent allergies or asthma from developing. […] Restricting a mother’s diet of specific allergens during pregnancy and while breast-feeding, when a child is otherwise well, is not routinely recommended as a means to prevent food allergies. […] Most recent information indicates there is no significant allergy prevention benefit to your baby if you avoid highly allergenic foods during this time. […] Especially recommended for the first four to six months, it may possibly reduce early eczema, wheezing and cows milk allergy.
#37 Severely Allergic Travelers | Yellow Book | CDC
https://www.cdc.gov/yellow-book/hcp/travelers-with-additional-considerations/severely-allergic-travelers.html
Advise travelers to purchase travel medical insurance that includes emergency services in the areas of travel. […] The pre-travel appointments for a traveler with allergic rhinitis and asthma should include a review of their current level of symptom control and medication regimen. Adjust medications to maximize symptom control prior to travel. […] Even in travelers who are well controlled at home, consider step-up or additional prophylactic therapy if a traveler will be exposed to reduced air quality or differing active pollen seasons. […] Encourage travelers with allergic rhinitis and asthma to research lodging that mitigates exposure to known triggers, such as dust mite bedding covers, air filtration with or without air conditioning, pet-free rooms, smoke-free rooms, and carpet-free rooms.
#38 Severely Allergic Travelers | Yellow Book | CDC
https://www.cdc.gov/yellow-book/hcp/travelers-with-additional-considerations/severely-allergic-travelers.html
Advise travelers with allergic rhinitis or asthma to keep inhalers, other medications, asthma action plan, medical phrases card, and so on, in a medical kit or on their person. […] Confirm that accommodations have allergen mitigation, air conditioning, and/or smoke-free rooms as appropriate for the traveler’s known triggers. […] The pre-travel appointments for a traveler with food allergy, stinging insect allergy, and others at risk for anaphylaxis should include a review of their current allergens and medication regimen. […] Provide an updated anaphylaxis action plan, review the proper use of their injectable epinephrine device, and ensure that expiration date exceeds period of travel. […] Instruct travelers to maintain original packaging with identifying information linking them to their injectable epinephrine.
#39 Avoidance Measures for Patients with Allergic Rhinitis: A Scoping Review
https://www.mdpi.com/2227-9067/10/2/300
Although allergen avoidance is widely recommended as part of secondary and tertiary prevention strategies for AR, a demonstration of its effectiveness is lacking. […] Therefore, it is necessary to consider a multi-faceted approach that includes a combination of prevention, treatment, and elimination of allergens from the environment to lower the incidence of allergy symptoms.
#40 Avoidance Measures for Patients with Allergic Rhinitis: A Scoping Review
https://www.mdpi.com/2227-9067/10/2/300
The proposed strategies followed two different directions: one focusing on the surrounding environment (for instance the use of acaricides or air filters) and the other focusing on the individual (for instance the use of nasal filters or topical microemulsions). […] Studies that combined multiple allergen measures showed more significant results in contrast with other studies that evaluated only one type of measure. This suggests that different ways of handling the exposure or concentration of the allergens could be a more effective way of AR control. […] Overall, although the majority of studies showed improvements in at least one outcome, the studies presented some limitations. […] Based on these findings, further well-designed studies including a larger number of patients with different allergen sensitivities should be conducted to support the recommendation of these measures.
#41 Prevention and Management with Pro-, Pre and Synbiotics in Children with Asthma and Allergic Rhinitis: A Narrative Review
https://www.mdpi.com/2072-6643/13/3/934
Allergic diseases including allergic rhinitis and asthma are increasing in the developing world, related to a westernizing lifestyle, while the prevalence is stable and decreasing in the industrialized world. […] There is little evidence to recommend administration of pro, pre- or synbiotics in the prevention of asthma and allergic rhinitis in children. […] Currently, there is no strong proof that probiotics are successful in preventing allergic rhinitis. […] A 2019 meta-analysis of seventeen RCTs including 5264 children could not identify a clear advantage of probiotic supplementation during pre- and postnatal periods in the prevention of allergic rhinitis. […] Probiotic intervention may have a favorable role in the prevention and additional treatment of allergic rhinitis, although results up to now are disappointing.
#42 Epidemiology, Prevention and Clinical Treatment of Allergic Rhinitis: More Understanding, Better Patient Care
https://pmc.ncbi.nlm.nih.gov/articles/PMC9605427/
With respect to prevention, graded prevention of AR has been proposed. Primary prevention involves eliminating causes that are critical to disease development, including changing causal or predisposing factors related to the environment and the workplace. Secondary prevention includes the avoidance of clinically relevant allergens and irritants. Tertiary prevention aims to prevent exacerbations, thereby improving disease control and reducing medication needs, where appropriate, pharmacological prophylaxis and allergen-specific immunotherapy for patients with early symptoms. […] In the future, carefully designed and executed randomized trials are needed to properly measure and report the effects of the above measures on AR prevention and potential adverse effects, so as to reduce the overall risk of bias. In addition, a correct assessment of any long-term adverse effect will require large observational studies.
#43 Avoidance Measures for Patients with Allergic Rhinitis: A Scoping Review
https://www.mdpi.com/2227-9067/10/2/300
The proposed strategies followed two different directions: one focusing on the surrounding environment (for instance the use of acaricides or air filters) and the other focusing on the individual (for instance the use of nasal filters or topical microemulsions). […] Studies that combined multiple allergen measures showed more significant results in contrast with other studies that evaluated only one type of measure. This suggests that different ways of handling the exposure or concentration of the allergens could be a more effective way of AR control. […] Overall, although the majority of studies showed improvements in at least one outcome, the studies presented some limitations. […] Based on these findings, further well-designed studies including a larger number of patients with different allergen sensitivities should be conducted to support the recommendation of these measures.
#44 Allergic Rhinitis (Hay Fever): Symptoms & Treatment
https://my.clevelandclinic.org/health/diseases/8622-allergic-rhinitis-hay-fever
Theres no way to prevent hay fever, but lifestyle changes can help you live with allergies. You can relieve hay fever symptoms by avoiding irritants as much as possible. To reduce symptoms, you should: […] Avoid touching your face and rubbing your eyes or nose. […] Close windows in your home and car during the spring, summer and early fall when pollen counts are higher. […] Put covers on pillows, mattresses and box springs to protect against dust mites. […] Keep pets off couches and beds, and close doors to bedrooms you dont want them to enter. […] Use filters in your vacuum cleaner and air conditioner to reduce the amount of allergens in the air. […] Wash your hands often, especially after playing with pets. […] Wear a hat and sunglasses to protect your eyes from pollen when youre outside. Change your clothes as soon as you come indoors.
#45 Allergic rhinitis
https://www.nhs.uk/conditions/allergic-rhinitis/
If you have allergic rhinitis, it’s not always possible to avoid the things you’re allergic to. But there are steps you can take to try to help reduce your symptoms. […] wear wraparound sunglasses to protect your eyes from pollen […] use hypoallergenic bedding and covers, and wash bedding regularly at 60C and above […] dust with a damp cloth and use a vacuum with a HEPA filter […] wash pets at least once every 2 weeks and groom them outside regularly […] regularly wash your pet’s bedding and clean any furniture they’ve been on […] keep your home dry and well-ventilated, and deal with any damp and condensation […] do not allow pets in bedrooms […] do not go outside or dry clothes outside when the pollen count is high, if possible.
#46 Allergic rhinitis Information | Mount Sinai – New York
https://www.mountsinai.org/health-library/diseases-conditions/allergic-rhinitis
You can sometimes prevent symptoms by avoiding the pollen you are allergic to. During pollen season, you should stay indoors where it is air-conditioned, if possible. Sleep with the windows closed, and drive with the windows rolled up.
#47 Treatment of Allergic Rhinitis | AAFP
https://www.aafp.org/pubs/afp/issues/2015/1201/p985.html
Allergic rhinitis is a common and chronic immunoglobulin Emediated respiratory illness that can affect quality of life and productivity, as well as exacerbate other conditions such as asthma. […] Patients should be educated about their condition and advised to avoid known allergens. […] Optimal treatment includes allergen avoidance and pharmacotherapy. […] Patients with allergic rhinitis should avoid exposure to cigarette smoke, pets, and allergens that are known to trigger their symptoms. […] Prevention has been a main focus in studies of allergic rhinitis, but few interventions have been proven effective. […] Although evidence does not support measures to avoid dust mites, such as mite-proof impermeable mattresses and pillow covers, many guidelines continue to recommend them. […] Other examples of proposed interventions without documented effectiveness include breastfeeding, air filtration systems, and delayed exposure to solid foods in infancy or to pets in childhood.
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