Childhood Allergic Rhinitis: What You Need to Know

Childhood Allergic Rhinitis: What You Need to Know--KELOPA

 

Chances are good that your children—and their children—will battle allergies, an overreaction of the immune system to things that we normally regard as harmless, such as pollen, pet dander, dust and mold. When the mucous membranes of the nose are involved in allergic reactions, with symptoms like runny nose and sneezing, it’s called allergic rhinitis.

Worldwide, from 40 to 50 percent of all school children have allergies of one kind or another, and the number is on the rise, increasing the odds of allergic rhinitis.

Why the Increase in Allergies?

Scientists are beginning to unravel some of the puzzles surrounding why some children develop allergies, and others don’t. Many children aren’t sensitized to indoor and outdoor allergies until around ages 4 to 6, which means we often don’t see the symptoms until then. However, children under 2 can be sensitized to indoor allergies; outdoor allergy sensitization occurs later.

Cigarette smoke an early trigger

Long before sensitization, some forces have already been set in motion that “select” certain children to have allergies.

A Johns Hopkins University study published in April 2015 showed that exposure to cigarette smoke is associated with an increase in non-food allergic sensitization and allergic rhinitis among children and teenagers. Inexplicably, this exposure also was linked to a lower incidence of food allergies.

Delivery and postpartum factors raise risk

Children face an increased likelihood of allergic rhinitis when three factors come together at their delivery and in their first several weeks of life, according to a Korean study published in May 2015. These factors are: use of antibiotics, delivery by Cesarean section and switching early from breastfeeding to formula. Another study, this one in China and published in February 2015, also concluded that Cesarean delivery and formula increased risk of allergic rhinitis—and added two more risk factors: infants born post-term and infants born to mothers who suffered depression before and after delivery.

Effects Go Way Beyond a Runny Nose

Children with nasal allergies can suffer serious physical and mental complications that can be life-altering. Children with allergic rhinitis are prone to otitis media with efflusion, a collection of non-infected fluid in the middle ear. It usually resolves on its own in 4 to 6 weeks, but regular recurrence of this condition can lead to more serious problems, such as changes in the inner ear structure, difficult speech/language development and, very rarely, hearing loss.

These children can also develop chronic sinusitis and asthma. Snoring, sleep apnea and other sleep disturbances also are more likely among children with allergic rhinitis. In turn, sleep disturbances frequently affect school performance and may contribute to hyperactivity.

In a study in Thailand, more than half of the students on a college campus had allergic rhinitis. Students with allergic rhinitis had poorer scores in every category on a quality-of-life survey, compared to students without allergic rhinitis.

Allergic Rhinitis: An Equal-Opportunity Condition

In the U.S., allergic rhinitis is the most common disease affecting children and the fifth most common chronic disease—and it appears not to discriminate based on race, ethnicity or gender, with all groups fairly evenly affected by it.

Common signs and symptoms

Here are some of the most common signs to look for in your children:

  • Nasal congestion and post-nasal drip
  • Nasal obstructions (turbinates) that cause congestion or block air flow
  • Repetitive sneezing
  • Itching of the palate, nose, ears and eyes
  • Snoring
  • Frequent sore throat
  • Coughing and need to constantly clear throat
  • Headaches

An allergy skin test can help determine the allergens that are the source of the problem.

Treatment Options

Convention medicine has three lines of attack

So, the doctor has diagnosed allergic rhinitis and together you have identified the malicious allergens—what’s next?

There’s no one-size-fits all when it comes to allergies. Diagnosis and treatment are very patient-specific. Basically, though, the type of treatment depends on the severity of the condition. The first step, of course, is to avoid the harmful allergens as much as possible. The first-line of therapy recommended by the American Academy of Family Physicians for mild-to-moderate disease is nasal corticosteroids. If that doesn’t work, the next step is antihistamines, decongestants and nasal irrigation. If that still doesn’t work, the third-line approach is immunotherapy, either as allergy shots or sublingual therapy, in which allergen extract is placed under the tongue as a liquid or a drop, instead of the injections of traditional immunotherapy.

Complementary and Alternative Medicine

Non-pharmacological, “natural” healing is of increasing interest in the western world, but it has been serving eastern cultures for thousands of years.

In fact, complementary and alternative medicine (CAM), as it’s called, which includes things like herbs, acupuncture, yoga, homeopathy and dietary changes, has been used by more than 40 percent of U.S.adults and children with atopic disorders, such as asthma and allergic rhinitis. High-quality scienfitic studies are scarce, but with more trials under way, that may soon change.

Probiotics, or beneficial gut bacteria, have been lauded for everything from irritable bowel to brain function. A new research review of 23 studies with nearly 2,000 patients concluded that taking probiotics may be beneficial in improving symptoms and quality of life for individuals with allergic rhinitis.

Dietary changes can mean benefits, with no downside

Simple adjustments in diet that promote good general health may also improve quality of life and reduce symptoms for allergic rhinitis sufferers. Some common recommendations all tend to conclude with the same idea we saw supported by research: taking probiotics. These are the recommendations:

  1. vegetable oil, mayonnaise and fried foods
  2. Use more herbs with rosmarinic acid, such as oregano, lemon balm, sage, marjoram, peppermint, thyme, and rosemary
  3. Eat foods that contain quercetin, a flavonoid with antihistamine properties. Try apples, onions, grapes, citrus fruits, berries and broccoli
  4. Eat fruits and vegetables with vitamin C to reduce the release of histamines, such as bell peppers, broccoli, cauliflower, strawberries and oranges
  5. Increase your vitamin E, which may lessen runny nose and congestion
  6. Eat foods with selenium, like cod, shrimp and tuna. Selenium is an antioxidant that works with vitamin E
  7. Probiotics may help lessen symptoms. They also help restore healthy bacteria, which are harmed by the use of antibiotics