Do saline nasal rinses alleviate allergic rhinitis symptoms?

For people suffering from pollen-sensitive allergic rhinitis, springtime often proves to be a particularly challenging period, marked by incessant runny noses and bouts of sneezing. The problem is the persistence of these symptoms, which can last for weeks or even months. In such cases, nasal irrigation with saline solution emerges as a beneficial lifestyle remedy for managing allergic rhinitis.

Nasal irrigation assists in calming swollen nasal mucosa, eliminating debris from the nasal passages, and diminishing inflammatory triggers. Nonetheless, it is important to note that it does not cure rhinitis; rather, it serves as a symptomatic treatment. Therefore, it is advisable to combine it with other treatments for allergic rhinitis.

"For the treatment of allergic rhinitis, it is crucial to initially identify the causative antigen," said Professor Kwak Jang-wook, an otolaryngologist at Nowon Eulji Medical Center. "Allergic rhinitis is categorized into 'seasonal rhinitis,' triggered by pollen, and 'perennial rhinitis,' provoked by factors such as house dust mites and cockroaches."

The primary treatment for allergic rhinitis involves “avoidance therapy” tailored to the specific antigen, followed by “pharmacotherapy” utilizing nasal sprays or medication if symptoms interfere with daily activities.

"Regular monitoring of your condition is crucial, as symptoms may exacerbate upon discontinuation of medication," Kwak said.

When allergic rhinitis patients are exposed to antigens like pollen and house dust mites, an “early response” typically occurs around 30 minutes afterward, followed by a “late response” approximately six hours later. During the early response, mast cells are activated to release chemical mediators like histamine, which in turn stimulates sensory nerves in the nasal mucosa, leading to symptoms such as itching, sneezing, and a runny nose. The later reaction is primarily instigated by eosinophils, inflammatory cells that contribute to chronic nasal congestion.

In addition to nasal rinses with saline solution, adopting measures such as avoiding exposure to fine dust, abrupt temperature changes, cigarette smoke, or soot, as well as limiting alcohol consumption, and maintaining clean surroundings can provide relief for individuals with allergic rhinitis. It's advisable to keep windows closed during peak pollen seasons and wear a mask when outdoors. 

For those sensitive to pet allergens, minimizing contact with pets is recommended; however, if unavoidable, frequent shampoo baths for pets and the use of air purifiers can be beneficial.

To minimize dust mite exposure, it's recommended to regularly wash bed covers in hot water, and change them frequently, and opt for leather furniture instead of fabric. 

Since sudden exposure to cold air can exacerbate rhinitis symptoms, wearing a mask when venturing outside in winter is advisable, and maintaining a moderate temperature indoors is crucial for comfort.

Treatment for allergic rhinitis typically falls into two primary categories: avoidance measures and medication. While avoidance strategies are important for symptom management, they may not always suffice on their own, necessitating the use of medication. Nasal sprays and oral medications, taken once or twice daily, are commonly utilized to both prevent and alleviate symptoms.

If symptoms persist despite medication, immunotherapy might be considered, depending on the antigen responsible. Immunotherapy comes in two forms: sublingual immunotherapy, administered as a pill, and avoidance immunotherapy, given via injection. If nasal congestion persists despite medication, surgical intervention may be an effective option.

"To effectively manage allergic rhinitis, it's crucial to comprehend its nature," Kwak said. "While avoiding triggers and mitigating factors through environmental control is beneficial, it's frequently insufficient. Seeking proper counseling and consistently adhering to prescribed medications are essential.” 

"In certain instances, immunotherapy or surgical intervention may yield favorable outcomes," he added.