Non-allergic rhinitis

What is rhinitis?

• “Rhinitis” occurs when blood vessels in your nose expand, causing inflammation or swelling in the nose. This can lead to 1 or more of the following symptoms:
  
  • stuffy nose
  • runny nose
  • post-nasal drip (mucus draining down the back of the throat)
  • sneezing
  • nasal itching
• Almost everyone experiences rhinitis at some point in their life.
• Short episodes of rhinitis are usually caused by respiratory tract infections with viruses (the common cold).
• Rhinitis symptoms that last for weeks to months at a time for at least 1 year are typically referred to as “chronic rhinitis.”

What causes chronic rhinitis?

• Rhinitis can be grouped into 2 different categories, based on what causes the symptoms to occur:
  
  • 1) Allergic rhinitis (e.g. “hay fever” or allergies to pollen, cat, dog, and/or
    mold) OR
  • 2) Non-allergic rhinitis
  • Some people can have a combination of both allergic and non-allergic rhinitis
    (known as “mixed” rhinitis).
• In order to determine the cause of your child’s rhinitis, your doctor will take a detailed history and perform a physical exam. Skin prick or blood tests may also be performed. These tests look for the presence of an allergy antibody (“IgE”) to various allergens in the environment. If the testing is negative, then it is unlikely that you have “allergic” rhinitis and a diagnosis of “non-allergic” rhinitis is often made. 

What can cause non-allergic rhinitis?

• Tobacco smoke
• traffic fumes
• strong odors (perfumes, essential oils, etc.)
• certain foods/beverages
• certain medications
• infections
• stress
• hormone changes
• changes in weather

How is non-allergic rhinitis treated?

• Avoid your triggers as best as you can.
• Nasal saline rinsing and irrigation
  
  • Rinse the nose with a salt water (saline) solution one or more times a day.
  • There are a variety of over the counter devices for rinsing the nose, including irrigation pots and bottle sprays.
  • Salt water solution is sold over the counter, but you can choose to mix your own solution at home.
  • If your doctor prescribes you a medicated nasal spray, try using saline first.
    and then having your child blow their nose. Wait 5 minutes and then apply your medicated nasal spray.
  • Please see www.uptodate.com for directions on “How to Perform Nasal Irrigation”.
• Nasal glucocorticoids (steroids) –Typically, the most effective medication for all forms of rhinitis. These are available over the counter and by prescription. These agents are most effective when used regularly.
• Nasal antihistamines – Sometimes used in combination with nasal glucocorticoids. These types of antihistamines usually work better than oral antihistamines for nonallergic rhinitis.
• Oral decongestant medications (containing ingredients such as
  “pseudoephedrine” or “phenylephrine”) are typically not recommended because of potential side effects

I’m doing my treatments but things aren’t getting better. What should I do?

• Talk to your doctor about how you’re using your nasal sprays. Proper technique is important in getting the medicine to the right place.
• Ask your doctor whether additional testing is needed.