Allergic rhinitis is classified as seasonal (pollen-related) or perennial (year-round, e.g., dust mites, pet dander). Symptoms include:

• Nasal Symptoms: Sneezing, rhinorrhea (runny nose), nasal congestion, and itching.
• Ocular Symptoms: Watery, itchy, or red eyes (allergic conjunctivitis).
• Throat and Ear Symptoms: Postnasal drip, sore throat, or ear fullness.
• General Symptoms: Fatigue, irritability, and impaired concentration (Mayo Clinic).

Red Flags:

• Persistent symptoms despite treatment may indicate comorbidities like asthma or chronic sinusitis (Lippincott Review of Pathology).

Allergic rhinitis results from an IgE-mediated hypersensitivity reaction to environmental allergens:

1. Common Allergens:
   • Outdoor: Pollen, grass, or mold spores.
   • Indoor: Dust mites, pet dander, or cockroach debris.
2. Genetic Predisposition: Family history of atopy (e.g., asthma, eczema).
3. Environmental Triggers: Air pollution, tobacco smoke, or occupational exposures.
4. Immune Dysregulation: Overactive Th2 immune response and mast cell degranulation (Lippincott Textbook of Pharmacology).

Reducing allergen exposure is key to preventing symptoms:

1. Environmental Control:
   • Use HEPA filters and allergen-proof bedding.
   • Regularly clean carpets, curtains, and upholstery.
2. Avoidance Measures:
   • Stay indoors during high pollen counts.
   • Keep windows closed and use air conditioning.
3. Personal Hygiene:
   • Shower after outdoor activities to remove allergens.
   • Wash hands and face frequently (WHO).

1. Non-Pharmacological Interventions:

• Nasal Saline Irrigation: Flushes out allergens and reduces congestion.
• Allergen Immunotherapy:
  • Subcutaneous Immunotherapy (SCIT): Allergy shots to desensitize the immune system.
  • Sublingual Immunotherapy (SLIT): Dissolvable tablets or drops under the tongue (Mayo Clinic).

2. Pharmacological Therapy:

• Antihistamines:
  • Oral: Cetirizine, loratadine, or fexofenadine (non-sedating).
  • Intranasal: Azelastine or olopatadine (for rapid relief).
• Corticosteroids:
  • Intranasal: Fluticasone, budesonide, or mometasone (first-line for moderate-severe symptoms).
  • Oral: Prednisolone (short-term for severe cases) (BNF).
• Leukotriene Receptor Antagonists: Montelukast (especially for comorbid asthma).
• Decongestants:
  • Oral: Pseudoephedrine (short-term use only).
  • Intranasal: Oxymetazoline (avoid >3–5 days to prevent rebound congestion).
• Mast Cell Stabilizers: Cromolyn sodium (prophylactic use) (Lange Textbook of Clinical Pharmacology).

3. Combination Therapies:

• Intranasal corticosteroid + antihistamine (e.g., fluticasone + azelastine) for refractory symptoms (Comprehensive Pharmacy Review).

4. Monitoring & Follow-Up:

• Assess symptom control and adjust treatment as needed.
• Screen for comorbidities like asthma, sinusitis, or sleep apnea (WHO).

Allergic rhinitis is a manageable condition with a combination of allergen avoidance, pharmacotherapy, and immunotherapy. Early diagnosis and tailored treatment can significantly improve quality of life and prevent complications. Consult healthcare providers for persistent or severe symptoms.