Rhinitis in children Jacqueline M Mardon A collaborative model retrospective review 47 children referred by ENT allergic or non-specific rhinitis ineffective conventional therapy assessed by homeopathic practitioner treated with homeopathy ± isopathy follow-up and outcomes The integrity of the child What is rhinitis and what is it an expression of in the child’s being? What is the significance? (different levels this can be approached) A very visible manifestation: flowing, sticky lurid green, yellow, clear burny blood Face full, tender, squeaky, stuffedup Unseen pain, itch - nose rub, palate scratch Eyes water, stick, searing tears Ears fuzzy, bubble Skin prickles and flakes Hard to breathe - the night is not peaceful, disturbed with grunts, snorts and gasps An assault to the dignity of the young individual and their integrity Affects concentration, distorts the face. Hard to gaze outwardly. There may be shame, mute misery Can experience being shunned, bullied Conventional approaches History, examination ± investigation (skin prick tests, RAST) Associated asthma, eczema, foods? Treatment nasal corticosteroids, anti-histamines Self-help approaches Allergen avoidance/reduction Saline nasal washes Light impulse probes? Homeopathic “holistic” approach The child first and always Welcome the family Symptoms Maternal history, birth Early life, breathing, feeding and weaning FHx Onset allergy - eczema,asthma, rashes, food Homeopathic “holistic” approach (2) Movement Physical, social and emotional development Sleeping Day rhythms Temperature Observations; significance of ages Review of cases(1) 47 children: 18 girls, 29 boys Age range: 1 - 16 years Review of cases (2) ENT referral/diagnosis Non-specific rhinitis - 8 children Allergic rhinitis/multiple allergies - 37 Other - 2 children Review of cases (3) other medical problems/Hx A hetereogeneous group Congenital heart disease Tonsils, adenoids Cleft lip and palate Nasal intubations/feeding, surgery Grommet insertions, ear problems Review of cases (4) medical hx cont Asthma (11 children) Eczema (13 children), 5 with both “ALLERGY MARCH” Urticaria/rashes Food allergies: milk protein, fish, egg, dairy Chest and respiratory tract infections - multiple antibiotics Review of cases (5) Allergy tests RAST - 2 children Skin prick tests - 39 children (9 negative results; 30 positive for one or more allergen) Review of cases (6) Family history Siblings with congenital heart disease (2) 30 children with family hx of atopy Review of cases (7) Maternal hx/birth 33 children recorded details 7 Caesarean Section births 5 births by Forceps delivery - SCBU with bruising to head/face in 2 babies Individual experiences eg “stuck”, purple large baby with excess mucus, lasted several months Review of cases (8) Conventional medication: - one child parents declined nasal spray - one child spray effective but parents concerned re side-effects - In most cases the tx (steroids,antihistamines) ineffective or limited effect - Also bronchoinhalers and antibiotics Review of cases (9) Previous homeopathy - one patient visited homeopath in Pakistan; another previous patient GHH Review of cases (10) Homeopathy/Isopathy Tx Many different remedies, first consultation and beyond No treatment (1) Single (constitutional) remedy (17) Single (local)remedy (1) Miasmatic nosode and constitutional (3) Isopathy and constitutional (23) Review of cases (11) Follow-up 11 children attended one appointment only- 1 was planned Further ENT assessment/treatment? (10/46 is DNA rate of 21.7%) 36 children attended at least one followup (range 1 to 14 months from first seen - patient-led!) Review of cases (12)Outcome Reduction/cessation conventional Tx No response at follow-up - 5 children (1 did not like powders): 5/36 (14%) Partial response - 9/39 (25%) Good response with significant improvement - 22/36 (61%) 31/36 children (86%) of those seen more than once have either partial or good response - some follow-up and Tx ongoing Review of cases (13) Discussion Rhinitis is a symptom - complexity of individual’s history and circumstances Many of these children had heavy load of interventions and Tx Allergies on many levels Can treating early in holistic way affect longer-term outcome? Collaborative model Child at centre Family General Practitioner Specialists - ENT surgeon, Homeopathic/holistic practitioner Community/environment Thanks Mr HA Sadiq ENT Surgeon, Royal Hospital for Sick Children, Glasgow Elaine Hamilton, Nadja Gunneburg, Kamal Ohri, Bridie O’Dowd, Robert Leckridge Linda and administrative staff Betty and pharmacy staff