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Old 04-28-2006, 19:15   #1
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Rhinitis

What are your thoughts on rhinitis and what do you use to treat it?

I would like to hear the good, bad, and ugly.

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Old 04-30-2006, 05:41   #2
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Any comments on the "one airway, one disease" correlation with asthma and rhinitis?

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Old 05-10-2006, 19:21   #3
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I'd be hesitant to say one airway one disease. Rhinitis is an upper airway issue where asthma is an issue below the carina. Oh well, off to medline to get data to either support or refute my position
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Old 05-10-2006, 19:25   #4
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There are 751 hits on medline. One common theme I kept coming across though was allergic rhinitis as a comorbidity for asthma. I'm still not convinced the two are directly associated yet. It's getting late, so I'll do the statistics tomorrow if anyone is interested.

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Old 05-10-2006, 20:04   #5
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Quote:
Originally Posted by medicerik
There are 751 hits on medline. One common theme I kept coming across though was allergic rhinitis as a comorbidity for asthma. I'm still not convinced the two are directly associated yet. It's getting late, so I'll do the statistics tomorrow if anyone is interested.

Erik
Please
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Old 05-11-2006, 07:48   #6
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After digging through the data, I've come across what's called the integrated airway hypothesis (what Doc referred to as one airway one disease) A study from the Allergy and Asthma Medical Group and Research Center showed by doing a metanalysis of several studies that 19 to 38 percent of patietns with rhinitis also have asthma.

The belief is that local inflammation in the upper airways by an allergen also causes inflammation in the lower airways leading to worsening of asthma. The same metanalysis of the data showed a moderate improvement in asthma symptoms in those who had their allergic rhinitis appropriately treated.

I learn something new everyday!!!!!
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Old 05-11-2006, 13:31   #7
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Based on my own experience, I believe that rhinitis exacerbates asthmatic symptoms. I have very mild asthma which is principally (and only occasionally) induced by strenuous exercise, and I have severe allergies which have been controlled through shots. I also use Rhinocort and have HEPA filters in the house because we have cats and I am allergic to them. Had a bad allergy attack in Oregon (probably from Juniper), and needed Ventolin . . .

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Old 05-11-2006, 17:51   #8
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Quote:
Originally Posted by medicerik

After digging through the data, I've come across what's called the integrated airway hypothesis (what Doc referred to as one airway one disease) A study from the Allergy and Asthma Medical Group and Research Center showed by doing a metanalysis of several studies that 19 to 38 percent of patietns with rhinitis also have asthma.
That's close to what I'm reading/seeing in the clinics too. Approx. 38% of rhinitis patients have asthma and approx. 75% of asthma patients have rhinitis according to what study you read.


Quote:
Originally Posted by medicerik

The belief is that local inflammation in the upper airways by an allergen also causes inflammation in the lower airways leading to worsening of asthma. The same metanalysis of the data showed a moderate improvement in asthma symptoms in those who had their allergic rhinitis appropriately treated.

I learn something new everyday!!!!!
Erik


For both rhinitis and asthma we use low dose corticosteroids to reduce inflammation, the leading culprit in both disease processes. Problem is, patient compliance can be an issue. Patients take medicine, symptoms improve, patient forgets to take medicine and symptoms re-occur. While this isn't really bad for a rhinitis patient, it can be really bad for an asthma patient when they have an exacerbation.

Does anyone know what an asthma medicine holiday is?
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Old 05-11-2006, 18:11   #9
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Quote:
Originally Posted by Roguish Lawyer
Based on my own experience, I believe that rhinitis exacerbates asthmatic symptoms. I have very mild asthma which is principally (and only occasionally) induced by strenuous exercise, and I have severe allergies which have been controlled through shots. I also use Rhinocort and have HEPA filters in the house because we have cats and I am allergic to them. Had a bad allergy attack in Oregon (probably from Juniper), and needed Ventolin . . .

Exercise is the number one "trigger" of an exacerbation.

It sounds like you have perennial allergic rhinitis which is a year round condition. Rhinocort is a good medicine for a variety of reasons; it has a low volume of spray compared to the competition, no alcohol or perfume additives and a nice safety factor.

Hepa filters are good too IMHO.
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Old 05-11-2006, 21:22   #10
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My ENT feels very strongly that the Ionic Breeze and similar machines are horrible for allergy sufferers. They magnetize particles, which causes them to stick to anything -- not just the collector tray, but also the inside of your nose.
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Old 05-15-2006, 18:24   #11
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The Ionic Breeze produce(s)(d) ozone which irritates mucosal tissue, hence the need for the ozone filter which they currently use to correct that problem.

You are on the right path with the HEPA filters from what I'm being told.

You might be better off to keep pets out of the bedroom and make it a "trigger" resistant sleeping room. I have two cats too btw.
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Old 05-15-2006, 18:44   #12
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You might be better off to keep pets out of the bedroom
You obviously have not met Catwoman. One of the cats sleeps next to my head.
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Old 05-15-2006, 19:20   #13
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Understood.
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Old 06-10-2006, 09:36   #14
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Does anyone have a preference for what inhaled nasal spray they use and/or prescribe???

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Old 06-10-2006, 12:08   #15
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Doc based on the recommendation from someone here I've used Afrin Sinus, found it very effective. I don't have to use it very often however.
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