What is Non allergic Rhinitis

Non allergic rhinitis is a condition that causes symptoms that affect the nose, such as a runny nose and a stuffed-up nose (nasal congestion) that can make it hard to breathe through the nose.

This condition is different from having an allergy (allergic rhinitis). Allergic rhinitis occurs when the body’s defense system (immune system) reacts to a substance that you are allergic to (allergen), such as pollen, pet dander, mold, or dust.

Nonallergic rhinitis has many similar symptoms, but it is not caused by allergens. Nonallergic rhinitis can be a short-term or long-term problem.

What are the causes?

This condition can be caused by many different things. Some common types of nonallergic rhinitis include:

Infectious rhinitis

• This is usually due to an infection in the upper respiratory tract.

Vasomotor rhinitis

• This is the most common type of long-term nonallergic rhinitis.
• It is caused by too much blood flow through the nose, which makes the tissue inside of the nose swell.
• Symptoms are often triggered by strong odors, cold air, stress, drinking alcohol, cigarette smoke, or changes in the weather.

Occupational rhinitis

• This type is caused by triggers in the workplace, such as chemicals, dusts, animal dander, or air pollution.

Hormonal rhinitis

• This type occurs in women as a result of an increase in the female hormone estrogen.
• It may occur during pregnancy, puberty, and menstrual cycles.
• Symptoms improve when estrogen levels drop.

Drug-induced rhinitis

Several drugs can cause nonallergic rhinitis, including:

• Medicines that are used to treat high blood pressure, heart disease, and Parkinson disease.
• Aspirin and NSAIDs.
• Over-the-counter nasal decongestant sprays. These can cause a type of nonallergic rhinitis (rhinitis medicamentosa) when they are used for more than a few days.

Nonallergic rhinitis with eosinophilia syndrome (NARES)

• This type is caused by having too much of a certain type of white blood cell (eosinophil).

Nonallergic rhinitis can also be caused by a reaction to eating hot or spicy foods. This does not usually cause long-term symptoms. In some cases, the cause of nonallergic rhinitis is not known.

What increases the risk?

You are more likely to develop this condition if:

• You are 30–60 years of age.
• You are a woman. Women are twice as likely to have this condition.

What are the signs or symptoms?

Common symptoms of this condition include:

• Nasal congestion.
• Runny nose.
• The feeling of mucus going down the back of the throat (postnasal drip).
• Trouble sleeping at night and daytime sleepiness.

Less common symptoms include:

• Sneezing.
• Coughing.
• Itchy nose.
• Bloodshot eyes.

How is this diagnosed?

This condition may be diagnosed based on:

• Your symptoms and medical history.
• A physical exam.
• Allergy testing to rule out allergic rhinitis. You may have skin tests or blood tests.

In some cases, the health care provider may take a swab of nasal secretions to look for an increased number of eosinophils. This would be done to confirm a diagnosis of NARES.

How is this treated?

Treatment for this condition depends on the cause. No single treatment works for everyone. Work with your health care provider to find the best treatment for you. Treatment may include:

• Avoiding the things that trigger your symptoms.
• Using medicines to relieve congestion, such as:
  • Steroid nasal spray. There are many types. You may need to try a few to find out which one works best.
  • Decongestant medicine. This may be an oral medicine or a nasal spray. These medicines are only used for a short time.
• Using medicines to relieve a runny nose. These may include antihistamine medicines or anticholinergic nasal sprays.

Surgery to remove tissue from inside the nose may be needed in severe cases if the condition has not improved after 6–12 months of medical treatment.

Follow these instructions at home:

• Take or use over-the-counter and prescription medicines only as told by your health care provider. Do not stop using your medicine even if you start to feel better.
• Use salt-water (saline) rinses or other solutions (nasal washes or irrigations) to wash or rinse out the inside of your nose as told by your health care provider.
• Do not take NSAIDs or medicines that contain aspirin if they make your symptoms worse.
• Do not drink alcohol if it makes your symptoms worse.
• Do not use any tobacco products, such as cigarettes, chewing tobacco, and e-cigarettes. If you need help quitting, ask your health care provider.
• Avoid secondhand smoke.
• Get some exercise every day. Exercise may help reduce symptoms of nonallergic rhinitis for some people. Ask your health care provider how much exercise and what types of exercise are safe for you.
• Sleep with the head of your bed raised (elevated). This may reduce nighttime nasal congestion.
• Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if:

• You have a fever.
• Your symptoms are getting worse at home.
• Your symptoms are not responding to medicine.
• You develop new symptoms, especially a headache or nosebleed.