Which intranasal medication is first-line for allergic rhinitis and also helps reduce nasal polyp burden?

Which intranasal medication is first-line for allergic rhinitis and also helps reduce nasal polyp burden?

• A. Oral antihistamines.
• B. Intranasal corticosteroids (e.g., fluticasone, mometasone).
• C. Oral decongestants.
• D. Intranasal saline spray.

Answer: (B)

Intranasal corticosteroids are the mainstay for allergic rhinitis because they dampen the local nasal inflammation driving the symptoms of congestion, itching, sneezing, and runny nose. By reducing inflammatory swelling of the nasal mucosa, they improve airflow and overall nasal patency. They also have a beneficial effect on nasal polyps by shrinking inflamed tissue, which lowers the polyp burden in chronic rhinosinusitis with polyps. This combination of broad symptom control and anti-polyp activity makes them the best first-line choice. Other options don't address the problem as comprehensively: oral antihistamines mainly reduce itching and sneezing but are less effective for nasal congestion and do not reduce polyps; oral decongestants provide quick relief but carry risks and can cause rebound congestion with longer use; intranasal saline spray helps with moisture and cleansing but does not treat the underlying inflammation or polyp burden.

Intranasal corticosteroids are the mainstay for allergic rhinitis because they dampen the local nasal inflammation driving the symptoms of congestion, itching, sneezing, and runny nose. By reducing inflammatory swelling of the nasal mucosa, they improve airflow and overall nasal patency. They also have a beneficial effect on nasal polyps by shrinking inflamed tissue, which lowers the polyp burden in chronic rhinosinusitis with polyps. This combination of broad symptom control and anti-polyp activity makes them the best first-line choice.

Other options don't address the problem as comprehensively: oral antihistamines mainly reduce itching and sneezing but are less effective for nasal congestion and do not reduce polyps; oral decongestants provide quick relief but carry risks and can cause rebound congestion with longer use; intranasal saline spray helps with moisture and cleansing but does not treat the underlying inflammation or polyp burden.