By James Connolly, MD, FAAOA Allergic rhinitis is caused by many different antigens. Some antigen exposure seasonal (limited exposure during the year such as ragweed or tree pollen), and some antigen exposure is year around or perennial, such as dust…
Many patients with allergies also have sinus problems. Chronic sinusitis is an inflammatory condition of the sinuses that may cause nasal congestion, drainage, postnasal drainage, facial pain or pressure, decreased smell, and fatigue. Allergies can cause many if not all of these same symptoms.
So how do you know which it is you might have or could you suffer from both?
Your ENT Allergist can help you sort this out and formulate the right personalized treatment for you.
In allergic rhinitis (allergy), the immune system reacts to something to which is it exposed as if it were a harmful invader. It creates IgE antibodies that then cause the release of histamine which leads to the classic allergy symptoms.
In chronic sinusitis, the nose and sinuses become inflamed and sometimes infected, leading to an ongoing set of symptoms from this persistent inflammation. The tricky thing is that many of the symptoms can be present in both conditions.
There have been a lot of studies looking to see if there is a relationship between allergies and chronic sinusitis, where one might impact the other.
An evidence-based review (reference IFAR article Int Forum Allergy Rhinol. 2014 Feb;4(2):93-103) found that there were nearly as many articles showing an association between the two as there were that showed no link at all.
They recommended that in patients with chronic sinusitis, allergy testing and treatment is an “option.”
So what should you do?
Your ENT doctor will ask you questions about your symptoms to try to identify the cause. Certain symptoms or findings on your physical exam may give it away. Sometimes he or she will perform a nasal endoscopy (scope) to gather more information.
Allergy testing can also be helpful in identifying triggers and treatment options.
Of course, the testing results should always be correlated back to you to make sure the best treatment is used.
Fortunately, since both conditions are inflammatory, many treatment options (such as nasal saline irrigations or steroid sprays) are effective in treating both conditions.
Your ENT Allergist is in the ideal situation to help make the correct diagnosis and formulate a personalized treatment plan for your symptoms.
Some problems are best treated with medications.
Others may require surgery.
Immunotherapy may be an appropriate option as well.
Whatever the case, help is just around the corner.