What initial treatment is recommended for a 24-year-old with seasonal allergic rhinitis and nasal congestion?

Nasal beclomethasone, a corticosteroid, is recommended for the initial treatment of seasonal allergic rhinitis, particularly when symptoms include nasal congestion. Corticosteroids are effective in reducing inflammation in the nasal passages, leading to relief from symptoms such as nasal congestion, itching, and sneezing.

The use of nasal corticosteroids generally provides broader control over the symptoms of allergic rhinitis compared to oral antihistamines, making it a suitable choice for addressing congestion specifically. While oral antihistamines like fexofenadine are effective for other symptoms such as sneezing and runny nose, they do not directly alleviate nasal congestion as effectively as intranasal corticosteroids.

Diphenhydramine, an antihistamine, is less advisable for this patient due to its sedative effects and the availability of more effective first-line therapies. Guaifenesin, an expectorant, is not indicated for allergic rhinitis, as it is typically used to relieve chest congestion in cases of respiratory infections rather than nasal symptoms caused by allergies.

In summary, nasal beclomethasone tackles the underlying inflammation associated with allergic rhinitis, making it a targeted and effective first-line treatment for someone experiencing nasal congestion and other allergy symptoms