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How to keep kids from getting allergic rhinitis: Don't shelter them too much.

Allergic rhinitis-often associated with symptoms such as sneezing, stuffy nose, clogged airways, runny nose and watery eyes-affects two out of 10 Filipinos, according to data collected by National Nutrition and Health Survey in 2008.

Allergic rhinitis is an Immunoglobulin E (IgE) mediated illness. IgE is a kind of antibody that plays an essential role in hypersensitivity that manifests in various allergic diseases, including allergic rhinitis.

And 20-30 percent of the time, it is genetic, said Dr. Clydine M.A. Guevara-Barrientos, ENT head and neck surgeon at Makati Medical Center.

Hypersensitivity occurs when the body overreacts to certain allergens. For allergic rhinitis, that means overreacting to dust mites, mold, animal dander (dead skin cells) and pollen.

If the nose airway reacts to food, such as pineapples, mangoes or spicy food, that's called gustatory rhinitis. It's basically a person's parasympathetic system that gets irritated, Barrientos said.

'There is a thin line between allergic rhinitis and nonallergic rhinitis-they have the same symptoms, except allergic rhinitis has a high genetic predisposition, or you had a history of allergies as a child. There are also specific allergens that, once you come in contact with, triggers the allergic rhinitis,' Barrientos explained.

Allergic rhinitis can also be aggravated by other factors such as fumes, perfumes, cologne, smoke and pollution.

The incidence of allergic rhinitis has been rising in recent decades, Barrientos said. According to the Philippine Society of Otolaryngology Head and Neck Surgery Inc. (PSO-HNS), the prevalence of allergic rhinitis is 26 percent in children and 32 percent in adolescents. (There is no data yet on adults.)

The rise is also partly because families today shelter their children a little too excessively.

No cure

'When we were born, our immune system had to learn what is good for the body and what is not,' Barrientos said. 'It needs to be able to identify them at a young age. When a child is too sheltered, with air-conditioned rooms, hand sanitizers, alcohol, the immune system will not learn to identify which ones in our natural environment are okay or not.'

She added: 'So that's why it treats every foreign object as an enemy. Now you have an immune system that overreacts, for example, to pollen or mold or dust, which is a natural part of our world.'

There is no cure for allergic rhinitis, but one can certainly avoid the allergens that trigger it, she pointed out.

If, for instance, pet dander cannot be avoided, Barrientos said the house must be kept clean at all times. Clean the pet as often as possible, use a damp mop to clean the floor so that it absorbs the allergens, and vacuum the house frequently.

Allergic rhinitis used to be identified as seasonal or perennial, she said, but now it is classified as mild, moderate, or severe, and intermittent or persistent (intermittent lasts less than four days a week; persistent lasts more than four days per week).

Another big mistake people with allergic rhinitis make is breathing through the mouth when it encounters an allergen.

The nose, said Barrientos, has a natural filter. So whether it is already runny or clogged, it will continue to filter out the allergens.

Breathing through the mouth invites more allergens to enter the lungs.

Medication, she said, must also be taken before the symptoms set in. That will determine if you'll experience a mild or severe form of allergic reaction.

'People with allergic rhinitis often know the triggers; they can feel them right away,' she noted. 'Take medication as soon as you feel something is clogging your nose, or if you have watery eyes. That will arrest the symptoms before they turn into a persistent condition.'

Contrary to popular belief, one cannot become immune to allergic rhinitis medications. Patients, she said, will be advised to switch brands if one doesn't work anymore but that doesn't mean they've become immune to the drug.

Allergic rhinitis can also turn into complications like sinusitis, bacterial sinusitis (infection), asthma and bronchitis. 'Children with allergic rhinitis are often advised to control the allergic rhinitis so that it won't go into full-blown asthma,' she said.

Another problem she noticed among Filipino patients is that majority seek professional help only when the condition is already severe. Education is important, she stressed. Consult with a physician while the symptoms are still in its early stages.

Allergic rhinitis has been classified by the World Health Organization as the fourth most important chronic disease in the world. It can affect the quality of life, including performance at work or in school.
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Publication:Philippines Daily Inquirer (Makati City, Philippines)
Date:Aug 2, 2016
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