What is Allergic Rhinitis? Symptoms and Treatment Options

Runny nose, sneezing attacks, itchy eyes every spring or when there is dust in the house... Many people ignore these symptoms thinking that they are “just a common cold”. However, this picture is often a symptom of allergic rhinitis (allergic rhinitis), which is very difficult to manage without a correct diagnosis. Allergic rhinitis is a chronic upper respiratory disease that affects one in every four people worldwide and can seriously reduce the quality of life. In Istanbul Sultanbeyli and surrounding districts, there is a significant increase in applications to ENT polyclinics, especially in spring and autumn periods.

What is Allergic Rhinitis?

Allergic rhinitis is a disease that develops as a result of an excessive immune response of the nasal mucosa (inner lining) to harmless substances called allergens. The immune system perceives normally harmless substances as a threat and releases various chemical substances, especially histamine. This process causes inflammation, swelling and excess mucus production in the lining of the nose.

This condition, popularly known as “hay fever”, is not only a seasonal condition. In some people, it can last throughout the year and has a negative impact on a wide range of areas, from work life to sleep quality.

Types of Allergic Rhinitis

Seasonal Allergic Rhinitis

It is limited to certain seasons. Tree pollen in spring, grass pollen in summer and weed pollen in autumn play a triggering role. People living on the Anatolian side of Istanbul, especially in districts with a high density of green areas such as Sultanbeyli, Pendik and Tuzla, frequently experience such symptoms in April-May.

Perennial Allergic Rhinitis

It lasts all year round, regardless of the season. It is caused by indoor allergens such as house dust mites, mold spores, pet dander and cockroaches. Symptoms may become more pronounced in winter as the time spent indoors increases.

Occupational Allergic Rhinitis

It develops as a result of contact with allergens (flour dust, chemical vapors, latex, etc.) in the workplace. It is a subtype that should be considered in those working in Sultanbeyli and neighboring industrial zones where production and industrial facilities are dense.

What are the Symptoms of Allergic Rhinitis?

Symptoms of allergic rhinitis can vary from person to person and can range from mild to severe. The most common symptoms are:

• Persistent or intermittent runny nose (usually transparent, watery consistency)
• Sneezing attacks (especially in the morning)
• Nasal congestion and mouth breathing
• Itching, redness and watering of the eyes (may be accompanied by allergic conjunctivitis)
• Itching of the palate, throat and ears
• Decreased sense of smell and taste
• Sleep disorders (due to stuffy nose)
• Fatigue and difficulty concentrating during the day

💡 Expert Note from our ENT Unit: In outpatient evaluations, the vast majority of our patients report difficulty in distinguishing allergic rhinitis from the common cold. The most decisive difference is this: The common cold usually resolves spontaneously in 7-10 days and may be accompanied by symptoms such as fever and muscle pain. Allergic rhinitis, on the other hand, exhibits a recurrent picture for weeks, months or even years; fever is not observed. Allergic origin should be considered if nasal discharge follows a pattern that increases significantly in the morning and is triggered in certain environments or seasons.

Triggers Causing Allergic Rhinitis

Allergic rhinitis is not due to a single cause; different allergens can play a triggering role in different people. The most common allergens can be listed as follows:

Outdoor Allergens:

• Pollen (trees, grass, weeds)
• Fungal and mold spores
• Air pollution particles (ozone, particulate matter)

Indoor Allergens:

• House dust mites (Dermatophagoides pteronyssinus)
• Pet hair and saliva (cat, dog)
• Mold fungi (especially in humid environments)
• Cockroach feces and body particles

Occupational Allergens:

• Flour and cereal powder
• Latex
• Wood dust
• Chemical vapors and dyes

In addition, irritants such as cigarette smoke, perfume and exhaust fumes can significantly worsen symptoms in people with allergic rhinitis.

Risk Factors: Who is More at Risk?

Although allergic rhinitis can occur in all age groups, some people have a higher risk of developing the disease:

• Family history The presence of allergic diseases (asthma, eczema, allergic rhinitis) in the mother or father significantly increases the risk.
• Personal history of allergy: Children with atopic dermatitis (eczema) in infancy are more likely to develop allergic rhinitis in later years.
• Age: It is more common in childhood and early adulthood; however, it can also start at an older age.
• Urban living and air pollution: There is growing evidence that people living in urban areas are more prone to allergic diseases.
• Early use of antibiotics and overly clean environment: Lack of early exposure of the immune system to various germs (hygiene hypothesis) can increase the risk of allergies.

How is Allergic Rhinitis Diagnosed?

The diagnosis of allergic rhinitis begins with a medical history and physical examination and is confirmed by special tests when necessary. The diagnostic process consists of the following stages:

1. Medical History and Symptom Evaluation

The physician evaluates in detail when the symptoms started, in which environments they increase, family history and the treatments applied so far. The seasonal pattern of symptoms contributes greatly to the diagnosis.

2. Rhinoscopy and Nasal Endoscopy

The ENT specialist directly visualizes the inside of the nose with rhinoscopy (nasal mirror) or nasal endoscopy. In allergic rhinitis, the nasal mucosa appears pale, purplish and edematous; this finding supports the diagnosis.

3. Skin Prick Test

This is the most common test to identify the allergen. Various allergen extracts are dropped onto the skin and a small prick is applied; after 15-20 minutes, the wheal is evaluated. It is painless and highly reliable.

4. Specific IgE Blood Test (RAST)

Measures the level of allergen-specific IgE antibodies in the blood. It is preferred in cases where a skin test cannot be performed (some skin diseases, certain medications).

5. Nasal Provocation Test

In more special cases, an allergen is applied to the nasal mucosa and the reaction observed. It is rarely needed in routine practice.

An ENT specialist or immunology-allergology specialist should be consulted for the diagnosis of allergic rhinitis. Self-diagnosis can lead to incorrect treatment and disease progression.

Allergic Rhinitis Treatment

Treatment of allergic rhinitis is individualized according to the severity of the disease, the type of allergen and the general health status of the patient. Basic treatment approaches can be evaluated under three headings:

1. Trigger Avoidance (Allergen Control)

The first step in treatment is always to minimize contact with the triggering allergen. Practical measures include the following:

• If possible, limiting the time spent outdoors during the pollen season; wearing a mask if going out
• Keeping windows closed and preferring air-conditioned environments during intense flowering periods
• Use bed linen that is not allergenic to house dust mites and wash weekly at over 60°C
• Minimizing dust collecting surfaces such as carpets, rugs and curtains
• If allergic to pets, keep them out of the bedroom and wash them regularly
• Preventing mold growth by keeping humidity below

2. Medication Therapy

Medication is often necessary to control symptoms. According to the physician's recommendation, the following groups of medicines can be used:

• Antihistamines (allergy medicines): They block the effects of histamine, reducing itching, wheezing and runny nose. Second generation antihistamines (such as cetirizine, loratadine, fexofenadine) are an effective option without causing drowsiness.
• Intranasal Corticosteroids (nasal sprays): It is now recognized as a first-line treatment for moderate to severe allergic rhinitis. It relieves inflammation in the nose; regular use is required for efficacy. Systemic absorption is extremely low with long-term use, offering a safe treatment profile.
• Decongestants Temporarily relieves nasal congestion; however, nasal decongestants should not be used for longer than 3-5 days; prolonged use may cause drug-induced rhinitis (rhinitis medicamentosa).
• Leukotriene Receptor Antagonists: It may be preferred especially in patients whose allergic rhinitis is accompanied by asthma or nasal polyps.
• Eye Drops If accompanied by allergic conjunctivitis (eye allergy), antihistamine eye drops significantly relieve symptoms.

It's important: The dose, duration and combination of medication should be determined by the physician. Self-medication may carry risks in terms of side effects and drug interactions.

3. Allergen Immunotherapy (Vaccine Therapy)

Allergen immunotherapy is the only treatment with the potential to radically change the course of allergic rhinitis. It is based on the administration of increasing doses of allergens in a specific program to increase the body's tolerance to allergens.

There are two ways of implementation:

• Subcutaneous (under the skin) immunotherapy: It is a treatment program in the form of injections, usually lasting 3-5 years.
• Sublingual immunotherapy: It is applied in the form of drops or tablets under the tongue and can be used at home.

Immunotherapy should be planned with the evaluation of an immunology-allergology or ENT specialist in appropriate patients who do not respond adequately to drug treatment, are sensitive to more than one allergen or do not want to use long-term medication. This treatment method is not suitable for every patient and must be applied under expert supervision we would like to emphasize.

What happens if allergic rhinitis is not treated?

Allergic rhinitis is a disease that, if left untreated, significantly reduces quality of life and predisposes to various complications:

• Sinusitis (sinus inflammation): Due to nasal congestion, air drainage of the sinuses is impaired; acute and chronic sinusitis become more frequent.
• Middle Ear Problems: Nasal congestion can lead to Eustachian tube dysfunction and middle ear fluid accumulation (effusion), especially in children.
• Sleep Apnea: Chronic nasal congestion increases mouth breathing and snoring tendency; sleep quality is significantly impaired.
• Development or Worsening of Asthma: Allergic rhinitis and asthma are linked; the term “combined respiratory disease” describes this association. Untreated allergic rhinitis can worsen asthma symptoms.
• Impact on Performance and Academic Achievement: Sleep disturbance and daytime fatigue have a negative impact on school success, especially in children; work productivity decreases in adults.

💡 Expert Note from our ENT Unit: It is critical to question asthma findings in patients with allergic rhinitis. In our evaluations, we observe that some patients have both rhinitis and mild asthma symptoms, but asthma is not recognized. Pulmonary function tests should definitely be planned if wheezing, cough after exertion or chest tightness are accompanying complaints.

How Do I Differentiate Allergic Rhinitis from the Common Cold?

Feature	Allergic Rhinitis	Common Cold
Duration	Repeat for weeks/months/years	Passes in 7-10 days
Fire	Invisible	Possible
Runny nose	Transparent, watery	Initially transparent, then dark
Sneezing	Serial, frequent	There is but less series
Itching	Prominent on nose, eyes, palate	Rarely
Seasonality/trigger	Yes (specific environment/season)	None (respiratory virus)
Eye watering	Frequent	Nadir

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Allergic Rhinitis in Children: Things to Consider

Allergic rhinitis is also common in childhood and has some differences from adults:

• Year-round rhinitis due to house dust and pet allergens is more common in preschool age; seasonal rhinitis increases from primary school age.
• Continuous mouth breathing can negatively affect the development of facial bones and tooth eruption in children.
• Otitis media is more common in children with allergic rhinitis and can affect hearing and speech development.
• A sudden drop in school success and distraction may accompany the picture.
• Asthma, eczema and allergic rhinitis can occur together in children (atopic gait); it is important for a specialist to evaluate the child holistically.

If you observe symptoms in your child, we recommend that you contact our Pediatrics Unit or ENT Unit for an evaluation.

Practical Tips for Managing Allergic Rhinitis in Daily Life

In addition to treatment, simple measures to be taken in daily life contribute significantly to the control of symptoms:

• Keep the windows closed for a few hours when you wake up in the morning: Early morning is the time when many plants release the most pollen.
• Change the filters of car and home air conditioners regularly: Dirty filters cause dust and mold spores to spread throughout the space.
• Change bed sheets and pillowcases frequently: House dust mites are particularly concentrated in the bedding environment.
• Apply nasal saline irrigation: Washing the nose once or twice a day removes allergens and irritants from the mucosa, increasing the effectiveness of the medication and relieving nasal congestion.
• Plan your activities according to the pollen calendar: Make use of daily pollen density reports published by meteorological and health organizations.
• Practice sports indoors: Prefer indoor exercise over outdoor exercise during periods of high polonality.

When Should You Apply to Sana Medical Center ENT Unit?

It is especially important to consult an ENT specialist if you suspect allergic rhinitis:

• Runny nose and sneezing attacks longer than two weeks lasts and does not go away
• Symptoms disrupt your sleep patterns and negatively affect your daytime performance
• If over-the-counter antihistamines do not provide sufficient benefit
• Your child has persistent mouth breathing, snoring or middle ear problems
• Symptoms are accompanied by wheezing or chest tightness
• You have more than three sinusitis attacks per year

To make an appointment to our ENT Unit at Sana Medical Center or to evaluate your current symptoms our online appointment system you can use it.

Frequently Asked Questions (FAQ)

1. Is allergic rhinitis a lifelong disease?

Allergic rhinitis does not mean that permanent treatment is mandatory; with the right treatment, it can often be well controlled. Allergen immunotherapy can provide long-term remission in appropriate patients. In some people, symptoms may improve with age, but this is different for each patient. An ENT specialist evaluation is required for a definitive decision.

2. Which specialist should I go to for allergic rhinitis?

The primary referral point is the ENT (Ear, Nose and Throat) specialist. You may be referred to an immunology-allergology specialist if nasal, throat and ear symptoms are accompanied or if a skin test is to be performed to determine the source of the allergy. In children, a pediatrician can make an initial assessment and refer to the relevant branch. At Sana Medical Center KBB Unit is carrying out these assessments.

3. Are the drugs used in the treatment of allergic rhinitis addictive?

Modern antihistamines and intranasal corticosteroid sprays are not addictive and can be used safely. Nasal sprays containing only decongestants may cause a condition called “drug-induced rhinitis” when used for longer than 3-5 days. Therefore, it is important not to use decongestants for a long time without a physician's recommendation.

4. Does my insurance cover treatment for allergic rhinitis?

Sana Medical Center has an agreement with many private health insurances; ENT examination and related examinations can be performed with insurance assurance according to your policy coverage. For insurance coverage details, you can call us for information or our online appointment system You can request information via.

5. Is it necessary to have a skin test for allergic rhinitis?

A skin test is not mandatory in all patients, but a skin test or a blood test is necessary if you want to clearly identify which allergen triggers the allergy and plan immunotherapy. The clinical picture and history usually provide sufficient information; your specialist will decide which is more appropriate.

6. Can allergic rhinitis develop into asthma in children?

The two can occur together as part of the same inflammatory process, but allergic rhinitis alone does not “develop” into asthma. Children with allergic rhinitis are known to have a higher risk of developing asthma. Therefore, if your child has coughing, wheezing or shortness of breath with nasal symptoms, a comprehensive evaluation by our Pediatric Health Unit or ENT specialist is recommended.

7. What should I do to make an appointment?

To make an appointment at Sana Medical Center our online appointment system or you can call our hotline at 0 216 496 10 10. It is very easy to reach the ENT polyclinics in our hospital from Sultanbeyli, Pendik, Ümraniye, Kartal or Tuzla.

It's Time to Take the Right Step in Allergic Rhinitis

Allergic rhinitis is a chronic condition that, if underestimated, can reduce quality of life and, as it progresses, can lead to sinusitis, asthma or sleep problems. The good news is that with the right diagnosis and a personalized treatment plan, symptoms can be largely controlled. Knowing which allergen triggers the symptoms increases the effectiveness of both medication and daily precautions. If your symptoms persist for more than two weeks, disrupt your sleep, or you notice your child's nasal congestion, do not delay consulting an ENT specialist.

Sana Medical Center for Allergic Rhinitis in Sultanbeyli

Sana Medical Center serves in Sultanbeyli, Istanbul with an ENT unit specialized in the diagnosis and treatment of upper respiratory tract diseases, especially allergic rhinitis. Rhinoscopy, nasal endoscopy, allergy tests and comprehensive treatment planning are carried out within the polyclinic.

In our center, which serves patients from Pendik, Ümraniye, Kartal and Tuzla as well as Sultanbeyli, examinations and examinations can be performed in agreement with many private health insurances. You can call us to find out your insurance coverage or to make an appointment, or you can easily apply through our online appointment system.

When you have any doubts about your respiratory health KBB Unit experts; if necessary Pediatric Health and Diseases Unit or Internal Medicine Unit coordinated assessment can be carried out.

To make your appointment with your private health insurance our online appointment system or you can call our hotline at 0 216 496 10 10.