Dear Doctor,
I have allergic rhinitis and have been struggling with this condition for years. My mother and brothers have it too. I have a 5-year-old daughter and I’m concerned that she may have inherited the condition. How should rhinitis be managed in children?
Leong, Banting
ANSWER
Allergic rhinitis is not uncommon in children nowadays, especially those with a significant family history of a similar condition.
Rhinitis means inflammation of the mucus membranes in the nose. The common symptoms associated with rhinitis are an itchy nose, red eyes, watery discharge from the nose and/or eyes, a blocked nose and sneezing.
The symptoms can appear shortly after exposure to an allergen, such as house dust mites, pets and moulds.
Some children may develop complications, such as inflammation of the airspaces within the bones of the face (sinusitis), nose bleeds, glue ear and temporary hearing loss.
Research has shown that children with rhinitis may have difficulty sleeping, become irritable and show lack of concentration during waking hours. These problems can affect a child’s ability to cope with their normal daily routine.
It is important to try to limit exposure to allergens where possible.
Avoidance of known allergens like domestic cats or dogs can be helpful too.
For house dust mites and moulds, the allergen load can be reduced through environmental measures such as vacuuming mattresses and pillow barrier covers as well as avoiding soft furnishings, for example, carpets.
Medication for allergic rhinitis can be very effective and is important in helping improve your child’s quality of life.
Some medications work by blocking the allergic response, others by reducing inflammation. Anti-histamines are probably the best known type of allergy medication.
While anti-histamines used to have a reputation for making people drowsy, more modern anti-histamines only occasionally have those side effects.
Nasal steroid sprays and drops are very effective in treating the inflammation of allergic rhinitis, and very little of the medicine is absorbed into the body so side-effects normally associated with oral steroids are rare.
Answers provided by Dr Lim Kok Chong, consultant paediatrician, Columbia Asia Hospital — Bukit Rimau.
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