Many will experience some relief at this first line of therapy, although these patients should be warned that many of these medications are associated with sedation and cognitive impairment. The primary care physician can offer additional medications, including non-sedating antihistamines and nasal corticosteroids.

The physician can also try to identify the asthma triggers through history and recommend environmental controls to limit exposures to allergens. Pollen allergy may be identified by seasonal symptoms which are worse outside during a pollen season (Trees begin pollinating in early spring, and persist through June. In this area Grass pollens spike in April, but can persist in lower levels into the autumn. Weeds begin pollinating in late summer through early autumn).

Closing the windows and using the air conditioning will decrease the pollen exposures. Avoiding the outdoors is also effective, but would be unacceptable to many people and would interfere with our efforts as physicians to encourage our patients to be more active.

Allergy Immunotherapy

Allergy Immunotherapy is also a safe and effective option that you should consider for your patients with Allergic Rhinitis, especially if they do not experience significant relief from the other treatment options. Some patients may prefer immunotherapy because of the high cost of medications, or they may prefer not to rely on medications for their relief.

Even if you find an effective medication, there is a chance that it may fail in the future. You may also want to consider immunotherapy for patients who have other related diseases, such as asthma or sinus disease.

Children with Allergic Rhinitis are at a higher risk of developing allergic asthma, and Allergy Immunotherapy has been demonstrated to significantly reduce the development of asthma in these patients. While the other treatments for Allergic Rhinitis focus on symptom control, allergy immunotherapy targets the cause. It can make the patient less allergic and often effects a cure.

The biggest downside to allergy immunotherapy is that it is often inconvenient for patients to come in for routine injections, but most patients are able to go 3-4 weeks between injections after the first year, and even less frequently after that. Also, most patients are able to discontinue allergy injections after 3-5 years and still maintain the benefit for many years later.

About The Author
Dr. Gary B. Moss received a BA in Biology from the University of Chicago and an MS in Human Physiology from Georgetown University. He graduated from the Medical College of Virginia, where he also completed his Internship and Residency in Internal Medicine. He served as a Fellow of Allergy and Immunology at Barnes-Jewish Hospital and Washington University at the St. Louis School of Medicine.

He is Board Certified in Internal Medicine and in Allergy and Immunology. Dr. Moss is on staff at Sentara Norfolk General Hospital, Sentara Leigh Memorial Hospital, Bon Secours De Paul Hospital, and Chesapeake General Hospital.