Since we’re into the hayfever season here in the UK, I imagine most people will be concerned with their seasonal allergic rhinitis and not their perennial allergic rhinitis, but no matter. There is a place for both here!

For me, the ‘hayfever’ section of my allergies happens at a different time to most sufferers, and I tend to get most of my annoying symptoms in early summer and then autumn, so at the moment I’m ok…. except when the heat and humidity and run-up to stormy weather stirs all the pollen into the air and keeps it there. Then I start to suffer with asthma symptoms, rather than hayfever.   

How about you? Does the weather affect how bad your hayfever/rhinitis is?

Yeah, that’s what I thought, too.

Postnasal means ‘in the back of the nasal cavity’, and the drip, well, that refers to the flow of mucous secretion onto the wall of the pharynx (that bit between your mouth and your food pipe). You get postnasal drip for a while when you have a cold or a virus, but its also one of the many (more permanent) annoying symptoms of allerigic rhinitis. I am a post-nasal dripper, and I’ve never ever thought about it until now.

For me, its that feeling that I must just blow my nose or sniff to clear my nasal passages.  Now that I come to think about how often it happens, I really can’t say. Sometimes its constant, and sometimes it will be just a few times an hour. That’s why I’ve always got tissues! The ‘mucous secretions’ are not like they are when you’ve got a cold, though. For me they are thin, watery and completely clear - no worse than thick tears. I was interested to read in this article, that you can produce up to 4 pints of secretions in a day!

Crikey! 

Would anyone else like to share their experiences of PND?

As an allergic rhinitis sufferer, I get nasal congestion most nights, so you’d think I would be used to it by now, but I’m still not. I can feel the fluid draining through my nose and sinuses, with the help of gravity every time I roll over in bed!

Ah well.

It will improve.  

What I wasn’t prepared for was how much better my allergic rhinitis has been in the smoke-free atmoshere. I managed a whole evening needing only one tissue! Fabulous! I hadn’t realised the smoke could be affecting my nose, too.

Has anyone else noticed the difference?

But also, see below for details about the condition in general terms (from NHS Direct):

Rhinitis

Introduction

Rhinitis means inflammation of the lining of the nose. The moist tissue (mucous membrane) that lines the nose becomes inflamed, causing swelling and blocking the airflow. Rhinitis also causes overactivity of the glands in the mucous membrane, causing excessive mucus production and a watery discharge.

Rhinitis is a symptom of the common cold and of hay fever (allergic rhinitis). Hay fever is an allergy to grass, weed and tree pollens, moulds, hair, feathers, skin scales (dander), house mites, house dust or other airborne substances. It causes sneezing, stuffiness and a watery discharge from the nose.

There are several varieties of rhinitis:

• Vasomotor rhinitis happens when the nerves that control the blood vessels supplying the mucous membrane are disturbed. The membrane becomes over-sensitive to hormonal, climate or psychological changes, and causes sneezing and a watery discharge.  Vasomotor rhinitis is an intermittent condition, meaning that it can come and go.
• Hypertrophic rhinitis happens when there has been repeated or long-term inflammation of the mucous membrane.  The lining of the nose thickens, causing a feeling of stuffiness that doesn’t go away.
• Atrophic rhinitis happens when the mucous membrane shrinks, usually as a result of sarcoidosis, tuberculosis or nose surgery (rhinoplasty). The symptoms are dryness, crusting and loss of the sense of smell.

Symptoms

Symptoms commonly affect the nose, throat and eyes, and occasionally wheezing and breathlessness occur.

The most common symptoms are:

• sneezing,
• blocked or stuffy nose,
• runny nose (rhinorrhoea), and
• itchy nose, throat and eyes.

Often, a person with rhinitis my also have hay fever, asthma or eczema. Asthma and eczema may start or become much worse in the summer or when the pollen count is high.

Causes

Rhinitis due to the common cold is caused by cold viruses and secondary infection with bacteria.

Allergic rhinitis is an allergic reaction to something, usually pollen, dust or animal hair and occurs when allergens trigger the release of histamine and other irritating substances.

Fundamental to an understanding of allergic rhinitis are the mast cells, these are cells full of granules of histamine and serotonin and other irritating substances. They are central to the allergic reaction and to many immune system processes. They are found in large numbers in the skin and mucous membranes and in the lymphatic system.

In people with allergies, a particular type of antibody is produced in unusually high numbers.  This is the immunoglobulin type E (IgE).  Like all antibodies, these are protein molecules.  Large numbers of these molecules remain attached to the specific receptors on the surface of the mast cells.

When a pollen or other granule reaches the cell and bridges across between two or more IgE molecules, it causes a strain on the mast cell membrane, which tears, releasing its contents. Histamine causes the muscle in the walls of the air tubes of the lungs to tighten, arteries to widen, small blood vessels (capillaries) to leak, and skin to itch.

Allergic rhinitis is most commonly caused by grass pollen, but tree and weed pollens and mould spores can also cause attacks.

Treatment

There is no specific treatment for cold rhinitis, but it seldom lasts for longer than about a week.Allergic rhinitis is treated with antihistamine drugs or local steroid sprays. Various drugs can be used to dry up excessive watery nasal secretions, and decongestants can sometimes be helpful.

Atrophic rhinitis is very difficult to treat. Sometimes a syringe, antibiotics or moistening sprays may be used to remove the crust blocking the airways.

Antihistamine drugs, taken by mouth, are convenient and relieve eye symptoms, running nose, sneezing and nasal irritation, but not nasal congestion. All are equally effective, but different people may find different methods more or less effective.

Steroid drugs (corticosteroids), taken as nose drops or a nose spray, are highly effective in treating all nasal symptoms, but ideally they should be started at least a week before the hay fever season starts. They can be combined with antihistamine taken by mouth for the first week or so until they start to take effect. Overuse can cause problems with the lining of the inside of the nose.

Sodium cromoglycate is a drug that prevents the release of the substances that cause the symptoms of allergic rhinitis. Taken as a nose spray it is less effective than nasal corticosteroids, but may be useful in young children as an alternative to betamethasone nose drops (no other corticosteroid preparation is licensed for use in young children).

Ipratropium is a natural substance that has many effects including the production of saliva, tears, sweat and respiratory secretions and narrowing of the air tubes. Taken as a nose spray, it can be useful when a runny nose is the main symptom, but it does not relieve nasal itching, blockage or sneezing.

For watering eyes, antihistamine eye drops work quickly and are suitable for people with eye symptoms that come and go.

Desensitisation injections can certainly be helpful, especially if started after the hay fever season and then continued all the year round. This must be done very carefully to avoid severe reactions and is usually used after other treatments have failed.

Well,  enough is enough. I say Rhinitis is sexy – or at least, its certainly something worth talking about. So I’ve set up this blog to share my experience of the condition (and the related conditions of eczema, asthma and hayfever) with other sufferers.

Join in. Share. Who knows where it will get us!