A nose of trouble
You may think it’s just a hypersensitive nose, but it is probably allergic rhinitis.
MARISSA, 15, has an unlucky nose, as she calls it. Her nose will itch first thing every morning, after which she will start sneezing nonstop.
Her nose will then turn runny and she can be heard from the bathroom, clearing her “flooded” nose. At school, when the classrooms or books are dustier than usual, Marissa’s runny spells will be triggered once again.
Her mother, Zara, has brought her to a few doctors, who informed them that Marissa has allergic rhinitis.
Hypersensitive sneezes
Allergic rhinitis is a chronic inflammatory nasal condition characterised by sneezing spells, runny, and eventually blocked noses.
Malaysians often term this condition colloquially as “sinus problem”.
But why does the nose behave this way? Contrary to popular belief, a sensitive nose does not result from allergens like dust.
Instead, it stems from a hypersensitive immune system that constantly recognises allergens like dust as being something harmful.
Harmless allergens present in the air, such as dust or pollen, will not normally affect the average person. Those with sensitive noses however, are overwhelmed by their presence.
This is the reason why up to 30% of the population, including many school children, have allergic rhinitis.
In Malaysia, the most common allergy triggers are house dust mites and the haze, as reported by more than half of nasal allergy sufferers, in a study published in the American Journal of Rhinology & Allergy in 2011, entitled Nasal Allergies in the Asian Pacific Population: Results from the Allergies in Asia-Pacific Survey.
Although Malaysians refer to the term “sinus” as having a sensitive nose, sinusitis is actually different from allergic rhinitis.
The sinuses are hollow cavities in the skull located by the cheeks, forehead, nose and eyes.
Sinusitis refers to the swelling or inflammation of the sinus mucous membranes, causing blockage of the sinus openings that normally drain mucous.
Headaches and facial pain usually accompany episodes of sinusitis, but not in allergic rhinitis.
Sinusitis will almost always happen after chronic bouts of rhinitis, and rarely occurs alone.
As the nasal and sinus passages are so closely interrelated, otolaryngologists now refer to sinusitis as rhinosinusitis.
Globally, it has been established that about 51% of rhinosinusitis cases are caused by allergies.
Nasal burden
Patients with allergic rhinitis visit the doctor almost twice as often, besides spending two times more in medication costs, compared to non-sufferers, with symptoms often returning.
People with sensitive noses and sinusitis also incur additional medical costs to treat related conditions such as frequent airway infections, headaches, ear infections, sleeping disorders, nasal polyposis and asthma.
Scientists have now confirmed that inflammatory reactions in the nose, if left uncontrolled, will eventually affect the lungs.
A 23-year-long study reported in Allergy & Asthma Proceedings in 2002 revealed that one in every three people with uncontrolled allergic rhinitis go on to develop asthma.
As asthma ranks as one of the top five most expensive conditions in the world to treat, early recognition and treatment of allergic rhinitis and rhinosinusitis presents a valuable opportunity to reduce the prevalence and severity of asthma.
Unfortunately, the public’s awareness on allergic rhinitis is poor. As a result, many people suffer in silence, and more often than not, find themselves functioning poorly in their daily activities – sleeping, eating, learning.
Being a chronic inflammatory condition, allergic rhinitis and sinusitis will not spontaneously disappear. In fact, unless the hypersensitive nature of the immune system is addressed and managed, hypersensitive noses are likely to worsen to affect the lungs.
Management options
The primary rule to managing a sensitive nose is avoidance. If a person knows what is causing their nose to start itching and sneezing, then the cause would have to be avoided, or at least minimised.
Nevertheless, this is easier said than done as it is not always possible to control the environment we are in.
Conventionally, pharmacotherapy options such as antihistamines, decongestants, nasal sprays and steroids, have been employed to gain relief from nasal symptoms.
Antihistamines are the mainstay of treatment, although these are not recommended for sinusitis due to its drying effects, which will increase risk of infections in the sinuses.
For all its usefulness, conventional drug treatment is not able to address the hypersensitive state of the immune system, which is the root cause of sensitive noses.
Most people who suffer from a sensitive nose or sinusitis simply live with their condition, believing that nothing else can be done.
The advent of naturopathic science however, is proof that it is possible to live life without the burden of a hypersensitive nose.
Scientists at the Ruder Boskovic Centre in Zagreb, Croatia, have formulated a natural, activated astragalus root extract.
This herbal medicine has been rigorously trialled and tested, and found to be able to “calm” hypersensitive noses.
The results of this research were published in the journal Phytotherapy Research in 2010.
The extract resulted in seven out of 10 patients experiencing significant relief in their nasal and eye symptoms after two months.
Unlike other general, non-specific therapies, the extract aims precisely at the hypersensitive nature of the immune system.
With it, the immune system is tuned naturally to a normal mode instead of a oversensitive mode as it has a tendency to be.
Essentially, the extract helps to calm hypersensitive immune systems from going out of control every time they meet allergens such as dust or a temperature change.
As it does this, the sufferer’s nose will not overreact, even when in an air-conditioned room.
The extract works differently from drugs such as antihistamines, which help dry a running nose, but do not aid with the root of the problem.
By directing the immune system towards normal response and helping it to recognise harmless allergens, the extract prevents the nose from going into a sensitive state.
This article is brought to you by the Nuvaceuticals Division of Nuvanta Sdn Bhd. For further information, contact 03-5636 3758 or email pharmacist@ nuvanta.com. The information provided is for educational and communication purposes only and it should not be construed as personal medical advice. Information published in this article is not intended to replace, supplant or augment a consultation with a health professional regarding the reader’s own medical care. The Star disclaims all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.