Trigger avoidance |
AR, NAR, CRS |
Allowed |
Not always feasible to
achieve. |
Saline douchings
|
AR, NAR, ARS, CRS
|
Allowed
|
Very safe and cheap treatment option recommended as an adjunct for all
mucosal pathology.
Might be considered specifically for symptomatic swimmers after leaving
a chlorinated pool.
|
Decongestants
|
Infectious rhinitis, ARS
|
Allowed: phenylephrine, phenylpropanolamine, adrenaline, xylometazoline
and synephrine
Allowed in limited concentrations: cathine, ephedrine and
methylephedrine, pseudoephedrine
Not allowed: sympathomimetic amines
|
Overuse can lead to rhinitis medicamentosa with paradoxal chronic nasal
obstruction.
|
Intranasal corticosteroids
|
AR, NAR, ARS, CRS
|
Allowed, TUE is not required
|
Transient side effects: minor epistaxis, nasal dryness and irritation of
nose and throat.
Golden standard for chronic mucosal sinonasal pathology.
|
Oral corticosteroids |
Severe therapy-resistant AR |
Allowed with TUE.
Indications are rare for AR. |
Gastro-intestinal, cardiovascular,
ocular, psychiatric side-effects. Avascular necrosis, suppression of
HPA-axis, osteopenia, diabetes mellitus, increased infection
rate. |
Antihistamines |
AR |
Allowed |
Side effect: first-generation
antihistamines can have a sedative effect. Second-generation and later
antihistamines are less sedative. |
Cromoglycates |
AR |
Allowed |
Less effective in suppressing nasal
symptoms than antihistamines. |
Antileukotrienes |
AR |
Allowed |
Comparable efficacy to antihistamines,
but no sedation. |
Allergen Immunotherapy
|
AR
|
SLIT: Allowed
SCIT: Allowed
|
Immunotherapy should be started before competition.
Local and systemic side effects are reported, more in SCIT than in SLIT.
Exercise is prohibited on day of injection for SCIT.
|
Nasal dilators |
Structural pathology |
Allowed |
No clear effect on
physiological parameters, however, beneficial effect on subjective
breathing. |
Surgery
|
Structural pathology, AR, NAR, CRS
|
Permitted
|
(Rhino)septoplasty is an option for medically resistant nasal
obstruction in the presence of structural abnormalities.
Turbinoplasty can be considered in medically resistant, reversible nasal
obstruction due to turbinate hypertrophy.
Endoscopic sinus surgery is an option in CRS patients in whom maximal
medical therapy has failed.
|