New guidelines for diagnosing and treating allergic rhinitis were released this month, just in time for the crush of fall allergy sufferers seeking relief from their allergist/immunologists.

The diagnosis and management of rhinitis: An updated practice parameter is featured in the August edition of the Journal of Allergy and Clinical Immunology (JACI) as is currently available for download at The JACI is the official scientific journal of the American Academy of Allergy, Asthma & Immunology (AAAAI).

Allergic rhinitis, commonly called hay fever, affects an estimated 20 percent of adults and 40 percent of children in the United States, according to the AAAAI. It is the No. 1 cause of work absenteeism due to chronic illness and leads to more than 2 million missed school days for children.

"The objective of The diagnosis and management of rhinitis: An updated practice parameter is to improve the care of patients with all types of rhinitis, with an emphasis on allergic rhinitis," said chief editor Dana V. Wallace, MD, FAAAAI. "Following a thorough review of the medical literature the evidence was incorporated into this guideline, thereby providing the practicing allergist an updated, practical guide for the diagnosis and management of rhinitis."

The new rhinitis parameter offers discussion on several recent developments in treatment of allergic rhinitis, including:

- Recognizing co-morbidities, such as asthma, sinusitis and sleep apnea, and testing pulmonary function in these patients
- Use of non-sedating antihistamines during pregnancy
- Advantages and disadvantages of single and combination treatment approaches
- Benefits vs. safety of use of oral decongestants on children under 6
- Medications released in the past 10 years
- Consideration of using a Rhinitis Action Plan

The parameter also introduces for the first time a classification of episodic allergic rhinitis. Episodic cases are those that are neither seasonal nor perennial, but rather those that are triggered by sporadic exposure to an allergen and therefore require a modified treatment plan.

The document also utilizes a series of charts to aid physicians in assessing symptom severity and determining treatment.

The previous parameter was published in 1998.

"In recent years, clinical research has significantly increased our knowledge about rhinitis treatments, and new treatments have been introduced. Therefore, an updated parameter was needed to provide new guidance for optimal rhinitis treatment," said chief editor Mark S. Dykewicz, MD, FAAAAI.

According to the practice parameter and the AAAAI, referral to an allergist/immunologist should be sought when:

- The patient has prolonged symptoms
- The patient has complications of rhinitis, including a middle ear infection, sinus infection or nasal polyps
- The patient has asthma, chronic sinusitis or another comorbid condition
- The patient's symptoms or medication side effects interfere with his ability to sleep, work or attend school, or otherwise affect quality of life

To find an allergist/immunologist in your area, or to learn more about diagnosis and treatment of rhinitis, visit the Patients and Consumers section of the AAAAI Web site at

The diagnosis and management of rhinitis: An updated practice parameter was developed by the Joint Task Force on Practice Parameters for Allergy & Immunology, a joint coalition of the American Academy of Allergy, Asthma & Immunology (AAAAI), the American College of Allergy, Asthma and Immunology (ACAAI) and the Joint Council of Allergy, Asthma and Immunology (JCAAI).

The AAAAI represents allergists, asthma specialists, clinical immunologists, allied health professionals and others with a special interest in the research and treatment of allergic disease. Established in 1943, the AAAAI has nearly 6,500 members in the United States, Canada and 60 other countries.

American Academy of Allergy, Asthma & Immunology