Allergic or non-allergic rhinitis is characterized by chronic sneezing or a congested, runny nose with no apparent cause. The symptoms of non-allergic rhinitis are similar to those of hay fever (allergic rhinitis), but without the usual evidence of an allergic reaction.
Non-allergic rhinitis can affect children and adults, but is more common after the age of 20. Triggers vary and can include certain odors or irritants in the air, changes in weather, certain medications, certain foods, and chronic health conditions.
The diagnosis, carried out by an ENT specialist, may include blood tests, especially to exclude allergic forms.
Symptoms
In the case of non-allergic rhinitis, symptoms may appear and vary throughout the year.
The most common are:
• Stuffy or runny nose
• Sneezing
• Mucus in the throat
• Cough
The non-allergic form is usually not accompanied by itching of the nose, eyes or throat, symptoms associated with allergic forms.
When to consult a doctor
Contact your doctor if:
• There is an aggravation of symptoms
• You have signs and symptoms that do not improve with the use of medications or avoidance of triggers
Causes
The etiology of the non-allergic form is still unknown.
What is known is that when it occurs there is an expansion of the blood vessels in the nose which fill the nasal lining with blood and fluid. There are many possible causes, including a particular reactivity of the nerve endings in the nose, similar to the way the lungs react in asthma.
Whatever the trigger, the result is the same: swollen nasal membranes, congestion, or excessive mucus.
Examining the triggering factors we find:
- Irritants, environmental or professional: Dust, smog, passive smoking or strong odors, such as perfumes. Chemical fumes, such as those you may be exposed to in certain work activities, can also be a cause.
- Weather changes: Changes in temperature or humidity can cause the
membranes inside the nose and cause a runny or stuffy nose.
- Some medications: Medications that can cause non-allergic rhinitis include aspirin, ibuprofen, high blood pressure 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. The abuse of decongestant nasal sprays can cause a non-type of rhinitis
- Foods and drinks: Nonallergic rhinitis can occur when eating, especially when eating hot or spicy foods. Drinking alcoholic beverages can also cause the membranes inside the nose to swell, resulting in nasal congestion.
- Some medications: Medications that can cause non-allergic rhinitis include aspirin, ibuprofen, high blood pressure 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 non-allergic rhinitis called rhinitis medicamentosa.
- Hormonal changes: Hormonal changes due to pregnancy, menstruation, use of oral contraceptives, or other hormonal conditions such as hypothyroidism can cause non-allergic rhinitis.
- Sleeping positions and conditions: Sleeping on your back, sleep apnea and acid reflux. Lying on your back while sleeping can cause nonallergic rhinitis, as can obstructive sleep apnea or acid reflux.
Risk factors
Factors that may increase the risk of non-allergic rhinitis include:
• Exposure to irritants: Being exposed to irritants such as smog, exhaust fumes or tobacco smoke could put us at greater risk of developing non-allergic rhinitis.
• Being over age 20: Unlike allergic rhinitis, which usually occurs before age 20, nonallergic rhinitis occurs after age 20 in most people.
• Prolonged use of decongestant nasal drops or sprays: Using decongestant nasal drops or sprays for more than a few days can actually cause more severe nasal congestion as the decongestant wears off, often called rebound congestion.
• Sex: Due to hormonal changes, nasal congestion often worsens during menstruation and pregnancy, thus affecting women of childbearing age more.
• Occupational exposure to fumes: In some cases, non-allergic rhinitis is triggered by exposure to an irritant in the air at work (occupational rhinitis). Some common triggers include building materials, solvents or other chemicals, and fumes from the decomposition of organic material such as compost.
• Clinical conditions: Several chronic health conditions can cause or worsen nonallergic rhinitis, such as hypothyroidism, chronic fatigue syndrome, and diabetes.
Related disorders:
Non-allergic rhinitis could be linked to:
- Nasal polyps, soft, noncancerous (benign) growths that develop on the lining of the nose or sinuses due to chronic inflammation. Small polyps may not cause problems. But larger polyps can block airflow through the nose, making it difficult to breathe.
- Sinusitis. Prolonged nasal congestion due to nonallergic rhinitis can increase your chance of developing an infection or inflammation of the lining of the sinuses (sinusitis).
- Daily activities interrupted. Nonallergic rhinitis can be disruptive. You may be less productive at work or school. You may also need to take time off due to symptom flare-ups or doctor visits.
Prevention
Some measures can be taken to reduce symptoms and prevent flare-ups:
• Avoid triggers. If you can identify the causes or worsening of symptoms, avoiding triggers can make a big difference.
• Do not abuse nasal decongestants. Using these drugs for more than a few days at a time can make symptoms worse.
• Osteopathic treatment can be a valid ally in the treatment of this disorder
Allergic rhinitis
As for the allergic form, this is associated with itching, watery eyes, sneezing, nasal congestion and rhinorrhea (runny nose). Symptoms can be seasonal or year-round.
Specialists perform a comprehensive evaluation that includes reviewing environmental history and a physical exam. Allergen tests may be necessary. After this first step, a treatment regime is outlined that emphasizes strategies, drugs and, if necessary, also immunotherapy, to avoid allergens