Blocked nose, sneezing, watering from the nose and a heavy head are symptoms that a child has, when a foreign invader (allergen) irritates the nose and windpipe. The allergen may be inhaled (pollen, perfume), ingested (egg or milk allergy) or be in contact with the skin (synthetic fabric, detergent). The symptoms warns the child (and the caregiver) that there is something amiss and that the child needs attention. If the symptoms are one-off eg. spring cleaning a dusty room or they are infrequent-few sneezes in the morning with watering-not much beyond an explanation is necessary. However if the child suffers perennial (year-round) or seasonal (worse in certain weather), allergic rhinitis (inflammation of the nose) is diagnosed.
Nasal allergy often occurs in daycare or when children begin visiting the park and attend playschool. Both places are fertile grounds for exposure to pollens, grass, pets, pesticide, coloured foods, etc.
?there is watery discharge from the nose – progresses to sticky, thick
?sneezing which disrupts day-to-day life
?nose block can be very disturbing, ordinary activities may make the child pant and there may be mouth breathing and snoring
?watery, itchy and red suffused eyes
?mild fever, tiredness, generalised itching and irritability tells caregivers to discourage the child from school and play
?in severe allergies the windpipe and skin may be affected with wheezing and eczema rash
The ENT doctor will talk to the parents and caregivers and elicit a careful history of possible allergens. He may ask you about the severity and type of symptoms, how often they occur and how they affect the child whilst a school and play. He will ask the parents whether there have been similar symptoms in the family. He will want to know the location of your home (some locations are dustier full of allergen), whether the household has pets, flowering plants, carpets drapes and air conditioning. He will enquire regarding the child’s eating habits; home-made food without artificial colour cause fewer food allergies. Eggs, milk, peanut, shellfish, mushrooms are common food allergens. He will examine the nose, throat, ears, eyes, windpipe and skin. At times the ENT doctor may prescribe tests to confirm the type and severity of allergen and whether there is co-existing infection.
The best treatment of allergy is to identify and prevent it.
✅smoking anywhere at home is a big no-no; there is irrefutable evidence that being in contact with smokers-second and even third-hand smoking- worsens symptoms.
✅avoid pets, flowering plants and carpets/rugs at home
✅frequent wet cleaning of home-preferably vacuum
✅clean filters of air conditioning, install air purifier, ioniser and dehumidifier
✅stay away from pest control, mosquito coils, perfumes, pressure deo’s
✅avoid contact with chemical, washing powders strong soaps etc
Often allergens cannot be identified or fully prevented. The ENT doctor will often prescribe allergy medication (antihistamine). Newer antihistamine drugs do not cause sedation and confusion and extremely safe even for long term use. When wheeze accompanies nasal symptoms he may add montelukast (anti-leukotrienes). In extreme cases, he may suggest steroids. Antibiotics and medication to relieve mucous and nose drops to decongest the nose may be suggested for a few days. Steroid nasal spray may be prescribed. This steroid is not absorbed into the body and is safe for long term use after the age of 1 year.
The goals in treating nose allergy are
?reduce/abolish sneezing, dripping from nose
?avoid a mouth breathing irritable child
?not to let allergic nose progress into allergic wheeze and asthma
?ensure that the child does not miss school, can participate in sport and social activity and live a happy healthy life with optimal mental and physical growth
#sneezing #dripper #blocker #mouth breather #snoring #wheeze #anti histamine #montelukast #steroid #allergy.