Allergic and non-allergic rhinitis: BSACI publishes new guideline on its diagnosis and management


In the UK, allergic rhinitis is common and affects between 10-15% of children and 26% of adults. The guidance on the diagnosis and management of allergic and non-allergic rhinitis would be published in The Standards of Care Committee of the British Society for Allergy & Clinical Immunology (BSACI) and it is predicted that the guidelines would help the healthcare professional to diagnose allergic rhinitis.

The BSACI first published guidance on the 'Management of Rhinitis' over a decade ago, since then new evidence underpinning our understanding of the concepts that control allergic rhinitis have been discovered, so an updated version has been developed. Although allergic rhinitis can sometimes be trivialized, the quality of life could be affected.

Besides, allergic rhinitis has a profound effect on work and a detrimental effect in school. The researchers found that the children who drop a grade in their GCSE exams were 40% more likely to have allergic rhinitis and to take sedating oral antihistamines. An allergic or non-allergic rhinitis is a major risk factor for developing asthma. About 80% of asthmatics have this condition, and the asthma control is impaired.

The rhinitis is managed using antihistamines. However, the sedating antihistamines worsen the psychomotor retardation of allergic rhinitis and should be avoided. The thinking process and the physical movements in an individual are reduced. Non-sedating antihistamines could be used in mild cases, but many individuals require a regular topical nasal corticosteroid spray which is more effective.

The combination therapy with an intranasal corticosteroid and intranasal antihistamine is more effective than used alone in treating allergic rhinitis; the treatment is used if the prior treatment were impotent. The accuracy of diagnosis and disease management could be improved if the underlying mechanism, comorbidities and specific triggers were identified.

“This is one of the 13 guidelines which the British Society for Allergy and Clinical Immunology (BSACI) Standards of Care Committee has published. The guidance continues the link of highly successful published guidelines. The rigorous NICE-accredited processes were used in the experts in the field, said Dr Shuaib Nasser, President of the British Society for Allergy & Clinical Immunology (BSACI).  

The accurate diagnosis of the kind of allergic rhinitis, determination of the allergens causing allergy would be easier if the healthcare professionals apply the guidance. Besides, ENT surgeons or allergists or immunologists would be suggested to the patients.