Diagnosis and management of allergic rhinitis

Abstract

• Objective: To provide an overview of the approach to diagnosis and management of allergic rhinitis. • Methods: Review of the literature. • Results: Allergic rhinitis affects 20% to 40% of the U.S. population and has a significant impact on patients, their families, and society. The diagnosis can often be ascertained from a history that points to a specific, often seasonal or environmental, trigger. Treatment is often begun without the aid of any testing and based on a diagnosis made on history and physical examination alone. The mainstays of first-line treatment are nonsedating oral antihistamines, nasal corticosteroids, and nasal antihistamine sprays. As an adjunct, mast cell stabilizing antihistamine eye drops may be used. First-line pharmacotherapy should be based on the nature and severity of the patient's symptoms. Allergy testing should be considered when a patient's symptoms are not controlled by routine medical therapies. • Conclusion: Allergy is a significant burden to society. A symptom-based approach to the pharmacologic treatment of allergic rhinitis will yield the most satisfactory control of the patient's major symptoms.