Renite Alérgica e Não-Alérgica

A renite alérgia é uma reacção alérgica que  acontece pela hipersensibilidade a várias substâncias como por exemplo o pólen.

Que tipos de renite alérgica conhece:

- sazonal, febre dos fenos, alérgenos ocasionais como o pólen
- recorrente, alérgenos comuns como o pó
Quais são as Queixas ?

As queixas são semelhantes às da constipação, mas a origem não é diferente.
Ao respirar um alérgeno o corpo sensível reage de forma exagerada desencadeando a libertação de IgEs e histamina no tracto respiratório.

Como resultado começa o prurido e congestão do nariz, os seios ou olhos.
•entupimento, corrimento e pingo nasal

•Espirros
•Olhos vermelhos e aquosos, com edema das pálpebras (sombra sub-ocular SR cansada)
•Garganta irritada com tosse seca

•Cefaleia e pressão e dor facial

•Diminuição da acuidade dos sentidos


The body's immune system is designed to fight harmful substances like bacteria and viruses. But in allergic rhinitis, the immune system overresponds to harmless substances -- like pollen, mold, and pet dander -- and launches an assault. This attack is called an allergic reaction.



Seasonal allergic rhinitis is caused by an allergic reaction to pollens and spores (depending on the season and area) as they are carried on the wind. Sources include:



•Ragweed -- the most common seasonal allergen (fall)

•Grass pollen (late spring and summer)

•Tree pollen (spring)

•Fungus (mold growing on dead leaves, common in summer)

Year-round allergic rhinitis is caused by an allergic reaction to airborne particles from the following:



•Pet dander

•Dust and household mites

•Cockroaches

•Molds growing on wall paper, house plants, carpeting, and upholstery

Risk Factors:

•Family history of allergies

•Having other allergies, such as food allergies or eczema

•Exposure to secondhand cigarette smoke

•Male gender

Diagnosis:

Your doctor will ask about your family and personal history of allergy. You may be asked some of the following questions:



•Do symptoms change depending on the time of day or the season?

•Do you have a pet?

•Have you made changes to your diet?

•Are you taking any medications?

Your doctor will perform a physical exam and may also recommend a skin test to find out what you are allergic to. In a scratch test, for example, small amounts of suspected allergens are applied to the skin with a needle prick or scratch. If there is an allergy, a hive (swollen reddened area) forms within about 20 minutes. Sometimes a blood test may be used to find out which allergens you react to.



With young children, it can help to watch what they do. For example, a child with allergic rhinitis may wiggle his nose and push it upward with the palm of the hand.



Prevention:

Preventing your exposure to allergens is the best way to control symptoms. These steps may help.



If you have hay fever, during days or seasons when airborne allergens are high:



•Stay indoors, and if possible, close the windows.

•Use an air conditioner.

•Avoid using fans that draw in air from outdoors.

•Don't hang laundry outside to dry.

•Bathe or shower and change your clothes after being outside.

•Use a HEPA air filter in your bedroom.

If you have perennial allergic rhinitis:



•Cover your pillows and mattress with dust mite covers.

•Remove carpet; install tile or hardwood floors. Use area rugs and wash them often in very hot water.

•Keep pets out of the bedroom.

•Use a HEPA filter on your vacuum.

•Use an air purifier.

•Wash bedding and toys such as stuffed animals in very hot water once a week.

Treatment:

The best way to reduce symptoms is to prevent exposure to allergens.



Drugs (such as antihistamines, decongestants, and nasal corticosteroid sprays) may help control allergy symptoms. Some complementary, and alternative therapies may also be used to treat the symptoms of allergic rhinitis.



Your doctor may recommend immunotherapy ("allergy shots"). This treatment includes regular injections of an allergen, with each dose being slightly larger than the previous dose. Your immune system should gradually get used to the allergen so that it no longer reacts to it.



In addition, certain lifestyle and dietary changes may help prevent or improve symptoms of allergic rhinitis.



Lifestyle

Although you can't stay indoors during all high pollen and ragweed seasons, avoiding peak exposure times can help. Use your air conditioner in your home and car, and wear a dust mask when working in the yard.



For perennial allergic rhinitis, you can take the following measures.



•Get rid of carpets and upholstered furniture.

•Wash bedding every week in very hot water.

•Keep stuffed toys out of the bedroom.

•Cover pillows and beds with allergen-proof covers.

To reduce mold:



•Clean moldy surfaces. Mold is often found in air conditioners, humidifiers, dehumidifiers, swamp coolers, and refrigerator drip pans.

•Use a dehumidifier indoors to reduce humidity to less than 50%.

•Fix water leaks and clean up water damage immediately.

•Make sure kitchens, bathrooms, and crawl spaces have good ventilation. Installing exhaust fans can help. Vent laundry dryers to the outside.

•Put flooring in crawl spaces.

Medications

Depending on the type of allergic rhinitis you have, your doctor may recommend medications. If you have perennial allergic rhinitis, you may need to take medication daily. If you have seasonal allergic rhinitis (hay fever) you may start medications a few weeks before the pollen season begins.



Nasal corticosteroids



These prescription sprays reduce inflammation of the nose and help relieve sneezing, itching, and runny nose. They are most effective at reducing symptoms, although you may not see improvement for a few days to a week after you start using them.



•Beclomethasone (Beconase)

•Fluticasone (Flonase)

•Mometasone (Nasonex)

•Triacinolone (Nasacort)

Antihistamines



Antihistamines are available in both oral and nasal spray forms, and as prescription drugs and over-the-counter remedies. Over-the-counter antihistamines are short-acting and can relieve mild-to-moderate symptoms. All work by blocking the release of histamine in your body.



•Over-the-counter antihistamines -- Include diphenhydramine (Benadryl), chlorpheniramine (Chlor-Trimeton), clemastine (Tavist). These older antihistamines can cause sleepiness. Loratadine (Claritin) and cetrizine (Zyrtec) do not cause as much drowsiness as older antihistamines.

•Prescription antihistamines -- These medications are longer-acting than over-the-counter antihistamines and are usually taken once a day. They include fexofenadine (Allegra).

Decongestants



Many over-the-counter and prescription decongestants are available in tablet or nasal spray form. They are often used with antihistamines.



•Oral and nasal decongestants -- Include Sudafed, Actifed, Afrin, Neo-Synephrin. Some decongestants may contain pseudoephedrine, which can raise blood pressure. People with high blood pressure or enlarged prostate should not take drugs containing pseudoephedrine. Nasal decongestants can cause "rebound congestion," where the nasal passages swell. Avoid using nasal decongestants for more than 3 days in a row, unless specifically instructed by your doctor, and do not use them if you have emphysema or chronic bronchitis.

Leukotreine modifiers



These prescription drugs block the production of leukotreines, which are inflammatory chemicals produced by the body. They are taken once a day and do not cause sleepiness, and are also used to treat allergic asthma. Leukotreine modifiers include montelukast (Singulair) and zafirlukast (Accolate).



Cromolyn sodium (NasalCrom)



This over-the-counter nasal spray prevents the release of histamine and helps relieve swelling and runny nose. It is most effective when taken before symptoms start and may needed to be used several times a day.



Nasal atropine



Ipratropium bromide (Atrovent) is a prescription nasal spray that can help relieve a very runny nose. People with glaucoma or an enlarged prostate should not use Atrovent.



Eye drops



•Antihistamine eye drops -- relieve both nasal and eye symptoms; examples include azelastine, olopatadine, ketotifen, and levocabastine

•Decongestant eye drops -- such as phenylephrine and naphazoline

Eye drops may cause stinging or even headache.



Other Treatments

Allergy shots (immunotherapy) are often recommended to anyone 7 years and older who has severe allergy symptoms or who also has asthma. Immunotherapy accustoms the immune system to allergens through regular injections of small doses of an allergen over a long period of time.



Nasal irrigation or nasal lavage can help reduce symptoms of allergic rhinitis, studies show. The technique uses a neti pot, bulb syringe, or squeeze bottle to “flush out” nasal passages with saline solution (salt water).



Nutrition and Dietary Supplements

Some



people with allergic rhinitis also have food allergies. If you have any food allergies, eliminate those items from your diet. Even if you don't have a food allergy, cutting back on foods that may contribute to inflammation (such as meats, dairy products, sugar, and highly processed foods) may improve your symptoms.



•Lactobacillus acidophilus -- One small study suggests that L. acidophilus, a type of "friendly" bacteria, might help reduce allergic reaction to pollen. More study is needed.

•Quercetin -- Quercetin is a flavonoid, a plant pigment responsible for the colors found in fruits and vegetables. In test tubes, it stops the production and release of histamine, which causes allergy symptoms of allergic rhinitis, such as a runny nose and watery eyes. However, there is not yet much evidence that quercetin would work the same way in humans. More studies are needed.

•Spirulina -- Preliminary test tube and animal studies suggest that spirulina, a type of blue-green algae, may help protect against harmful allergic reactions. Spirulina prevents the release of histamine, which contribute to symptoms of allergic rhinitis. Human research is needed.

•Vitamin C (2,000 mg per day) -- Vitamin C has antihistamine properties and some preliminary research suggested it might help reduce allergy symptoms. But another placebo-controlled trial failed to show any effect.

Herbs

The use of herbs is a time-honored approach to strengthening the body and treating disease. Herbs, however, can trigger side effects and can interact with other herbs, supplements, or medications. For these reasons, you should take herbs only under the supervision of a health care practitioner.



•Butterbur (Petasites hybridus, 500 mg per day) -- Butterbur has been used traditionally to treat asthma and bronchitis and to reduce mucus, and several scientific studies show that it can be helpful. One study of 125 people with hay fever found that an extract of butterbur was as effective as Zyrtec. Another study compared butterbur to Allegra with similar findings. Both studies were small, however, so more research is needed. It hasn't been established whether taking butterbur longer than 12 - 16 weeks is safe. Butterbur can cause stomach upset, headache, and drowsiness. Pregnant and breastfeeding women, and young children, should not take butterbur.

•Goldenseal (Hydrastis canadensis) -- Goldenseal is sometimes included in herbal remedies for allergic rhinitis. Laboratory studies suggest that berberine, the active ingredient in goldenseal, has antibacterial and immune-enhancing properties. But there is no evidence that it is effective specifically for allergic rhinitis.

•Stinging nettle (Urtica dioica, 600 mg per day for one week) -- Stinging nettle has been used traditionally for treating a variety of conditions, including allergic rhinitis. But studies so far are lacking. Only one small study suggested that stinging nettle might help relieve symptoms of allergic rhinitis. Pregnant women and young children should not take stinging nettle. Talk to your doctor before taking stinging nettle if you take blood pressure medication, anticoagulants (blood thinners), diuretics (water pills), or have diabetes.

Acupuncture

Some evidence suggests that acupuncture may be a useful complementary or alternative treatment for people with allergic rhinitis, although not all studies have found any benefit. In one study that included 45 people with hay fever, acupuncture worked as well as antihistamines in improving symptoms, and the effects seemed to last longer. However, a controlled trial that compared acupuncture to placebo (sham acupuncture) found no real benefit. One study suggested that combining acupuncture with traditional Chinese herbs did help relieve symptoms.



Homeopathy

Although few studies have examined the effectiveness of specific homeopathic therapies, professional homeopaths may consider the following remedies for the treatment of allergic rhinitis symptoms based on their knowledge and experience. Before prescribing a remedy, homeopaths take into account a person's constitutional type -- your physical, emotional, and psychological makeup. An experienced homeopath assesses all of these factors when determining the most appropriate treatment for each individual.



•Nux vomica -- for stuffiness with nasal discharge, dry, ticklish, and scraping nasal sensations with watery nasal discharge and a lot of sneezing; an appropriate person for this remedy is irritable and impatient.

•Arsenicum album -- for stuffiness with copious, burning nasal discharge and violent sneezing; an appropriate candidate for Arsenicum feels restless, anxious, and exhausted.

•Allium cepa -- for frequent sneezing, a lot of irritating nasal discharge and tearing eyes; this person tends to feel thirsty.

•Euphrasia -- for bland nasal discharge, with stinging, irritating tears; a suitable person for this remedy has worse nasal symptoms when lying down.

Traditional Chinese Medicine

Biminne



Biminne is a Chinese herbal formula used to treat allergic rhinitis. In a study of 58 people with year-round allergic rhinitis, biminne relieved at least some symptoms in most of the participants. People in the study took the formula five times a day for 12 weeks, and they still showed the benefit of biminne even after one year. It is not known how biminne works, or if it is safe to use for extended periods. Biminne includes these herbs:



•Chinese skullcap (Scutellaria baicalensis)

•Ginkgo biloba

•Horny goat weed (Epimedium sagittatum)

•Schizandra chinensis

•Japanese apricot (Prunus mume)

•Ledebouriella divaricata

•Astragalus (Astragalus membranaceus)

Other Considerations:

Using some nasal sprays for long periods of time can make your allergic rhinitis worse. Call your health care provider if you develop severe symptoms, if treatment that helped before is no longer working, or if symptoms do not get better with treatment.



Pregnancy

If you are pregnant or breastfeeding, avoid the following:



•Decongestants, unless you ask your doctor

•Stinging nettle

•Chinese skullcap

•Butterbur (Petasites) extracts

•Goldenseal

•High doses of vitamin C

Warnings and Precautions

Do not take stinging nettle without talking to your doctor first if you take blood pressure medication, anticoagulants (blood thinners), diuretics (water pills), or have diabetes.



You should not use goldenseal over a long period of time, and you should avoid it if you have high blood pressure.



Skullcap can make you sleepy, and should be used with caution or not at all with antihistamines that also make you drowsy.



Prognosis and Complications

Chances are your symptoms of allergic rhinitis can be treated, but they will appear each time you are exposed to an allergen.



Although perennial allergic rhinitis is not a serious condition, it can interfere with many important aspects of life. Depending on how severe your symptoms are, allergic rhinitis can lead you to miss school or work. Medication may cause drowsiness and other side effects. Your allergies could also trigger other conditions, such as eczema, asthma, sinusitis, and ear infection (called otitis media). Seasonal allergies may improve as you get older.



Immunotherapy (allergy shots) may cause uncomfortable side effects (such as hives and rash) and may have dangerous side effects such as anaphylaxis. It often requires years of treatment and is effective in about two-thirds of cases.


Allergic rhinitis is an allergic reaction that happens when your immune system overreacts to substances that you have inhaled, such as pollen. The two types of allergic rhinitis are seasonal allergic rhinitis (hay fever) and perennial allergic rhinitis, which occurs year-round. Hay fever is caused by outdoor allergens. Perennial allergic rhinitis is caused by indoor allergens such as dust mites, pet dander, and mold.




Symptoms of allergic rhinitis resemble a cold, but they are not caused by a virus the way a cold is. When you breathe in an allergen, your immune system springs into action. It releases substances known as IgEs into your nasal passages, along with inflammatory chemicals such as histamines. Your nose, sinuses, or eyes may become itchy and congested. Scientists aren't sure what causes your immune system to overreact to an allergen.



Allergic rhinitis is common, affecting about 1 in 5 Americans. Symptoms can be mild or severe. Many people who have allergic rhinitis also have asthma.



Signs and Symptoms:

Allergic rhinitis can cause many symptoms, including the following:



•Stuffy, runny nose

•Sneezing

•Post-nasal drip

•Red, itchy, and watery eyes

•Swollen eyelids

•Itchy mouth, throat, ears, and face

•Sore throat

•Dry cough

•Headaches, facial pain or pressure

•Partial loss of hearing, smell, and taste

•Fatigue

•Dark circles under the eyes

Causes:

The body's immune system is designed to fight harmful substances like bacteria and viruses. But in allergic rhinitis, the immune system overresponds to harmless substances -- like pollen, mold, and pet dander -- and launches an assault. This attack is called an allergic reaction.



Seasonal allergic rhinitis is caused by an allergic reaction to pollens and spores (depending on the season and area) as they are carried on the wind. Sources include:



•Ragweed -- the most common seasonal allergen (fall)

•Grass pollen (late spring and summer)

•Tree pollen (spring)

•Fungus (mold growing on dead leaves, common in summer)

Year-round allergic rhinitis is caused by an allergic reaction to airborne particles from the following:



•Pet dander

•Dust and household mites

•Cockroaches

•Molds growing on wall paper, house plants, carpeting, and upholstery

Risk Factors:

•Family history of allergies

•Having other allergies, such as food allergies or eczema

•Exposure to secondhand cigarette smoke

•Male gender

Diagnosis:

Your doctor will ask about your family and personal history of allergy. You may be asked some of the following questions:



•Do symptoms change depending on the time of day or the season?

•Do you have a pet?

•Have you made changes to your diet?

•Are you taking any medications?

Your doctor will perform a physical exam and may also recommend a skin test to find out what you are allergic to. In a scratch test, for example, small amounts of suspected allergens are applied to the skin with a needle prick or scratch. If there is an allergy, a hive (swollen reddened area) forms within about 20 minutes. Sometimes a blood test may be used to find out which allergens you react to.



With young children, it can help to watch what they do. For example, a child with allergic rhinitis may wiggle his nose and push it upward with the palm of the hand.



Prevention:

Preventing your exposure to allergens is the best way to control symptoms. These steps may help.



If you have hay fever, during days or seasons when airborne allergens are high:



•Stay indoors, and if possible, close the windows.

•Use an air conditioner.

•Avoid using fans that draw in air from outdoors.

•Don't hang laundry outside to dry.

•Bathe or shower and change your clothes after being outside.

•Use a HEPA air filter in your bedroom.

If you have perennial allergic rhinitis:



•Cover your pillows and mattress with dust mite covers.

•Remove carpet; install tile or hardwood floors. Use area rugs and wash them often in very hot water.

•Keep pets out of the bedroom.

•Use a HEPA filter on your vacuum.

•Use an air purifier.

•Wash bedding and toys such as stuffed animals in very hot water once a week.

Treatment:

The best way to reduce symptoms is to prevent exposure to allergens.



Drugs (such as antihistamines, decongestants, and nasal corticosteroid sprays) may help control allergy symptoms. Some complementary, and alternative therapies may also be used to treat the symptoms of allergic rhinitis.



Your doctor may recommend immunotherapy ("allergy shots"). This treatment includes regular injections of an allergen, with each dose being slightly larger than the previous dose. Your immune system should gradually get used to the allergen so that it no longer reacts to it.



In addition, certain lifestyle and dietary changes may help prevent or improve symptoms of allergic rhinitis.



Lifestyle

Although you can't stay indoors during all high pollen and ragweed seasons, avoiding peak exposure times can help. Use your air conditioner in your home and car, and wear a dust mask when working in the yard.



For perennial allergic rhinitis, you can take the following measures.



•Get rid of carpets and upholstered furniture.

•Wash bedding every week in very hot water.

•Keep stuffed toys out of the bedroom.

•Cover pillows and beds with allergen-proof covers.

To reduce mold:



•Clean moldy surfaces. Mold is often found in air conditioners, humidifiers, dehumidifiers, swamp coolers, and refrigerator drip pans.

•Use a dehumidifier indoors to reduce humidity to less than 50%.

•Fix water leaks and clean up water damage immediately.

•Make sure kitchens, bathrooms, and crawl spaces have good ventilation. Installing exhaust fans can help. Vent laundry dryers to the outside.

•Put flooring in crawl spaces.

Medications

Depending on the type of allergic rhinitis you have, your doctor may recommend medications. If you have perennial allergic rhinitis, you may need to take medication daily. If you have seasonal allergic rhinitis (hay fever) you may start medications a few weeks before the pollen season begins.



Nasal corticosteroids



These prescription sprays reduce inflammation of the nose and help relieve sneezing, itching, and runny nose. They are most effective at reducing symptoms, although you may not see improvement for a few days to a week after you start using them.



•Beclomethasone (Beconase)

•Fluticasone (Flonase)

•Mometasone (Nasonex)

•Triacinolone (Nasacort)

Antihistamines



Antihistamines are available in both oral and nasal spray forms, and as prescription drugs and over-the-counter remedies. Over-the-counter antihistamines are short-acting and can relieve mild-to-moderate symptoms. All work by blocking the release of histamine in your body.



•Over-the-counter antihistamines -- Include diphenhydramine (Benadryl), chlorpheniramine (Chlor-Trimeton), clemastine (Tavist). These older antihistamines can cause sleepiness. Loratadine (Claritin) and cetrizine (Zyrtec) do not cause as much drowsiness as older antihistamines.

•Prescription antihistamines -- These medications are longer-acting than over-the-counter antihistamines and are usually taken once a day. They include fexofenadine (Allegra).

Decongestants



Many over-the-counter and prescription decongestants are available in tablet or nasal spray form. They are often used with antihistamines.



•Oral and nasal decongestants -- Include Sudafed, Actifed, Afrin, Neo-Synephrin. Some decongestants may contain pseudoephedrine, which can raise blood pressure. People with high blood pressure or enlarged prostate should not take drugs containing pseudoephedrine. Nasal decongestants can cause "rebound congestion," where the nasal passages swell. Avoid using nasal decongestants for more than 3 days in a row, unless specifically instructed by your doctor, and do not use them if you have emphysema or chronic bronchitis.

Leukotreine modifiers



These prescription drugs block the production of leukotreines, which are inflammatory chemicals produced by the body. They are taken once a day and do not cause sleepiness, and are also used to treat allergic asthma. Leukotreine modifiers include montelukast (Singulair) and zafirlukast (Accolate).



Cromolyn sodium (NasalCrom)



This over-the-counter nasal spray prevents the release of histamine and helps relieve swelling and runny nose. It is most effective when taken before symptoms start and may needed to be used several times a day.



Nasal atropine



Ipratropium bromide (Atrovent) is a prescription nasal spray that can help relieve a very runny nose. People with glaucoma or an enlarged prostate should not use Atrovent.



Eye drops



•Antihistamine eye drops -- relieve both nasal and eye symptoms; examples include azelastine, olopatadine, ketotifen, and levocabastine

•Decongestant eye drops -- such as phenylephrine and naphazoline

Eye drops may cause stinging or even headache.



Other Treatments

Allergy shots (immunotherapy) are often recommended to anyone 7 years and older who has severe allergy symptoms or who also has asthma. Immunotherapy accustoms the immune system to allergens through regular injections of small doses of an allergen over a long period of time.



Nasal irrigation or nasal lavage can help reduce symptoms of allergic rhinitis, studies show. The technique uses a neti pot, bulb syringe, or squeeze bottle to “flush out” nasal passages with saline solution (salt water).



Nutrition and Dietary Supplements

Some



people with allergic rhinitis also have food allergies. If you have any food allergies, eliminate those items from your diet. Even if you don't have a food allergy, cutting back on foods that may contribute to inflammation (such as meats, dairy products, sugar, and highly processed foods) may improve your symptoms.



•Lactobacillus acidophilus -- One small study suggests that L. acidophilus, a type of "friendly" bacteria, might help reduce allergic reaction to pollen. More study is needed.

•Quercetin -- Quercetin is a flavonoid, a plant pigment responsible for the colors found in fruits and vegetables. In test tubes, it stops the production and release of histamine, which causes allergy symptoms of allergic rhinitis, such as a runny nose and watery eyes. However, there is not yet much evidence that quercetin would work the same way in humans. More studies are needed.

•Spirulina -- Preliminary test tube and animal studies suggest that spirulina, a type of blue-green algae, may help protect against harmful allergic reactions. Spirulina prevents the release of histamine, which contribute to symptoms of allergic rhinitis. Human research is needed.

•Vitamin C (2,000 mg per day) -- Vitamin C has antihistamine properties and some preliminary research suggested it might help reduce allergy symptoms. But another placebo-controlled trial failed to show any effect.

Herbs

The use of herbs is a time-honored approach to strengthening the body and treating disease. Herbs, however, can trigger side effects and can interact with other herbs, supplements, or medications. For these reasons, you should take herbs only under the supervision of a health care practitioner.



•Butterbur (Petasites hybridus, 500 mg per day) -- Butterbur has been used traditionally to treat asthma and bronchitis and to reduce mucus, and several scientific studies show that it can be helpful. One study of 125 people with hay fever found that an extract of butterbur was as effective as Zyrtec. Another study compared butterbur to Allegra with similar findings. Both studies were small, however, so more research is needed. It hasn't been established whether taking butterbur longer than 12 - 16 weeks is safe. Butterbur can cause stomach upset, headache, and drowsiness. Pregnant and breastfeeding women, and young children, should not take butterbur.

•Goldenseal (Hydrastis canadensis) -- Goldenseal is sometimes included in herbal remedies for allergic rhinitis. Laboratory studies suggest that berberine, the active ingredient in goldenseal, has antibacterial and immune-enhancing properties. But there is no evidence that it is effective specifically for allergic rhinitis.

•Stinging nettle (Urtica dioica, 600 mg per day for one week) -- Stinging nettle has been used traditionally for treating a variety of conditions, including allergic rhinitis. But studies so far are lacking. Only one small study suggested that stinging nettle might help relieve symptoms of allergic rhinitis. Pregnant women and young children should not take stinging nettle. Talk to your doctor before taking stinging nettle if you take blood pressure medication, anticoagulants (blood thinners), diuretics (water pills), or have diabetes.

Acupuncture

Some evidence suggests that acupuncture may be a useful complementary or alternative treatment for people with allergic rhinitis, although not all studies have found any benefit. In one study that included 45 people with hay fever, acupuncture worked as well as antihistamines in improving symptoms, and the effects seemed to last longer. However, a controlled trial that compared acupuncture to placebo (sham acupuncture) found no real benefit. One study suggested that combining acupuncture with traditional Chinese herbs did help relieve symptoms.



Homeopathy

Although few studies have examined the effectiveness of specific homeopathic therapies, professional homeopaths may consider the following remedies for the treatment of allergic rhinitis symptoms based on their knowledge and experience. Before prescribing a remedy, homeopaths take into account a person's constitutional type -- your physical, emotional, and psychological makeup. An experienced homeopath assesses all of these factors when determining the most appropriate treatment for each individual.



•Nux vomica -- for stuffiness with nasal discharge, dry, ticklish, and scraping nasal sensations with watery nasal discharge and a lot of sneezing; an appropriate person for this remedy is irritable and impatient.

•Arsenicum album -- for stuffiness with copious, burning nasal discharge and violent sneezing; an appropriate candidate for Arsenicum feels restless, anxious, and exhausted.

•Allium cepa -- for frequent sneezing, a lot of irritating nasal discharge and tearing eyes; this person tends to feel thirsty.

•Euphrasia -- for bland nasal discharge, with stinging, irritating tears; a suitable person for this remedy has worse nasal symptoms when lying down.

Traditional Chinese Medicine

Biminne



Biminne is a Chinese herbal formula used to treat allergic rhinitis. In a study of 58 people with year-round allergic rhinitis, biminne relieved at least some symptoms in most of the participants. People in the study took the formula five times a day for 12 weeks, and they still showed the benefit of biminne even after one year. It is not known how biminne works, or if it is safe to use for extended periods. Biminne includes these herbs:



•Chinese skullcap (Scutellaria baicalensis)

•Ginkgo biloba

•Horny goat weed (Epimedium sagittatum)

•Schizandra chinensis

•Japanese apricot (Prunus mume)

•Ledebouriella divaricata

•Astragalus (Astragalus membranaceus)

Other Considerations:

Using some nasal sprays for long periods of time can make your allergic rhinitis worse. Call your health care provider if you develop severe symptoms, if treatment that helped before is no longer working, or if symptoms do not get better with treatment.



Pregnancy

If you are pregnant or breastfeeding, avoid the following:



•Decongestants, unless you ask your doctor

•Stinging nettle

•Chinese skullcap

•Butterbur (Petasites) extracts

•Goldenseal

•High doses of vitamin C

Warnings and Precautions

Do not take stinging nettle without talking to your doctor first if you take blood pressure medication, anticoagulants (blood thinners), diuretics (water pills), or have diabetes.



You should not use goldenseal over a long period of time, and you should avoid it if you have high blood pressure.



Skullcap can make you sleepy, and should be used with caution or not at all with antihistamines that also make you drowsy.



Prognosis and Complications

Chances are your symptoms of allergic rhinitis can be treated, but they will appear each time you are exposed to an allergen.





Although perennial allergic rhinitis is not a serious condition, it can interfere with many important aspects of life. Depending on how severe your symptoms are, allergic rhinitis can lead you to miss school or work. Medication may cause drowsiness and other side effects. Your allergies could also trigger other conditions, such as eczema, asthma, sinusitis, and ear infection (called otitis media). Seasonal allergies may improve as you get older.



Immunotherapy (allergy shots) may cause uncomfortable side effects (such as hives and rash) and may have dangerous side effects such as anaphylaxis. It often requires years of treatment and is effective in about two-thirds of cases.


Tipos:

* Ocasional/sazonal: pólens, mofos, humidade, inversões térmicas, etc.
* Perene: ácaros, pêlos e penas de animais, odores fortes; uso abusivo de descongestionantes nasais, etc.

* Rinite não alérgica ou vasomotora: produz sintomas semelhantes, mas a causa geralmente é obscura. Sensibilidade: frio, correntes de ar, ar seco, umidade, psicossomáticas, fadiga, luz solar.
* Associação com outros distúrbios atópicos, como conjuntivite, asma, urticária e eczema. Diferente da asma, no entanto, a maioria dos sintomas da rinite alérgica respondem muitas vezes a anti-histamínicos orais.


3- Quais as causas da Rinite Alérgica?










Muitas substâncias podem causar alergia como a poeira de casa, pólens e alguns alimentos. Aqui no Brasil é a poeira domiciliar é o fator mais importante. Ela é constituída por descamação da pele humana e de animais, restos de pelos de cães e gatos, restos de barata e outros insetos, fungos, bactérias e organismos microscópicos que são chamados ácaros (família dos aracnídeos). O principal fator da poeira que causa alergia é o ácaro. Existem vários ácaros, e o que mais freqüentemente esta relacionado à alergia é o Dermatophagoides ssp., que significa, aquele que se alimenta de pele. Este é o seu nome pois uma de suas fontes de alimentos é a descamação da pele. No colchão de nossas camas e nos móveis estofados que existem em nossas casas encontramos muita descamação de pele e é exatamente por esta razão que nestes locais existe grande quantidade de ácaros. Estes ácaros vivem nas camadas profundas dos tecidos, abraçados as fibras. Eles não são capazes de viver sobre uma superfície lisa, como por exemplo nas paredes.











Em São Paulo, e outras regiões do Brasil onde não há uma clara definição das quatro estações do ano, a forma de rinite alérgica que predomina é a causada pelos ácaros, sendo que os doentes, em geral, apresentam sintomas durante o ano inteiro. Em outras regiões (como no sul do país), na época da primavera, ocorre a polinização das flores, e podemos ter a rinite alérgica da estação, chamada nos países do hemisfério norte de febre do feno. Apesar deste nome, não existe febre e tampouco o feno é o responsável pelos sintomas. São fungos que proliferam nos maços de feno as substâncias que desencadeiam os sintomas.

































Normalmente o paciente com rinite alérgica, apresenta os sintomas quando em contato com o alérgeno, e em geral, estes sintomas são proporcionais á quantidade de alérgeno. Na época do inverno, estes pacientes sofrem mais, pois, neste período, são usados cobertores e roupas que ficaram guardados por muito tempo, e podem estar cheios de ácaros e fungos. Além disto estes doentes são mais susceptíveis a resfriados. Na verdade o resfriado é uma inflamação do nariz, que irá comprometer os mecanismos de proteção nasal, com isto facilitando a entrada dos alérgenos.

































4- Como tratar Rinite Alérgica?









O tratamento dos pacientes portadores de rinite alérgica é composto por três pontos fundamentais:









A- Higiene ambiental.









B- Tratamento medicamentoso.









C- Vacinas anti-alérgicas.

































A- Higiene ambiental.









A forma mais simples de tratar alergia é evitar o contato com a substância que desencadeia os sintomas. Por exemplo, se o paciente apresenta obstrução nasal, coriza e espirros quando ingere determinado alimento, o mais fácil a fazer é simplesmente não comê-lo. Infelizmente, a principal causa de rinite alérgica é o ácaro, e não é fácil evitar o contato com ele.

































Algumas medidas simples podem ser adotadas, e irão diminuir a quantidade destes insetos. A casa e principalmente o quarto onde o doente dorme devem ser limpos com bastante freqüência. Infelizmente a vassoura e espanador de pó apenas espalham o pó pelo ambiente. Os aspiradores são capazes de reter alguma sujeira, porém normalmente sue filtro não é desenvolvido para limpar o ar por completo, e portanto muitas vezes o que ele faz é uma pulverização de poeira no ambiente. Aspiradores com filtros especiais e de alta eficiência existem, porém tem um custo muito elevado. No caso de não existir carpete ou tapetes no chão, o uso de pano úmido na limpeza é uma forma bastante eficaz para remover a poeira.

































Um ponto importante a ser considerado, é a existência de uma boa ventilação na casa e no quarto, e se possível ambientes ensolarados, para evitar o surgimento de bolor (fungos).

































Além disto, o ideal é que não existam carpetes, tapetes, cortinas, bichos de pelúcia ou outros móveis ou utensílios que possam acumular poeira. Ainda, deve-se evitar o uso e contato com travesseiros e almofadas de penas ou outros materiais que possam causar alergia. A utilização de capas protegendo os colchões e travesseiros, assim como de substâncias para eliminar os ácaros do ambiente apresentam eficácia quando aplicados corretamente.

































Estas medidas de higiene não acabam com os ácaros e outros alérgenos, mas diminuem a sua quantidade.

































Além destas mediadas de higiene ambiental, onde o objetivo é reduzir a quantidade de alérgenos, é muito importante que os doentes fiquem afastados de de outras substâncias capazes de irritar o nariz. Cheiros de perfumes, produtos de limpeza, produtos para deixar os ambientes com cheiro agradável, fumaça de cigarro, tintas, inseticidas e poluição, são alguns exemplos de substâncias capazes de irritar o nariz, e desencadear sintomas. Outros fatores inespecíficos como as mudanças bruscas de temperatura, frio e umidade do ar são também prejudiciais aos doentes.

































B- Tratamento medicamentoso.









A critério médico, se estas medidas não forem suficientes para controlar os sintomas do paciente, poderá ser receitado medicamentos.

































Existem dois grandes grupos de drogas que podem ser usadas. Um tipo funciona preventivamente e outro apenas alivia os sintomas.

































Do ponto de vista farmacológico, dispomos de descongestionantes, anti-histamínicos, estabilizadores de membranas, e corticosteróides. Cada uma destas drogas atuam de forma diferente, e nenhuma é isenta de efeitos colaterais que algumas vezes podem ser graves. Por isto, o ideal, é não realizar auto medicação e procurar seu médico.

































C- Vacinas anti-alérgicas
Quando o tratamento feito nestas condições (higiene ambiental e medicamentos) falha, pode-se associar o uso de vacinas anti-alérgicas. Este tratamento é longo, porém quando feito corretamente, diminuí a sensibilidade do doente àquela substância ao qual ele era alérgico. Muitas vezes chegamos ao ponto onde não há mais necessidade do uso de medicamentos


Proposta óbvia para Rinite alérgica: Mag. phos., Nat. mur., Silicea.

Caso 1 - " Sofro de rinite alérgica, não apenas por aromas fortes mas também pela sensação de frio na cabeça, ombros ou pés. Quando essas partes do corpo estão desprotegidas começo a espirrar intensamente por muito tempo mesmo depois de me agasalhar. Outras vezes, sem motivo aparente, inicio o dia espirrando e fico durante todo o dia assim. Sinto-me exaurido, exausto de tanto espirrar. Há dias em que sinto uma friagem interna no meio de minhas e que por mais que tente me aquecer, é impossível. Me cubro com muitos agasalhos e a friagem continua também com incontáveis espirros. Não sei o que fazer. Às vezes me trato com cortisona mesmo sabendo que não resolve a causa do problema. Nenhum tratamento surtiu efeito até o momento. Há duas semanas iniciei o tratamento (Calcárea carbônica 1000CH 1x/ semana). No dia seguinte meu nariz ficou gotejando sem parar. Pingava como uma goteira. Sem espirros. Nada mais senti. Alguns dias depois ainda tive problemas com friagem em minha cabeça (sou calvo) que me pôs a espirrar. Protegendo a mesma o espirro cessou imediatamente. " - O.

Em consideração que as eliminações que ocorreram após ter tomado a dose de Calcarea, aparenta um bom prognóstico.
Um abraço e as melhoras.
Quais os sintomas da Rinite Alérgica ?
Os sintomas que os pacientes portadores de rinite alérgica apresentam são obstrução nasal (entupimento), coriza, espirros (algumas vezes o paciente espirra mais 20 vezes seguidas) e coceira no nariz. Esta coceira pode ser na garganta ou nos olhos.
Além disto a rinite alérgica, pode causar outros problemas, como otites (inflamação dos ouvidos), sinusites (inflamação de cavidades existentes na face) e roncos (pelo entupimento do nariz) que faz com que o paciente não durma bem a noite. O paciente só vai apresentar estes sintomas quando estiver em contato com as substâncias aos quais é alérgico. Estas substâncias recebem o nome de alérgenos. Quanto maior o contato, mais intensos tendem a ser os sintomas.
Todos os doentes apresentam estes sintomas minutos após o contato com o alérgeno, e cerca de metade deles terão novamente sintomas cerca de 4 a 6 horas depois.