Nonallergic rhinitis
Definition :
Nonallergic rhinitis involves chronic sneezing or having a congested, drippy nose with no apparent cause. The symptoms of nonallergic rhinitis are similar to those of hay fever (allergic rhinitis), but there's no allergic reaction involved. Nonallergic rhinitis can affect children and adults, but is more common after age 20.
Although nonallergic rhinitis is more annoying than harmful, it can make you miserable. Triggers of nonallergic rhinitis symptoms vary from person to person and can include certain odors or irritants in the air, changes in the weather, some medications, certain foods, and chronic health conditions. A diagnosis of nonallergic rhinitis is made after an allergy is ruled out. This may require allergy skin or blood tests.
Symptoms:
If you have nonallergic rhinitis, you probably have symptoms that come and go year-round. You may have constant symptoms, symptoms that last for hours or symptoms that last for days. Signs and symptoms of nonallergic rhinitis may include:
When to see a doctor
See your doctor if:
Nonallergic rhinitis occurs when blood vessels in your nose expand (dilate), filling the nasal lining with blood and fluid. There are several possible causes of this abnormal expansion of the blood vessels or inflammation in the nose. But, whatever the trigger, the result is the same — swollen nasal membranes and congestion.
Many things can trigger the nasal swelling in nonallergic rhinitis — some resulting in short-lived symptoms while others cause chronic problems. Nonallergic rhinitis triggers include:
Complications from nonallergic rhinitis include:
Treatment of nonallergic rhinitis depends on how much it bothers you. For mild cases, home treatment and avoiding triggers may be enough. For more bothersome symptoms, certain medications may provide relief, including:
In rare cases, surgical procedures may be an option to treat complicating problems, such as a deviated nasal septum or persistent nasal polyps.
Some studies have shown repeated applications to the inside of the nose of capsaicin, the ingredient responsible for the heat in hot peppers, to be effective. But the use of capsaicin to treat nonallergic rhinitis hasn't been approved.
Definition :
Nonallergic rhinitis involves chronic sneezing or having a congested, drippy nose with no apparent cause. The symptoms of nonallergic rhinitis are similar to those of hay fever (allergic rhinitis), but there's no allergic reaction involved. Nonallergic rhinitis can affect children and adults, but is more common after age 20.
Although nonallergic rhinitis is more annoying than harmful, it can make you miserable. Triggers of nonallergic rhinitis symptoms vary from person to person and can include certain odors or irritants in the air, changes in the weather, some medications, certain foods, and chronic health conditions. A diagnosis of nonallergic rhinitis is made after an allergy is ruled out. This may require allergy skin or blood tests.
Symptoms:
If you have nonallergic rhinitis, you probably have symptoms that come and go year-round. You may have constant symptoms, symptoms that last for hours or symptoms that last for days. Signs and symptoms of nonallergic rhinitis may include:
- Stuffy nose
- Runny nose
- Mucus (phlegm) in the throat (postnasal drip)
When to see a doctor
See your doctor if:
- Your symptoms are severe
- You have signs and symptoms of nonallergic rhinitis that aren't relieved by over-the-counter medications or self-care
- You have bothersome side effects from over-the-counter or prescription medications for rhinitis
Nonallergic rhinitis occurs when blood vessels in your nose expand (dilate), filling the nasal lining with blood and fluid. There are several possible causes of this abnormal expansion of the blood vessels or inflammation in the nose. But, whatever the trigger, the result is the same — swollen nasal membranes and congestion.
Many things can trigger the nasal swelling in nonallergic rhinitis — some resulting in short-lived symptoms while others cause chronic problems. Nonallergic rhinitis triggers include:
- Environmental or occupational irritants. Dust,
smog, secondhand smoke or strong odors, such as perfumes, can trigger
nonallergic rhinitis. Chemical fumes, such as those you might be exposed
to in certain occupations, also may be to blame.
- Weather changes. Temperature or humidity changes can trigger the membranes inside your nose to swell and cause a runny or stuffy nose.
- Infections. A common cause of nonallergic rhinitis
is a viral infection — a cold or the flu, for example. This type of
nonallergic rhinitis usually clears up after a few weeks but can cause
lingering mucus in the throat (postnasal drip). Sometimes, this type of
rhinitis can become chronic, causing ongoing discolored nasal discharge,
facial pain and pressure (sinusitis).
- Foods and beverages. Nonallergic rhinitis may occur
when you eat, especially when eating hot or spicy foods. Drinking
alcoholic beverages, such as beer and wine, also may cause the membranes
inside your nose to swell, leading to nasal congestion.
- Certain medications. Some medications can cause
nonallergic rhinitis. These include nonsteroidal anti-inflammatory drugs
(NSAIDs), such as aspirin and ibuprofen (Advil, Motrin, others), and
high blood pressure (hypertension) medications, such as beta blockers.
Nonallergic rhinitis can also be triggered in some people by sedatives,
antidepressants, oral contraceptives or drugs used to treat erectile
dysfunction. Overuse of decongestant nasal sprays can cause a type of
nonallergic rhinitis called rhinitis medicamentosa.
- Hormone changes. Changes in hormones due to
pregnancy, menstruation, oral contraceptive use or a hormonal condition
such as hypothyroidism can cause nonallergic rhinitis.
- Stress. Emotional or physical stress can trigger nonallergic rhinitis in some people.
Complications from nonallergic rhinitis include:
- Nasal polyps. These are soft, noncancerous (benign)
growths that develop on the lining of your nose or sinuses due to
chronic inflammation. Small polyps may not cause problems, but larger
ones can block the airflow through your nose, making it difficult to
breathe.
- Chronic sinusitis. Prolonged nasal congestion due
to nonallergic rhinitis may increase your chances of developing
sinusitis — an infection or inflammation of the membrane that lines the
sinuses. When sinusitis lasts for longer than 12 consecutive weeks, it's
referred to as chronic sinusitis. Sinusitis causes pain, tenderness and
swelling around your eyes, cheeks, nose or forehead.
- Middle ear infections. Increased fluid and nasal congestion may lead to middle ear infections.
- Interrupted daily activities. Nonallergic rhinitis can be disruptive. You may be less productive at work or school, and you may need to take time off because of symptom flares or doctor visits.
Treatment of nonallergic rhinitis depends on how much it bothers you. For mild cases, home treatment and avoiding triggers may be enough. For more bothersome symptoms, certain medications may provide relief, including:
- Saline nasal sprays. Use an over-the-counter nasal
saline spray or homemade saltwater solution to flush the nose of
irritants and help thin the mucus and soothe the membranes in your nose.
- Corticosteroid nasal sprays. If your symptoms
aren't easily controlled by decongestants or antihistamines, your doctor
may suggest a prescription corticosteroid nasal spray, such as
fluticasone (Flonase) or mometasone (Nasonex). Corticosteroid
medications help prevent and treat inflammation associated with some
types of nonallergic rhinitis. Possible side effects include
indigestion, nausea, headache and bodily pains.
- Antihistamine nasal sprays. Try a prescription
antihistamine spray such as azelastine (Astelin) and olopatadine
hydrochloride (Patanase). While oral antihistamines don't seem to help
nonallergic rhinitis, antihistamine in the form of a nasal spray may
reduce symptoms of nonallergic rhinitis. Side effects may include a
bitter taste in your mouth, headache and fatigue.
- Anti-drip anticholinergic nasal sprays. The
prescription drug ipratropium (Atrovent) is often used as an asthma
inhaler medication. But it's now available as a nasal spray and can be
helpful if a runny, drippy nose is your main symptom. Side effects may
include a bitter taste in your mouth and drying of the inside of your
nose.
- Oral decongestants. Available over-the-counter or
by prescription, examples include pseudoephedrine-containing drugs
(Actifed, Sudafed, others) and phenylephrine (Neo-Synephrine, others).
These medications help narrow the blood vessels, reducing congestion in
the nose. Possible side effects include high blood pressure, insomnia,
loss of appetite, heart pounding (palpitations), anxiety and
restlessness.
- Decongestant nasal sprays. These include oxymetazoline (Afrin, others). Don't use these medications for more than three or four days, as they can cause congestion to come back with even worse symptoms when you stop using them. Other possible side effects include headache, insomnia and feeling nervous.
In rare cases, surgical procedures may be an option to treat complicating problems, such as a deviated nasal septum or persistent nasal polyps.
Some studies have shown repeated applications to the inside of the nose of capsaicin, the ingredient responsible for the heat in hot peppers, to be effective. But the use of capsaicin to treat nonallergic rhinitis hasn't been approved.
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