Finding the Treatment that Works Best for Allergic Rhinitis

Thirty-six year old Rolando Ebreo was diagnosed with allergic rhinitis in 2013.

"I was sneezing for hours daily and it was very uncomfortable. After self-medicating which obviously did not yield lasting results, I decided to see a doctor. My incessant sneezing was already affecting my performance at work. I could not work properly," said Rolando.

In allergic rhinitis, the lining of the nose becomes inflamed in response to breathing in certain substances, known as allergens. The most common allergens that trigger allergic rhinitis are house dust mites, animal/pet dander, molds, cockroach particles and pollens; irritants such as smoke and strong odors, and changes in the temperature and humidity of the air.

Rolando consulted Dr. Carmela Kasala, an allergist-immunologist at The Medical City.

"I remember the first words of Dr. Kasala, “I know what your problem is.” I asked, “Is it going to be forever?” And yes, may forever.  I was diagnosed with Allergic Rhinitis at age 32," he related.
 
Rolando had a skin allergy test to pinpoint what triggered his allergies.

"It turned out that I am allergic to house dust mites or in short, HDM. Determined to be free from this allergy, I asked for treatment options. I was prepared for an answer referring to eternal medications but luckily, I was also given an option to get immunotherapy," said Rolando.

Although medications available for allergy are usually very effective, they do not cure people of allergies. Doctors believe that allergen immunotherapy is the closest thing there is for a "cure" for allergies, as it reduces the severity of symptoms and the need for medication for many allergy sufferers.

Allergen immunotherapy is often recommended for treatment of allergic rhinitis due to pollen or dust mite allergy (and sometimes asthma) when symptoms are severe, when the cause is difficult to avoid, when medications do not help or cause adverse side effects or when people prefer to avoid medications.

However, immunotherapy is not a quick fix form of treatment. Allergen immunotherapy involves the regular administration of gradually increasing doses of allergen extracts over a period of years.

"The treatment course had a pre-requisite. Dr. Kasala needed to know first how much allergen would be the optimal amount that I would need to be immune to. That amount of allergen would be the regular amount of subcutaneous injection (for men out there, it’ll not hurt as much as a flu shot would) I would have throughout the five-year period."

"I started getting the injection weekly, then bi-weekly, then monthly. The progression is dictated by how much your body can actually sustain the level of allergen that you would need to be immune to," Rolando explained.

Immunotherapy can be given to patients as an injection or as tablets, sprays or drops under the tongue (sublingual). Allergen immunotherapy changes the way the immune system reacts to allergens, by switching off allergy. The end result is that you become immune to the allergens, so that you can tolerate them with fewer or no symptoms.

Those agreeing to allergen immunotherapy like Rolando need to be committed to three to five years of treatment for it to work, and to cooperate with their doctor to minimise the frequency of side effects.

At first, Rolando considered the five-year treatment as a drawback.

"The drawback I was thinking of at that time was that it’s going to be done for five long years," he admitted.

But he is determined to finish it and is now on his third year of immunotherapy at 36 years old.  

"With medications and immuno-therapy injections, to-date, yes, I still have a few allergy attacks (sneezing, post-nasal drip) once in a while but it isn’t as significantly bothersome or disruptive as before and I am hoping that at the end of this treatment course, I will graduate with flying colors," said Rolando.

For proper diagnosis and treatment of your allergies, schedule an appointment with a TMC allergist by calling (02) 988-1000 / 988-7000 loc. 6376 or visit http://www.themedicalcity.com/services/department-of-medicine.