How to treat allergic rhinitis in children?

If children develop allergic rhinitis, they can be treated with physical therapy. The purpose of physical therapy is to avoid allergens and irritants, or to use steam inhalation and saline spray to make the nose more unobstructed, and some anti-inflammatory drugs should also be used correctly.

1. Physical therapy

(1) Avoid allergens and irritants.

(2) Steam inhalation and saline spray or inhalation: can temporarily relieve nasal congestion and increase airflow.

(3) Exercise: It can reduce nasal airway resistance and relieve nasal congestion.

2. Antihistamines

It is effective for sneezing, itchy nose and runny nose, but not for nasal congestion and nasal obstruction. Newer antihistamines such as desloratadine have a longer duration of action and are less likely to cause drowsiness.

3. Decongestants

Nasal decongestant sprays and solutions include phenylephrine, hydroxymetazoline, and ephedrine. If infants and young children use it too much, they will become excited, cry and unable to sleep. Continuous use may lead to drug-induced rhinitis after discontinuation of the drug.

4. Anti-inflammatory Agents

(1) Topical sodium cromoglycate and nedocromil are more effective for sneezing, clear nasal discharge, and itchy nose than for nasal congestion, but are less effective than nasal corticosteroids in more severe cases.

(2) Nasal corticosteroids should be discontinued if there is infection in the nose. Domestically, there are sodium bromocriptine (containing chlormethasone dipropionate) and fluticasone nasal spray (containing fluticasone), etc. The effect of corticosteroids occurs after a few days to a few weeks. Injection of corticosteroids into the nasal turbinates is not recommended because of the risk of visual loss. Oral or intramuscular corticosteroids are used only for short periods of time when nasal medications are ineffective.

5. Anticholine drugs

Long-term topical use of Atrovent is safer.

6. Immunotherapy

It can be considered for a small number of cases caused by inhaled allergens such as pollen, for which other treatment methods are ineffective and for patients over 5 years old. Immunotherapy can significantly improve symptoms in 80% to 90% of children and prevent the development of asthma.

7. Leukotriene receptor antagonists

Such as zafirlukast and montelukast, they are often used in combination with anti-H1 receptor antagonists, but their effectiveness needs further evaluation.