October 6, 2001
It's rhinitis -- but is it allergic rhinitis?
If you believed what TV and advertising told us, everyone with rhinitis who comes into your office is allergic," family physician Harold Hedges III, M.D., said in Thursday's Dialogue session on managing patients with allergies. But for about 50 percent of patients, something else -- such as cleaning solutions, perfume, chemicals, hair spray or exhaust fumes -- may trigger the rhinitis, he said. For them, allergy medications won't solve the problem.
With some patients, it's even more complicated. "About one-half of the people we see have both allergic and nonallergic rhinitis in the same nose," Hedges said. "That helps explain why an allergy shot doesn't seem to help. It does help the allergic part, but it does nothing for the nonallergic part."
Radioallergosorbent -- RAST -- and skin test screenings are helpful starting points in determining whether it's allergic or nonallergic rhinitis, Hedges said. He suggested screening for six allergens -- the most common weeds, trees and grass in your area, plus house dust mites, mold and cat -- by either method.
Hedges has practiced in Little Rock, Ark., for 43 years and became interested in allergy treatment more than 20 years ago.
FP Report is published by the AAFP News Department.
Copyright © 2001 by American Academy of Family Physicians.
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