Ask the Allergist: Clearing Up Allergic Rhinitis

Rhinitis2Q: “My teenage son has allergies and asthma. He is constantly clearing his throat. Why is this? How can he clear out the mucus?” 

Martha White, MD: Many people with asthma have allergies, so treating the nose for allergic rhinitis (inflammation of the mucous membranes in the nose caused by an allergic reaction) is just as important as treating the lungs.

The nose and lungs are at opposite ends of the respiratory tract. The mucus that you’re describing is coming from his nose and/or sinuses and dripping down his throat, causing him to constantly clear it.

Both asthma and allergic rhinitis symptoms can be set off by allergens, cold air and inhaled irritants (such as smoke or strong smells). Both conditions are characterized by inflammation, which causes narrowed airways and shortness of breath in the lungs and nasal congestion in the nose. They’re also both characterized by increased mucus production, causing coughs for people with asthma and sniffling and throat clearing for those with allergic rhinitis.

We treat allergic rhinitis and asthma similarly. The first line of treatment is to identify the relevant triggers and avoid whatever is practical to avoid. A board-certified allergist can help you with this.

The second line of treatment is medication. For acute symptoms, we prescribe antihistamines for allergic rhinitis and albuterol for asthma. People with more persistent problems also need anti-inflammatory medications such as inhaled corticosteroids for asthma and intranasal corticosteroids for allergic rhinitis.

If environmental controls and prescription medications do not provide sufficient symptom relief, allergy shots (immunotherapy) might be appropriate. Allergy shots offer the closest thing that we have to a cure, and over time can lead to a marked reduction in sensitivity to allergens. Allergy shots typically require a 4-5 year commitment, but they are effective in about 95 percent of people who are treated properly.

Martha White, MD, FACAAI, is a board-certified allergist at the Institute of Asthma and Allergy in Wheaton, Md., a member of The Network’s Board of Directors, an Allergy & Asthma Network medical editor since 1985 and a fellow of the American College of Allergy, Asthma & Immunology.

Have a medical question? Email or write to Ask the Allergist, Allergy & Asthma Network, 8229 Boone Blvd., Suite 260, Vienna, VA 22182.