Yes, it is a very common problem. It is one of the 4 manifestations of allergy that patients seek treatment for. The other 3 are asthma, atopic eczema (skin allergy), and food allergy. about 20% of the population have allergic rhinitis in Singapore. so 1 in 5 people.
This is easy to confuse. The sinuses are air spaces connected to the nasal cavity (internal nose, or rhino). the sinuses are located beside and around the nose. So symptoms can overlap and it needs a doctor who is familiar with nasal and sinus issues to differentiate the two, preferably an ENT specialist. In general, rhinitis refers to inflammation of the nose passages alone, whereas sinusitis refers to inflammation of the sinuses surrounding the nasal passages. The symptoms can overlap but there are some differentiating features. For eg. those with rhinitis, whether allergic or non allergic rhinitis, can have symptoms such as watery runny nose, and stuffiness of the nose, or nose block. Those with sinusitis will predominantly present with facial or cheek pain, with discoloured nasal discharge that can be thick and yellowish or greenish. Often times, sinusitis can also cause a loss of smell, which is less common in rhinitis. However, as I mentioned, it requires an experienced doctor who will need to take a good history of the problem, examine and where necessary, perform an outpatient fibreoptic camera endoscopy of the nose and sinus passages to make an accurate diagnosis, so that the appropriate treatment can be given to treat the correct problem.
The common symptoms are nose itch, sneezing, runny nose usually watery, and nasal blockage. Less common symptoms are associated eye itch, throat itch or phlegm, or constant sensation of irritation of the throat. Ear symptoms can also be a related symptom including intermittent sensation of ear block, and fluid in the middle ear, especially in children with allergic rhinitis.
Identification of the allergic trigger is important. As part of the allergic rhinitis assessment in the clinic, the doctor will perform a skin prick test (if the patient is suitable). this will identify, in 20 minutes or so, what exactly is the allergic trigger. For example. if house dust mite is the trigger, then avoidance measures can be started. This includes removing thick fabric such as carpets in the house, and placing the pillows under the sun to reduce the dust mite count, relieving the symptoms of the nasal allergy or allergic rhinitis.
Beyond the allergen avoidance measures above, the doctor will prescribe some medications to prevent flare ups. This includes intranasal steroid sprays (not tablet steroids). These have been proven to be safe for longer term use with no risk of major health issues such as addiction to the sprays, weight gain or systemic side effects of tablet steroids. For some patients, we will add on tablet anti histamines to relieve acute symptoms. Last but not least, it is important to know that once a definite diagnosis of allergic rhinitis with a positive allergic skin prick test is done, there is an important treatment option known as allergen immunotherapy. This is the only treatment that not only avoids any steroid use, but alters the course of the disease by treating the underlying cause of the allergy to reduce or eliminate the symptoms of allergic rhinitis in the long term. this treatment either comes in the form of a dissolvable allergy tablet, or a spray that needs to be used daily. This is generally a safe and effective treatment option for allergic rhinitis, and the doctor will explain more during a consultation.