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New Guidelines Issued for Treatment of Allergic Rhinitis

Testing is recommended, sinus imaging is not

TUESDAY, Feb. 3, 2015 (HealthDay News) — For the one in six Americans with allergic rhinitis, new treatment guidelines have been issued by the American Academy of Otolaryngology-Head and Neck Surgery Foundation. The recommendations for those ages 2 and up appear in the February issue of Otolaryngology-Head and Neck Surgery.

Allergy testing tops the “do” list; sinus imaging is a “don’t” for people with signs of allergic rhinitis, the guidelines say.

Other key recommendations include: For patients with a stuffy nose, nasal passage discoloration, and/or red and watery eyes, doctors should forgo sinus imaging process in favor of specific immunoglobulin E screening. Environmental controls for dealing with problematic triggers could include use of chemical agents to kill dust mites, installation of air filter systems, and using bedding with allergen-barriers. For people whose quality of life is affected by nasal allergies, other treatments include nasal steroid sprays taken alone or in combination with newer antihistamines, which are less likely to cause drowsiness than earlier versions. Oral leukotriene receptor antagonists are not advised as a first-line treatment for allergic rhinitis.

Immunotherapy — either desensitization shots or under-the-tongue pills — is an option when medication and environmental controls don’t work well. Turbinate reduction should be offered only when medical management fails. Acupuncture can be suggested to patients who want to avoid medications. Herbal supplements were not addressed.

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