Complications of allergic rhinitis

If you have allergic rhinitis, there's a risk you could develop further problems.

Ablocked or runny nose can result in difficulty sleeping, drowsiness during the daytime, irritability and problems concentrating. Allergic rhinitis can also makesymptoms of asthma worse.

The inflammation associated with allergic rhinitis can also sometimes lead to other conditions, such as nasal polyps,sinusitis and middle ear infections. These are described below.

Nasal polyps

Nasal polyps are swellings that grow in the lining inside your nose or sinuses, the small cavities above and behind your nose.

They're caused by inflammation of the membranes of the nose and sometimes develop as a result of rhinitis.

Nasal polyps are shaped like teardrops when they're growing and look like a grape on a stem when fully grown.

They vary in size and can be yellow, grey or pink. They can grow on their own or in clusters, and usually affect both nostrils.

If nasal polyps grow large enough, or in clusters, they can interfere with your breathing, reduce your sense of smelland block your sinuses, which canlead to sinusitis.

Small nasal polyps can be shrunk using steroid nasal sprays so they don't cause an obstruction in your nose. Large polyps may need to be surgically removed.

It's where the sinuses become inflamed or infected.

The sinuses naturally produce mucus, which usually drains into your nose through small channels.

However, if the drainage channels are inflamed or blocked for example, because of rhinitis or nasal polypsthe mucus can't drain away and it may become infected.

Common symptoms of sinusitis include:

• a blocked nose, making it difficult to breathe through your nose
• a runny nose
• mucus that drips from the back of your nose down your throat (post-nasal drip)
• areduced sense of smell or taste
• a feeling of fullness,pressure or painin the face
• snoring
• obstructive sleep apnoea (OSA) your airways become temporarily blocked while you're asleep, which can disturb your sleep

Over-the-counter painkillers, such as paracetamol, ibuprofen or aspirin, can be used to help reduce any pain and discomfort in your face.

However, these medications aren't suitable for everyone, so check the leaflet that comes with them before using them.

For example, children under the age of16 shouldn't take aspirin, and ibuprofen isn't recommended for people with asthma or a history of stomach ulcers. Speak to your GP or pharmacist if you're unsure.

Antibiotics may also be recommended if your sinuses become infected with bacteria. If you have long-term (chronic) sinusitis, surgery may be needed to improve the drainage of your sinuses.

If this tubedoesn't function properly, fluid can build up in the middle ear behind the ear drum andcan become infected.

There's also the possibility of infection at the back of the nose spreading to the ear through the Eustachian tube.

The mainsymptoms of a middle ear infection include:

• earache
• a high temperature (fever)
• being sick
• a lack of energy
• slight hearing loss

Ear infections often clear up within a couple of days, butparacetamol or ibuprofen can be used to help relieve fever and pain. Antibiotics may also be prescribed if the symptoms persist or are particularly severe.

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