National guidelines needed to manage rhinitis and prevent complications.
OBJECTIVE
Rhinitis is an extremely common disease worldwide and nasal allergies are one of the major causes of the condition. Allergic rhinitis not only produces a range of nasal and non-nasal symptoms, but it has been closely associated with other chronic airways diseases, such as asthma and sinusitis. This review was undertaken to evaluate the relationship of allergic rhinitis to these diseases and to provide support for proposing national guidelines for managing rhinitis.


METHODS
Relevant studies in English were searched for using MEDLINE, bibliographies from obtained articles, and consultation with experts.


METHODS
All major studies related to the epidemiology and effects of allergic rhinitis and the relationship between allergic rhinitis and asthma, sinusitis, and other airways diseases were reviewed.


RESULTS
There is substantial scientific and clinical evidence that allergic rhinitis frequently coexists with asthma, and sinusitis and may be a predisposing factor for both. In addition, a number of studies have demonstrated that nasal inflammation and obstruction directly affect pulmonary function and clinical symptoms of asthma. Finally, it has been clearly demonstrated that treating allergic rhinitis with antihistamines, nasal corticosteroids, immunotherapy, and allergen avoidance have a significant, positive effect on lung function and asthma symptomology.


CONCLUSIONS
The prevalence of allergic rhinitis, asthma, and sinusitis are increasing. Asthma and sinusitis can be debilitating conditions. Asthma alone can be life threatening and costly to treat. The timely and optimal treatment of allergic rhinitis may help prevent these conditions or, at least, prevent them from worsening. Consequently, there is an immediate need to establish national, evidence-based, practice guidelines to assist primary care physicians in diagnosing and managing rhinitis and in evaluating and managing rhinitis and in evaluating and managing allergic rhinitis coexisting with other airways diseases.
Rachelefsky
G S
GS
Department of Pediatrics; UCLA School of Medicine, Los Angeles, California, USA.
D000328:Adult; D000402:Airway Obstruction / Q000209:etiology; D018926:Anti-Allergic Agents / Q000627:therapeutic use; D018927:Anti-Asthmatic Agents / Q000627:therapeutic use; D001249:Asthma / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D002648:Child; D015897:Comorbidity; D003888:Desensitization, Immunologic; D006801:Humans; D006969:Hypersensitivity, Immediate / Q000150:complications / Q000453:epidemiology; D009298:Nasal Polyps / Q000150:complications / Q000453:epidemiology; D010033:Otitis Media / Q000453:epidemiology / Q000209:etiology; D017410:Practice Guidelines as Topic; D012141:Respiratory Tract Infections / Q000150:complications / Q000453:epidemiology; D012220:Rhinitis / Q000150:complications / Q000453:epidemiology / Q000628:therapy*; D012221:Rhinitis, Allergic, Perennial / Q000150:complications / Q000453:epidemiology / Q000628:therapy; D006255:Rhinitis, Allergic, Seasonal / Q000150:complications / Q000453:epidemiology / Q000628:therapy; D012852:Sinusitis / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*
D018926:Anti-Allergic Agents; D018927:Anti-Asthmatic Agents