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Non Allergic Rhinitis – Symptoms, Causes & Treatment

What is non-allergic rhinitis?

Non-allergic rhinitis is a condition in which the inside of the person’s nose becomes inflamed or swollen that cause cold-like symptoms such as sneezing, runny nose, blocked nose, and itchiness.

Often people with non-allergic rhinitis may have a runny nose that does not seem to get better, or they may also develop recurring symptoms.

Non-allergic Rhinitis
Non-allergic Rhinitis

If a person has rhinitis, the blood vessels inside the nose expand and cause the lining of the nose to swell. This stimulates the mucus glands in the nose and causes it to become congested and dripping.

Non-allergic rhinitis affects both children and adults. Women may be prone to nasal congestion during menstruation and pregnancy.

You probably have symptoms that come and go around when you have non-allergic rhinitis. These symptoms may be for a short time or may stay for a long time.

These symptoms include:

  • Stuffy Nose
  • Runny Nose
  • Sneezing
  • Mucus in the throat
  • Cough
  • Mild irritation around your nose
  • Reduced sense of smell

Types of Non-allergic Rhinitis

Non-allergic rhinitis has various types which are mentioned below:

  • Vasomotor Rhinitis – It is triggered by physical conditions like strong odors, perfumes, change in temperature or humidity, smoke, fumes, and bright sunlight. In this condition, most people will experience nasal congestion or a runny nose.
  • Infectious Rhinitis – It is related to a bacterial or viral infection. Its symptoms can be facial pain and green nasal discharge. Infectious rhinitis resolves within a few days on its own.
  • Hormonal Rhinitis – It can occur in pregnant women and in patients with low thyroid function. Symptoms of nasal congestions occur during the second month of pregnancy and can continue until the baby is born. But these symptoms disappear shortly after delivery.
  • Medication-induced Rhinitis – It can occur in patients who use high blood pressure medication, birth control pills, and non-steroidal anti-inflammatory drugs like aspirin and ibuprofen.
  • Rhinitis Medicamentosa – It is caused by overuse of over-the-counter decongestant sprays like Afrin. People who use these sprays regularly become addicted to the medication.
  • Gustatory Rhinitis – It can be related to the over intake of food or alcohol. Its symptoms are a runny nose, watery fluid, especially after eating hot or spicy foods.
  • Rhinitis Related to Acid Reflux – It is a common disease in young children. Its symptoms are nasal congestion, runny nose, and post nasal drip. These symptoms can occur in the morning because the person is having acid reflux while lying flat at the night before. And they can also occur after heavy meals.

Causes of Non-allergic Rhinitis

It is unclear as to what really causes non-allergic rhinitis in children as well as adults. And the condition is often confirmed only after other conditions, such as allergic rhinitis or infections are ruled out.

Environmental irritants are the ones that commonly triggers non-allergic rhinitis in people. While a few types of irritants are basically found in homes, there are also other types which are more prevalent in the surroundings and workplace.

Some of the common irritants that can affect individuals are:

  • Smog
  • Carbon dioxide exhaust from vehicles
  • Laundry detergents
  • Glues
  • Chlorine
  • Perfume
  • Hair spray
  • Cigarette smoke
  • Dust from wood
  • Metal Salts
  • Latex
  • Cleaning solutions
  • Change in Wheather

When such triggers help in causing non-allergic rhinitis, they also often helps in causing asthma.

Use of certain medicines can also trigger non-allergic rhinitis, such as:

  • Anti-inflammatory drugs such as aspirin and ibuprofen
  • Oral contraceptives
  • Medicines for blood pressure
  • Anti-depressants
  • Tranquilizer
  • Drugs used for treating erectile dysfunction

Foods and beverages may also contribute to the cause of non-allergic rhinitis. These include hot foods (soup), spicy food and alcoholic beverages.

Apart from these, there may be other triggers like the use of illegal drugs, changes in the weather, rise and fall in temperature, hormonal changes and so on.

Complications

Complications related to non-allergic rhinitis include:

Nasal Polyps

Nasal polyps are soft and noncancerous growth that develops on the lining of the nose because of chronic inflammation. Small or tiny polyps don’t cause any problem but the large ones are able to block the airflow of your nose which makes difficulty in breathing.

Nasal Polyps
Nasal Polyps

Sinusitis

Long nasal congestion due to nonallergic rhinitis can increase your chance of developing sinusitis. It is an infection or inflammation of the membrane.

Sinusitis
Sinusitis

Middle Ear Infections

Increased level of fluid or nasal congestion can lead you to a middle ear infection. It is also called as Otitis Media.

Middle Ear Infections

Obstructed Daily Activities

Non-allergic rhinitis can be harmful that can make you less productive at work. Also, it makes you take time off because of symptoms flares and doctor visits.

Risk Factors of Non-allergic Rhinitis

Some factors that can increase the risk of non-allergic rhinitis include:

  • Exposure to irritants – Exposure to irritants like smog, exhaust fumes or tobacco smoke can increase the risk of developing nonallergic rhinitis.
  • Age – It occurs after age 20 in most people unlike allergic rhinitis, that often occurs before age of 20 or in childhood.
  • Regular Use of Nasal Sprays – Using over-the-counter nasal sprays or decongestant nasal drops like Afrin and Dristan, for more than a few days can cause more-severe nasal congestion.
  • Being Female – Because of hormonal changes, nasal congestion usually gets worse during menstruation and pregnancy.
  • Exposure to Fumes – Sometimes, nonallergic rhinitis is triggered by exposure to airborne irritant at the workplace. Some other triggers are construction materials, solvents, chemicals, and fumes from decomposing organic material.
  • Certain Health Problems – Some health conditions like hypothyroidism and chronic fatigue syndrome can cause or worsen rhinitis.
  • Stress – In some people, emotional or physical stress can also trigger non-allergic rhinitis.

Diagnosis of Non-allergic Rhinitis

It is diagnosed on your symptoms basis and ruling out other causes like allergies by either performing a physical examination or simply by just asking questions about your symptoms.

In some cases, your doctor may want you to try a medication and see whether your symptoms improve. If not, then your doctor may carry on with two methods which are “Ruling out an allergic cause” and the second one is “Ruling out sinus problem”. Let’s discuss what are these two terms is useful for.

Ruling out an Allergic Cause

Many times rhinitis is caused by an allergic reaction. To check out if your rhinitis is caused by an allergic reaction or not, you have to go through allergy testings which are:

Skin Test

In this test, your skin is pricked and exposed to a tiny amount of common airborne allergens like dust mites, pollen, cat and dog dandruff. If you found allergic to a particular allergen, you will develop a hive (raised bump) on the test location of your skin. And if you are not found allergic to any of the substances than your skin stays normal.

Blood Test

Through a blood test, your immune system’s response to common allergens is measured by measuring the number of antibodies in your bloodstream.

Ruling out Sinus Problem

You might also want to be sure that your symptoms of rhinitis are not caused by a sinus problem. And to ensure this, you have to go through an imaging test to view your sinuses. These tests are:

Nasal Endoscopy

In this test, a doctor will look inside your nasal passages with the help of a thin, fiber optic viewing instrument called Endoscope. The endoscope will be passed through your nostrils to examine your nasal passages and sinuses. Watch the below video to know how it’s done:

Computerized tomography scan

CT Scan is a computerized X-ray technique that helps in producing images of your sinuses that are in more details in comparison of conventional X-ray exams. Watch the video below to understand in detail:

Treatment

Home Remedies

Although there is no cure for non-allergic rhinitis, however, it is possible to treat or control the condition by the help of the following:

  • Avoiding rhinitis triggers
  • Using home remedies such as nasal irrigation
  • Taking over-the-counter and prescribed medicines

If you have non-allergic rhinitis, it is important to keep away from smoking – both active smoking and passive or second-hand smoking. Other measures that can help reduce exposure to triggers include:

  • Avoid using wood-burning stoves and fireplaces.
  • Avoid using cleaning agents such as household sprays, perfumes, room freshening sprays, and other scented products.
  • Scented products at your workplace should be avoided.
  • Any chemical or material that tends to make you sneeze or have a runny nose should be avoided.

If the above tips don’t work out than consult your doctor for medications.

Medicines

However, for mild cases home treatment and avoiding triggers may be enough but for more severe symptoms, certain medications may provide relief. These are:

  • Saline Nasal Spray – Use of an over-the-counter nasal spray or a homemade saltwater solution is good to flush irritants of your nose. It also helps in thinning of mucus and soothering of membranes in your nose. Watch the following video to know how to do it:

  • Corticosteroid Nasal Sprays – If your symptoms are not getting in control by decongestants or antihistamines than your doctor might suggest you a nonprescription corticosteroid like Fluticasone or Triamcinolone.
  • Antihistamine Nasal Spray – Nasal sprays that contain antihistamine can help in reducing the symptoms of non-allergic rhinitis. These antihistamine nasal sprays include Azelastine and Olopatadine hydrochloride.
  • Anti-drip Anticholinergic Nasal Sprays – The popular drug used as an asthma inhaler medication that is Ipratropium is now also available as a nasal spray. It can be helpful to get rid of a runny or drippy nose.
  • Decongestants – These can help in narrowing of the blood vessels that results in reducing congestion in the nose. You can get it on over-the-counter or by prescription. These medications include Pseudoephedrine and Phenylephrine.

These are some medications that can provide you with relief from bothersome symptoms of non-allergic rhinitis. But we advise you to consult your doctor first before taking any of the medications.

Conclusion

Many people with non-allergic rhinitis often benefit from performing nasal irrigation, where rinsing the nostrils with salt water once or twice daily can help in giving relief. Avoiding given triggers in this article may also help you to get relief from non-allergic rhinitis.

And if you are not getting relief from any of the above methods than consult your doctor as soon as possible. Your doctor will check out your condition and symptoms and can suggest you the best to cure it

Non Allergic Rhinitis – Symptoms, Causes & Treatment
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