Allergic rhinitis?

[leletmd]

@milksha:
I understand your concern regarding the need to use the maintenance meds for a long time, but I hope you understand that Allergic rhinitis is a life long disease and medications are needed to control the symptoms so that the quality of life of the patient doesn't get affected.

But we have also encountered a few doctors who disagree with this and they even say that allergic rhinitis is not to be treated. Mas ok pa daw na monthly mag antibiotic ang anak ko kaysa sa naka longterm na antihistamine na aerius and avamys.

I strongly disagree with whoever said that it is better to put your kid on monthly antibiotics than to treat Allergic rhinitis the way it should be treated.
Why? The rampant use of antibiotics is one reason as to why there is a rise in allergic diseases worldwide. In fact, the frequent use of antibiotics in the 1st year of life is a risk factor for development of allergies.
Antibiotics kill both good and bad bacteria. You need good bacteria enable to steer away from the allergic phenotype.
Also, if you don't treat allergic rhinitis symptoms, then you are putting your son at risk for complications such as frequent ear infections, sinusitis, pharyngitis, conjunctivitis and worse, he might develop Asthma later on.
At the risk of sounding biased, I think among all the doctors, I would listen to the allergologist. 
You mentioned that your child already underwent a skin test. Would you mind sharing the results?
The allergic triggers would dictate development of symptoms so if for example, house dust mites are his main trigger then expect that he needs to be maintained on meds for a long time because his triggers are persistent all year round.
Has your allergologist discuss the need for allergy vaccines/immunotherapy for your son? We have no cure yet for allergic rhinitis, but allergy vaccination is the closest thing we have to a cure right now. It might benefit him in the long run.

[iwannabeasupermodel]

^OT sis: wow you're an allergologist? i've never met yet talked or seen an allergologist. hahaha! lumalaki na talaga ang knowledge ko sa medical field. ok ba naman ang practice?

anyway masama sis talaga na mag antibiotic monthly, napapatay lahat ng bacteria, including good bacteria and normal flora ng katawan ng anak mo. the spray thing (sorry bata pa ako nung nagtatake ako nun) is effective. i dont take that meds now, i think it will fade in time? hahaha.

anyway ang kelangan ko na lang ngayon is mga oral antihistamine (and only when sobrang tindi na niya and more on to relieve the never ending sneezing lang) then after taking one pill i'm good to go.

[agape]

I have allergies all my life. From food (seafood), nature (dust, smoke), chemicals (perfume) and medicine (ibuprofen).
If my allergies are bad, it escalates and I get sinusitis, cough, colds, asthma, etc. So sometimes I am prescribed antibiotics, usually 3 days lang, [textspeak!] malakas, kasi mahirap na baka allergic din pala ako sa antibiotics if I get the 7 days prescription, the doctor gives me the option.

When I had sinusitis, it was 3 weeks antibiotics. I did not believe I had sinusitis until I felt the sinus pain when the airplane was landing. The cause was long term post nasal drips.

I got into the habit of taking probiotics after antibiotics, like yakult, yogurt, kefir, etc. to restore the balance of fungi, bacteria and virus in my body.

Oh yeah, tinakot din ako of getting polyps but I still don't like nasal sprays, na-swallow ko rin sya eventually. Longterm use still not recommended according to my research. But I try to do a saline solution to clean/wash my nose of whatever smell/smoke that's left that triggers the symptoms.
As much as possible, I boost my immune system thru vitamins/mineral supplements, healthy lifestyle and enough rest/sleep.

Sometimes, I take loratidine/montelukast on demand, but if antihistamines don't work, I just wait out 24 hours until my symptoms are gone. Cetirizine makes me sleepy, so I only take that if I wont go to work. And if it lasts days/weeks, I take those with a little bit? of steroids, bethamethasone (co-aleva/claricort)

[miksha]

sa mga nababasa ko you usually take medicines on an on-off basis kumbaga when needed. with my son it's on a regular long-term basis as in almost 2years na kami na walang patlang. The allergologist has not yet recommended any other treatment kumbaga for him ito pa din daw ang best way of treating my child since tumatalab naman. pero worry ko talaga ang long term na yan, iniisip ko tuloy hindi kaya dahil diyan sa aerius na yan kaya madalas makakalimutin ang anak ko or confused?

[agape]

^I dont know if it's related to allergy, but there was a time when I had so many singaw (like 5 and big ones which never heals) and then I got big lumps sa neck due to enlarged lymph nodes (feels like mumps), my allergologist recommended me to take Immunoglobulin (IgE) injections. I was only 13 and in High School. But I dont know if it's an immune booster ( to fight allergies ) or immuno suppressant ( suppresses the immune so there would be no allergy symptoms at all).

[TANYEN]

doc lelet i have a kid diagnosed din with allergic rhinitis pinainum lang sya ng antihistamine tapos after few months meron parin lagi namamantal anak ko and sneezing..everytim may pantal sya sa face like misan sa gabi bigla nalang namamaga nguso nya at ilalim ng eyes nya kahit wala naman kumakagat kasi malinis naman ang beddings bakit ganun po..meaning po ba hindi sya nagamit sa antihistmines ang immuzinc? ok lang ba [textspeak!] ginawa namin na papainumin ng antihistamines pag may allergy na lumalabas sa kanya? thanks doc need your advise

[leletmd]

@ agape and milksha:
Would you mind sharing the research you mentioned which says anti - allergy meds cannot be used as maintenance? I would like to know if it is based on anecdotal data or evidence based research. Anecdotal data kasi is not accepted in the medical community.
Also, correct ko lang the misconception that you get allergic rhinitis from smoke, dust and the smell of perfume. Those 3 are not considered "allergens". Thus, they do not cause allergic rhinitis. They are mostly irritants. Smoke and strong fumes like in perfumes as well as change of weather from hot to cold can trigger a different type of rhinitis called vasomotor rhinitis. Treatment is similar to allergic rhinitis and some patients with allergic rhinitis may also have vasomotor rhinitis.
Dust mites are the ones that causes allergies, not the dust per se.

@agape, if your symptoms lead to complications such as sinusitis most of the time, then sorry to say, but you are not managing your symptoms well. Kulang ang treatment so to speak.
Did you receive IgE injections or IgG injections? As far as I know, around 2003 lang nalaunch ang anti - IgE injections (Omalizumab).

@milksha: I suggest you ask your allergologist regarding allergy shots/immunotherapy. It is one option for parents/patients who do not want to have their kids on maintenance meds for a long time.

[mistyb]

suffered allergic rhinitis all my life. been to different doctors. had soo many meds. i feel like my kidneys are begging off. 2 weeks ago, a doctor prescribed nasal irrigation. It was unfamiliar to me kase palaging medicine and nasal spray. After research, i found that this is a very common practice in US. So i tried it and even purchased nasal irrigator and saline packets instead of preparing it myself (cheapest). Ang galing!:) My swollen turbinates are quite ok now and hindi na congested ang nose. So when I came back after two weeks (due to another reason), i asked the doctor kung bakit hindi yun nirerecommend ng ibang doctors, sabi  nya siguro hindi sila nakikinig sa lecture nya (he's a pioneer of that in the Philippines). Share ko lang kase minsan, I feel like SOME doctors are not really after the quality life of the patients, basta prescribe nlang ng medicines (which we know is really a huge business) and we know naman na doctors are given reinforcements by pharma companies by the medicines they prescribe. opinion ko lang naman after consulting soooo many doctors and seeing sooo many med reps in their offices:)

[agape]

^is that draining the nasal of mucus etc, or just cleaning by washing with saline water?

[mistyb]

Both. Kase kasabay ng saline yung mucus na lumalabas and after that, i can breathe sooooo heavenly:) Try to research about it sis. Now, I also use nasonex (prescribed) which works well with nasal irrigation and it works for 12 hours of smooth breathing--without sneezing, runny and congested nose:)

[agape]

I think I had done this before, pero sa doctor's clinic and parang meron machine to suck/suction something like that, it will literally let mucous just flow out, drained. Pero it scared me, and I got/felt so weak after, can't walk. Maybe it was the experience I was only High School then, and I dont know if I want to do that again.

As for saline solution DIY, mejo tamad, walang time, don't know how lang.

[TANYEN]

mga sis ano ba diff from allerkid and alnix? meron ba?

[chez]

^ sis the generic name for both allerkid and alnix is ceterizine, so magkapareho sila and manufactured and marketed by 2 companies under unilab

[spring_snow]

I use AVAMYS nasal spray for maintenance.  I was advised by my ENT to use this everyday pero di ko sinusunod. pinapahinga ko ng 1-2 weeks pagkaubos ng 1 spray bottle.  If ever ma-immune ako from AVAMYS, he'll prescribe daw a different nasal spray pero so far,hiyang pa rin naman ako.

pag may nasal drip, i also take alnix for 10 days. 

maintenance ko na yan for more than 2 years.

[TANYEN]

^ sis the generic name for both allerkid and alnix is ceterizine, so magkapareho sila and manufactured and marketed by 2 companies under unilab

thanks sis..natatakot ako kasi baka may side effect sya kung lagi sya umiinom ng antihistamine. though hindi sya daily pag may pantal lang.

Doc leletmd is there any side effects for this po ba? do i have to visit allergologists na? TIA

[leletmd]

Nasal irrigation has been used for a long period of time already as part of the management of allergic rhinitis. It is also called nasal wash and it should be done as part of the nasal routine.
For patients using nasal steroids, the nasal routine should be as follows:
A. Nasal wash first with either homemade saline solution or commercially available saline nasal spray
B. Instillation of the steroid nasal spray as directed by the doctor
C. Last step should be to gargle to prevent dryness of the throat/mouth (side effect of using nasal steroids).
Sunod sunod lang yang 3 steps na yan.
Example ng nasal wash na ginagamit in the market are: salinase, muconase, sterimar, physiomer, nasoclear. Meron din gumagamit ng neti pot but personally, I find it hard to use, especially in little kids.
Bakit kailangan ang nasal irrigation or wash prior to nasal steroid use? It ensures proper delivery o the medication kasi nalinis and natanggal muna ang dirt/mucus that will impair proper absorption of the nasal steroids.

doc lelet i have a kid diagnosed din with allergic rhinitis pinainum lang sya ng antihistamine tapos after few months meron parin lagi namamantal anak ko and sneezing..everytim may pantal sya sa face like misan sa gabi bigla nalang namamaga nguso nya at ilalim ng eyes nya kahit wala naman kumakagat kasi malinis naman ang beddings bakit ganun po..meaning po ba hindi sya nagamit sa antihistmines ang immuzinc? ok lang ba [textspeak!] ginawa namin na papainumin ng antihistamines pag may allergy na lumalabas sa kanya? thanks doc need your advise

Sorry I did not see this earlier post.
Based on studies, mas maganda ibigay ng tuloy tuloy ang anti-histamines (meaning straight for a week rather than as needed) since nawawala ang effectivity niya kapag tinigil kaagad.
Side effects of anti-histamines in children include either hyper-activity or sleepiness, dryness of secretions as well as feeling of being tired.
Cetirizine can be given for as long as 18 months straight without any ill effects to the liver, kidneys, brain or heart based on the study called "Early treatment of the atopic child".
If the allergic rhinitis as well as the wheal formation (pamamantal) has been going on for quite some time, then I suggest that you consult an allergologist already.
Sa mukha lang ba siya nagpapantal or in other areas of the body? Baka related pa kasi ang pagpantal niya sa allergic rhinitis niya.

[daisy_duck]

Same here. WHen my son was 1+, he was diagnosed with asthma then a few months after primary complex. It will always start with sipon, then a day after most often than not ubo na yan. After a week antibiotic na. We were on primary complex meds for 9 mos. However after the treatment, once in a while sisipunin na nanaman which wil be followed by ubo. Then las July, his pedia pulmo again suspected primary complex kasi na pneumonia cya. Which she recommended again 9 mos of treatment. Naawa naman ako sa son ko, lumipat kmi nang pulmo kasi negative kaming lahat sa house sa TB plus kami ni hubs nagpamantoux test na pero negative din. This new pulmo said that it is most likely allergic rhinitis kasi dito sa province since maraming sugarcane, every harvest time ata, dahil sa pollens, uso yung allergic rhinitis. So now, were taking Xyzal for 2 weeks, Meptin, nebulize and 3-4 mos of Nasonex. Then everyday, 3 times kaming magnasal wash, before magspray nang Nasonex, pagkagising sa hapon and before going to sleep. haaaaayyyy... I bet this will be the routine everytime me sipon siya to avoid asthma and eventually pneumonia.

[leletmd]

Important talaga na mamanage ng maayos ang Allergic rhinitis para ma-prevent ang complications like asthma, sinusitis, etc.
It is also important to understand that Allergic rhinitis is a lifelong condition kaya expect that the child or patient needs to be on medications for a period of time talaga. Dito pumapasok ang need to know the specific trigger para mas madaling maiwasan ang triggers.

[glyzza026]

Hubby has this too. kakaawa sya. sensitive sya when it comes to dust, feathers. masinghot nya lang grabe na bara ng ilong nya.sabi ng dr hindi na daw nawawala ito. kaya iwas na lang daw sa mga bagay na nakakapagtrigger.

[whitebishop]

question po: ano po ba ang magandang antihistamine na di masyado nakakantok?

saka suggestion na rin try nyo po mag take ng grape seed extract. it will help a lot in reducing the instance of allergy attack.  ako dati everyday, pag gising sa umaga sinisipon, bahing ng bahing, nangangati ang eyes and nose.  pero medyo improved na mga thrice a year na lang ako nagkaka allergy attack.