Allergic rhinitis is a chronic inflammatory disorder of the nasal mucosa that develops after exposure to aeroallergens in sensitized individuals. It is usually mediated through immunoglobulin E-dependent mechanisms and is characterized by recurrent sneezing, watery rhinorrhea, nasal obstruction, nasal itching, and variable ocular symptoms. Although it is not a life-threatening illness, its high frequency, recurrent nature, and effect on sleep, school or work performance, and daily activity make it an important public health problem [1-4]. The global literature consistently identifies allergic rhinitis as one of the most common upper airway disorders, and ARIA documents have placed it within the concept of united airway disease because of its close relationship with bronchial asthma [2,3].

The epidemiology of allergic rhinitis varies across regions, age groups, climatic zones, and methods of diagnosis. Indian data indicate that allergic rhinitis is increasingly recognized in both community and clinic-based settings, with urbanization, indoor dust exposure, changing environmental conditions, and coexisting asthma contributing to the disease burden [1]. International studies have also shown wide variation in prevalence, partly because some patients self-treat symptoms or remain undiagnosed until symptoms become troublesome [9,10]. In otorhinolaryngology outpatient departments, the observed prevalence is expected to be higher than community estimates because patients present with nasal symptoms, recurrent obstruction, or associated upper airway complaints.

Clinically, allergic rhinitis is relevant to ENT practice because it overlaps with common conditions such as deviated nasal septum, sinusitis, adenoid or turbinate hypertrophy, and nasal polyposis. Persistent nasal inflammation can impair quality of life and contribute to sleep disturbance, reduced concentration, facial heaviness, and frequent health-care visits [11-13]. The ARIA classification is useful for clinical description because it separates disease into intermittent or persistent patterns and into mild or moderate-to-severe categories according to symptom duration and functional impact [2,3,5]. Such classification helps clinicians understand the symptom burden beyond a simple diagnosis.

The present study was undertaken to estimate the prevalence of allergic rhinitis among patients attending the otorhinolaryngology outpatient department of KIMS, Amalapuram, Andhra Pradesh, India, and to describe the clinical profile of affected patients. The specific objectives were to assess the frequency of allergic rhinitis among ENT outpatient attendees, evaluate common symptoms and clinical findings, classify disease pattern and severity using ARIA-based categories, and document common triggers and associated clinical conditions. Generating local institutional data is useful because regional exposure patterns, patient awareness, and referral practices differ across settings, and these factors influence the clinical spectrum seen in routine ENT care.

Study design and setting: This observational cross-sectional study was conducted in the Department of Otorhinolaryngology, KIMS, Amalapuram, Andhra Pradesh, India. The study was designed to assess the burden and clinical presentation of allergic rhinitis among patients attending the ENT outpatient department during routine clinical care. Study period: The study was carried out over six months, from August 2025 to January 2026. All eligible patients attending the outpatient department during this period were screened for symptoms suggestive of allergic rhinitis. Study population and sample size: A total of 100 consecutive patients attending the otorhinolaryngology outpatient department were included. Consecutive sampling was used to avoid selective enrolment and to reflect the usual outpatient case mix. The sample consisted of patients presenting with nasal, throat, ear, or related upper airway complaints, among whom allergic rhinitis was assessed clinically. Eligibility criteria: Patients of either sex who attended the ENT outpatient department and provided consent for clinical evaluation were included. Patients with acute febrile upper respiratory tract infection, recent nasal trauma, previous nasal surgery during the immediate postoperative period, and incomplete clinical records were excluded. Patients with mixed nasal pathology were retained if allergic rhinitis symptoms were clinically evident and could be classified separately. Data collection: A structured data collection form was used to record demographic variables, residence, family history of allergy, presenting symptoms, duration and pattern of symptoms, probable triggers, anterior rhinoscopic findings, and associated conditions. Symptoms recorded included sneezing, nasal obstruction, watery rhinorrhea, nasal itching, postnasal drip, ocular itching or watering, cough, headache or facial heaviness, and reduced smell sensation. Clinical assessment and classification: Allergic rhinitis was diagnosed on the basis of characteristic nasal symptoms, recurrent or exposure-related pattern, and supportive clinical findings such as pale nasal mucosa, watery nasal discharge, and inferior turbinate hypertrophy. Disease was classified using ARIA-based clinical categories as intermittent or persistent and as mild or moderate-to-severe, in line with established allergic rhinitis guidance [2-5]. Common triggers such as dust, cold weather, pollen, smoke, and strong odours were recorded from patient history. Statistical analysis: Data were entered and analyzed using descriptive statistics. Categorical variables were summarized as frequencies and percentages. Continuous variables were expressed as mean and standard deviation. The prevalence of allergic rhinitis was calculated as the proportion of clinically diagnosed allergic rhinitis cases among the total outpatient study sample. No inferential statistical comparison was planned because the primary objective was descriptive. Ethical considerations: The study was conducted according to institutional ethical standards and the principles of the Declaration of Helsinki. Written informed consent was obtained from participants before enrolment. Confidentiality of patient information was maintained throughout the study. Ethical approval was obtained from the Institutional Ethics Committee of KIMS, Amalapuram, Andhra Pradesh, India, and the approval number and date can be inserted by the authors before final submission.

A total of 100 patients attending the otorhinolaryngology outpatient department were evaluated. The mean age of the study population was 31.8 ± 12.6 years. The largest age group was 21-30 years, comprising 34.0% of the participants, followed by 31-40 years in 24.0%. Females constituted 54.0% of the study population, and urban residence was recorded in 58.0%. A family history of allergy was present in 29.0% of patients, as shown in Table 1.

Table 1. Baseline characteristics of the study population

Allergic rhinitis was diagnosed in 42 patients, giving an overall prevalence of 42.0% among ENT outpatient attendees. The remaining 58 patients did not fulfil the clinical criteria for allergic rhinitis. The distribution of allergic rhinitis diagnosis in the study population is presented in Table 2.

Table 2. Prevalence of allergic rhinitis among ENT outpatient attendees

Among the 42 patients with allergic rhinitis, sneezing was the most common presenting symptom, reported by 38 patients (90.5%). Nasal obstruction was observed in 32 patients (76.2%), watery rhinorrhea in 30 patients (71.4%), and nasal itching in 26 patients (61.9%). Postnasal drip and ocular itching or watering were reported in 42.9% and 38.1% of cases, respectively. Other symptoms included cough, headache or facial heaviness, and reduced smell sensation, as detailed in Table 3.

Table 3. Clinical symptoms among patients with allergic rhinitis

Seasonal symptoms were noted in 22 patients (52.4%), while 20 patients (47.6%) had perennial symptoms. Based on ARIA classification, intermittent allergic rhinitis was observed in 17 patients (40.5%), whereas persistent allergic rhinitis was seen in 25 patients (59.5%). Mild disease was present in 18 patients (42.9%), while moderate-to-severe disease was recorded in 24 patients (57.1%). Dust exposure was the most frequently reported trigger, followed by cold weather, pollen exposure, smoke exposure, and strong odours or perfumes. These findings are summarized in Table 4.

Table 4. Pattern, duration, and triggers of allergic rhinitis

On anterior rhinoscopic examination, pale nasal mucosa was the most frequent finding and was observed in 29 patients (69.0%). Inferior turbinate hypertrophy was present in 27 patients (64.3%), and watery nasal discharge was seen in 24 patients (57.1%). Deviated nasal septum was found in 26.2% of allergic rhinitis cases, while nasal polyps were observed in 9.5%. Associated sinusitis was documented in 21.4%, bronchial asthma in 16.7%, and atopic dermatitis in 9.5% of affected patients, as shown in Table 5. Overall, allergic rhinitis was characterized by a symptom profile dominated by sneezing, nasal obstruction, watery rhinorrhea, and nasal itching, with dust exposure and persistent disease pattern being common clinical features.

Table 5. Examination findings and associated conditions among allergic rhinitis cases

The present observational study showed that allergic rhinitis was diagnosed in 42.0% of patients attending an otorhinolaryngology outpatient department. This proportion is higher than many community-based prevalence estimates, but such a pattern is expected in a symptom-driven ENT outpatient setting, where patients frequently attend with nasal obstruction, sneezing, rhinorrhea, and related upper airway complaints. Indian reviews have emphasized that allergic rhinitis is a growing clinical concern and that its true burden is underestimated because several patients normalize recurrent nasal symptoms or use over-the-counter medication before seeking specialist care [1]. The observed prevalence therefore reflects an institutional outpatient burden rather than a population prevalence.

The mean age of the study population was 31.8 years, and allergic rhinitis was most frequently observed in the 21-30 years age group. This age distribution is clinically relevant because young adults are more likely to report symptoms that interfere with study, work, sleep, and daily activity. Previous epidemiological studies and reviews have also described allergic rhinitis as a condition with substantial burden in children, adolescents, and young adults, although it persists across the adult age spectrum [8-10]. The slight female predominance in the present sample was modest and should be interpreted cautiously because outpatient attendance patterns often influence sex distribution.

Sneezing, nasal obstruction, watery rhinorrhea, and nasal itching were the dominant symptoms among affected patients. This symptom cluster is consistent with standard descriptions of allergic rhinitis and with current diagnostic guidance, which recognizes recurrent sneezing, watery discharge, nasal blockage, and itching as key clinical indicators [5-8]. Ocular itching or watering was reported in more than one-third of cases, supporting the common association between nasal and ocular allergic symptoms. Postnasal drip, cough, headache, and reduced smell sensation were less frequent but clinically meaningful because they influence patient discomfort and can overlap with sinus disease.

Dust exposure was the most frequently reported trigger, followed by cold weather, pollen, smoke, and strong odours. This pattern is plausible in Indian outpatient settings, where indoor dust, environmental pollution, and seasonal climatic variation contribute to symptom aggravation [1,14]. More than half of allergic rhinitis cases had persistent disease and moderate-to-severe symptoms. This finding agrees with the ARIA concept that duration and functional impact are essential for describing disease burden rather than relying only on the presence of symptoms [2,3]. The predominance of persistent and moderate-to-severe disease suggests that many patients seek ENT consultation after symptoms become recurrent or disruptive.

On anterior rhinoscopy, pale nasal mucosa, inferior turbinate hypertrophy, and watery nasal discharge were the most common findings. These findings support the clinical diagnosis and are commonly described in allergic rhinitis [6-8]. Associated sinusitis and bronchial asthma were also documented, reinforcing the concept of shared upper and lower airway inflammation [2,3,13]. Overall, the study highlights the need for systematic clinical screening of nasal allergy in ENT outpatient practice, patient education regarding trigger avoidance, and careful assessment of comorbid airway disease.

Limitations

The study has certain limitations. It was conducted at a single tertiary-care outpatient department with a modest sample size; therefore, the findings represent an institutional clinical profile rather than a community estimate. Diagnosis was mainly clinical, and objective allergen testing, serum IgE estimation, and quality-of-life scoring were not performed. Seasonal variation was assessed during a six-month period only.

This observational study found that allergic rhinitis was a common diagnosis among patients attending the otorhinolaryngology outpatient department at KIMS, Amalapuram, with a prevalence of 42.0%. Sneezing, nasal obstruction, watery rhinorrhea, and nasal itching formed the principal symptom complex. Dust exposure was the leading trigger, and persistent as well as moderate-to-severe disease patterns were frequent. Pale nasal mucosa, inferior turbinate hypertrophy, and watery nasal discharge were the dominant examination findings. The findings support routine screening for allergic rhinitis in ENT outpatient practice, especially among young adults with recurrent nasal symptoms. Early diagnosis, trigger counselling, and structured follow-up can reduce symptom burden and improve patient care.

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