Non-allergic rhinitis
Non-allergic rhinitis, or irritant rhinitis, is triggered by certain factors, such as strong smells, pollution, particulate matter in the air, smoke or other irritants. These substances differ from allergens in that they do not produce a reaction in an individual’s immune system. Symptoms of rhinitis can also be triggered by temperature and atmospheric changes. Non-allergic rhinitis usually afflicts adults and causes year-round symptoms, especially nasal congestion or "stuffiness" and headaches. If the rhinitis sufferer also has a very runny nose, the condition is often referred to as vasomotor rhinitis. Although medications cannot completely relieve symptoms, your doctor may prescribe decongestants or a steroid nose spray to lessen symptoms. Interestingly, regular exercise can also be helpful.
Symptoms of non-allergic rhinitis may also occur as a result of pregnancy, thyroid disorders or as a side effect of certain medications. When the symptoms are traced to a deficiency of thyroid hormone, thyroid medication can help.
Another type of non-allergic rhinitis, called eosinophilic non-allergic rhinitis, is named after the blood cell—the eosinophil—which distinguishes it from the other forms of non-allergic rhinitis. This type of rhinitis behaves like allergic rhinitis in that it causes frequent, recurrent bouts of sneezing and a runny nose. This disorder, which may seem to appear from out of the blue, can be provoked by changes in the environment such as air pressure variations or weather shifts. Allergy skin tests are negative with this type of rhinitis, and growths in the nose, called nasal polyps, are a common complication. Medications such as antihistamines, decongestants and topical cromolyn may be beneficial, but topical nasal corticosteroids provide the best relief for many patients.
Rhinitis medicamentosa occurs when non-prescription topical decongestants—over-the-counter nose sprays—are used in excess, often for more than three consecutive days. This form of rhinitis causes severe nasal congestion and is best treated by stopping use of the offending nasal spray. This often leads to temporary severe congestion, which can be helped by topical or oral corticosteroids.
Neutrophilic rhinosinusitis is usually triggered by a sinus or related infection. It may also be associated with viral infections such as a cold or flu. This form of rhinitis causes symptoms such as post-nasal drip and sinus pain, which may be treated with decongestants and nasal saline solution. Antibiotics are prescribed when the sinuses are infected, but not for simple colds.
Structural rhinitis is caused by structural abnormalities in the nasal septum. These abnormalities can be the result of an injury, such as a broken nose, or something that the person was born with, such as small or crooked nasal passages. Structural rhinitis may produce year-round congestion that usually affects one side of the nose more than the other. Surgery can aid in correcting this abnormality.
Symptoms of rhinitis can also be caused by nasal polyps—growths on the mucus membrane of the nose that can cause congestion and loss of sense of smell. They provoke symptoms year-round and usually begin between the ages of 20 and 40. Nasal polyps may be associated with aspirin sensitivity and asthma, and may cause recurrent sinusitis. Decongestants or corticosteroid nasal sprays or pills may provide temporary relief. Nasal polyps can be surgically removed, but they have a tendency to recur.
By learning about the causes and symptoms of various forms of rhinitis, you will be better able to identify your symptoms and triggers. Your allergist can assist by making an accurate diagnosis and developing an effective treatment plan for you.