Patient's question:
The baby has been sneezing frequently and has severe nasal congestion recently. It was finally diagnosed as pediatric allergic rhinitis. When this condition flares up in such a young child, it is extremely uncomfortable. How can pediatric allergic rhinitis be treated most effectively? What should be done?Doctor's answer:
There is no vaccine for pediatric allergic rhinitis, but it can be treated with desensitization therapy. Severe nasal congestion, with a bit of blood in the snot once blown out, is a symptom of rhinitis, and it can be completely healed after treatment.Prevention and Treatment of Pediatric Allergic Rhinitis
Currently, the prevention and treatment of pediatric allergic rhinitis only adopt conventional methods:
1. Avoiding allergens (this is the most important measure);
2. Antiallergic drug treatment;
3. Plant immune desensitization therapy.
I. Avoiding Allergens
The most fundamental health measure for pediatric allergic rhinitis is to identify the allergens that cause the child's allergy and avoid them as much as possible.
- If symptoms primarily occur outdoors, outdoor activities should be limited, especially contact with flowers, grass, or decaying leaves. Masks can be worn, or the child can go to a seaside area with fewer allergens.
- If symptoms primarily occur indoors, the following points should be noted:
1. If the child is allergic to fur or dust mites, feather pillows, feather quilts, etc., should be removed. A vacuum cleaner should be used to clean the environment instead of sweeping with a broom. The windows and doors of the bedroom should be opened frequently to maintain fresh and flowing air.
2. If the child is allergic to chemical gases, special attention should be paid to home decoration and furnishings, and environmentally friendly materials should be used as much as possible.
3. If the allergy is severe, antiallergic drugs can be used, including local and systemic medications. For children around 2 years old, local nasal sprays such as Beconase, Rhinocort, and Nasacort can be used.
4. If the allergic rhinitis is triggered by a cold, improving the child's physical fitness and reducing colds can also help prevent it.
5. If the allergy is seasonal, such as when the child always experiences allergic symptoms in September or October, it is best to start preventive treatment one or two months in advance. This can significantly reduce symptoms if allergic rhinitis occurs later.
II. Antiallergic Drug Treatment for Pediatric Allergic Rhinitis
The medications for pediatric allergic rhinitis are generally similar to those for adults, primarily corticosteroids, which can lead to drug resistance. Drug treatment for rhinitis not only fails to solve the problem but also brings side effects from the drugs. Especially for adolescents, whose internal organs are not yet mature, the damage caused by drugs to the internal organs should not be ignored. Long-term, high-dose use of a single antiallergic drug can not only render the drug ineffective but also cause adverse reactions, even leading to death. There are many types of antiallergic drugs, and their indications vary. Therefore, when selecting antiallergic drugs, antihistamines should be prioritized, but long-term, high-dose use of a single antiallergic drug should be avoided, as it can not only render the drug ineffective but also cause adverse reactions, even leading to death.
① Diphenhydramine: This drug is widely used for itchy allergic diseases such as urticaria and allergic dermatitis. Common side effects include dizziness, drowsiness, and fatigue. Occasionally, rash may occur. Long-term use for over 6 months can lead to anemia.
② Chlorpheniramine: Compared to diphenhydramine, its side effects such as drowsiness and dry mouth are milder. However, excessive use in children can cause hallucinations and restlessness. It is contraindicated for patients with benign prostatic hyperplasia, pyloric stenosis, or duodenal obstruction. It can also induce epilepsy, so it is contraindicated for patients with a history of epilepsy. Driving or engaging in highly concentrated mental work during medication is not recommended.
③ Cetirizine: Used for acute and chronic allergic rhinitis and other allergic skin diseases. Side effects may include fatigue, dry mouth, rash, hematuria, abdominal pain, and difficulty breathing.
④ Ketotifen: Ketotifen belongs to anti-inflammatory mediator-releasing inhibitors used for asthma treatment. It can also be used for allergic rhinitis and allergic dermatitis. The main side effects are drowsiness and fatigue. Long-term use can increase appetite, leading to weight gain.
⑤ Sodium Cromoglicate: This drug is a preventive antiallergic agent, primarily used to prevent allergic bronchial asthma, allergic rhinitis, and allergic eczema. Side effects may include irritation in the throat and bronchi, such as coughing, nausea, or even asthma attacks. Therefore, after the drug takes effect, the frequency of administration should be reduced, and the dosage should be gradually decreased. It is absolutely forbidden to stop taking it suddenly.
Common symptoms of pediatric allergic rhinitis include:
- Itching in the nose (the child often rubs their nose)
- Alternating nasal congestion (leading to dry throat and sore throat due to mouth breathing)
- Sneezing (usually sudden and severe)
- Runny nose (clear mucus; purulent mucus during infection)
- Nasal obstruction (reduced or lost sense of smell)
- Dizziness, headache, stuffy ears, red, itchy, and watery eyes (dark circles under the eyes are often caused by frequent rubbing of the eyes)
The nose and nasopharynx are important defensive organs of the upper respiratory tract. Through the function of mucociliary cells and glandular secretions, they can prevent the invasion of pathogens, allergens, and foreign substances in the air. The nose, sinuses, mouth, and middle ear are interconnected, with the nose at the center. Therefore, long-term, chronic allergic rhinitis, especially when infected or inflamed, can easily spread to surrounding organs, causing sinusitis, bronchitis, pharyngitis, otitis media, conjunctivitis, tonsillar hypertrophy, adenoid hypertrophy, sleep breathing disorders, and long-term chronic otitis media damage leading to hearing and language disorders. If pediatric allergic rhinitis becomes chronic, it is prone to complications such as allergic asthma and cough variant rhinitis. Therefore, pediatric allergic rhinitis requires special attention. Currently, the prevention and treatment of pediatric allergic rhinitis only adopt conventional methods:
1. Avoiding allergens (this is the most important measure);
2. Antiallergic drug treatment;
3. Plant immune desensitization therapy.