Visiting an ENT to address rhinitis

Rhinitis brings about nasal congestion, a runny and itchy nose, and sneezing. This nasal sensitivity can be due to an allergy which is referred to as allergic rhinitis. Another form of rhinitis is non-allergic rhinitis, which can be triggered by chemical vapes, fumes, and cigarette smoke.

These conditions are best assessed by an ENT specialist. An ENT doctor, also known as an otolaryngologist, specializes in treating disorders solely related to the ears, nose, and throat.

In Singapore, Dr. Annabelle Leong is a reputed ENT physician with extensive experience and has won multiple ENT accolades in her career. She is a highly qualified and well-trained ENT specialist in diagnosing and treating adult and children’s ENT disorders.

She sees many cases of allergic and non-allergic rhinitis all year round and provides comprehensive care for ENT maladies. Below she discusses in further detail allergic and non-allergic rhinitis.

Allergic rhinitis is common in Singapore and affects roughly 24% of the population. While it can affect adults, it is more common in children where it can affect nearly 50% of them. The age group 4-17 years is the most affected. Understanding rhinitis is important and seeking timely medical help can greatly improve the quality of life and reduce missed school days.

What is rhinitis?

It is an inflammatory condition where the nasal mucous membrane gets swollen. This condition is characterized by nasal stuffiness and a runny nose. It may be due to a respiratory tract infection or a seasonal allergy.

What are the two classes of rhinitis?

Rhinitis can originate due to an allergy or it can be non-allergic in nature. The nasal passage is the most affected and this condition can be short-lived or acute or it can be a long-standing condition and be chronic in nature. Acute rhinitis is generally due to viral infections and chronic rhinitis may occur due to chronic sinusitis.

What is allergic rhinitis?

This is a reaction caused by the body’s immune system due to an environmental trigger. Some of the most common triggers which bring about allergic rhinitis include dust and molds in Singapore. In addition, pets, pollen, and grasses too can trigger rhinitis.

Both seasonal and all-year-round allergies can be present. Seasonal allergies are brought about by certain grasses and pollen present seasonally. These allergies can result in itchiness in the nose, watery eyes, sneezing, and a runny nose.

An ENT doctor will make a diagnosis based on clinical symptoms as well as past medical history. Generally, allergies run in the family. The doctor may advise a skin prick test where the ENT doctor would place various allergens on the skin to see how the body reacts to it.

If the individual has an allergy then a small red lump appears. Additionally, a blood test or a radioallergosorbent test (RAST) is also common. It measures the immunoglobulin E antibody levels in the blood.

How does an ENT doctor treat allergic rhinitis?

The most common treatment methods include:

Nasal corticosteroid sprays: This helps to reduce inflammation in the nasal passages and is suitable for long-term use.

Antihistamines: This helps in the prevention of allergy symptoms, but side effects like drowsiness and a dry nose may be present.

Saline: Use of saltwater solutions to flush the nose with a squeeze bottle can be done. This helps to relieve symptoms

Desensitization: Immunotherapy helps with an almost permanent solution to the allergy problem. In this case, the ENT doctor would inject small doses of the allergen into the body, to trigger an immune response.

This helps to build a tolerance to specific environmental triggers. However, this takes a long time as it takes a few years to get it done with frequent visits to the ENT doctor. It could, however, give lasting effects.

What is non-allergic rhinitis?

Non-allergic rhinitis causes chronic sneezing or a congested nose with no reason at all. It is present in both adults and children. Certain fragrances and air pollutants may trigger this condition. In addition, weather, foods and certain medications, and chronic health conditions may lead to non-allergic rhinitis. It affects both children and adults and is more common in individuals over 20 years of age.

The diagnosis is made through medical history and physical symptoms. The types of non-allergic rhinitis include:

Viral rhinitis: This is rhinitis caused by viruses that cause the common cold. Sneezing, runny nose, and fever are symptoms that follow. The doctor may give decongestants to relieve the stuffiness. Nasal sprays or antihistamines may also be prescribed.

Chronic rhinitis: It is an extension of acute rhinitis caused by a viral infection. Other diseases which can lead to this condition include tuberculosis, rhinoscleroma, and leprosy. All these conditions lead to inflamed lesions. In addition, low humidity and airborne irritants can lead to this chronic rhinitis condition.

Chronic rhinitis can cause nasal obstruction, frequent bleeding, pus from the nasal cavity. Decongestants will help to relieve symptoms. If symptoms are persistent a biopsy may be needed to exclude cancer.

Atrophic rhinitis: Older people face this condition when the mucous membrane thins and hardens, causing nasal passages to dilate and dry out. A long-standing bacterial infection can be a cause too. Crusts can form inside the nose to give an offensive smell. An otolaryngologist will help to reduce crusting which will help to reduce foul smell.

Vasomotor rhinitis: This is when people react strongly to irritants such as strong fragrances and dry air. The nasal membranes can vary from red to purple. There may be inflammation in the sinuses too.  Nasal corticosteroid and antihistamine sprays may sometimes help. Nasal decongestant sprays however are not generally used.

Rhinitis medicamentosa: This is when severe congestion is caused by the overuse of decongestant nasal sprays. Generally, saline irrigation is done and the drug causing the condition is discontinued.

Dr. Annabelle Leong is well versed in distinguishing different forms of rhinitis and offers the best possible treatment option to suit your lifestyle and needs. She is a leading choice for a consultation with an ENT physician in Singapore.