Allergic rhinitis

Abstract

Allergic rhinitis (AR) is a common disorder that is strongly linked to asthma and conjunctivitis. Classic symptoms include nasal congestion, nasal itch, rhinorrhea and sneezing. A thorough history, physical examination and assessment of allergen sensitization are important for establishing the diagnosis of AR. Intranasal corticosteroids and second-generation antihistamines are the mainstay of treatment. Allergen immunotherapy is an effective immune-modulating treatment for use in addition to or as an alternative to pharmacologic therapy. This article provides an overview on the pathophysiology, diagnosis, and appropriate management of AR.

Fig. 1

Classification of AR according to symptom duration and severity (Adapted from Small et al. [1], Bousquet et al. [9])

Fig. 2

A simplified, stepwise algorithm for the treatment of AR. The choice of therapeutic intervention should be a shared decision-making process involving both the patient and the prescriber, with importance placed on balancing factors such as disease severity, therapy safety, and cost. IgE immunoglobulin E (Reproduced from Ellis et al. 2024 [7])