At least one out of three people with nasal symptoms have no allergies. Non-allergic rhinitis usually afflicts adults and causes year-round symptoms, especially runny nose and nasal congestion . This problem differs from allergic rhinitis because the immune system does not seem to be involved. Unfortunately, we do not have good understanding of why non-allergic rhinitis occurs.
Some people with non-allergic rhinitis have inflammation in their nose and sinuses. In the most severe forms of this problem, patients have polyps, which are growths on the mucus membranes of the nose that block the airflow in the nose. Patients with these problems also suffer from loss of the sense of smell. In other forms of non-allergic rhinitis there is very little if any inflammation in the nose and the symptoms are mostly triggered by strong smells, pollution, barometric pressure changes, smoke and other irritants. Some doctors call this condition vasomotor rhinitis.
Symptoms of non-allergic rhinitis can be caused by medications as side-effects. These include some blood pressure medicines, oral contraceptives, or medications used for erectile dysfunction. The most common form of this type of non-allergic rhinitis is caused by nasal decongestant sprays, when they are used by some people for long periods of time there tends to be a rebound effect where nasal congestion worsens when the medication wears off. This type of medication-induced rhinitis is also called rhinitis medicamentosa .
Nasal steroids as well as antihistamine nasal sprays have been found helpful in relieving most of the symptoms of non-allergic rhinitis.
Nasal steroids are particularly helpful if there is inflammation in the nose. If the nose is runny, ipratropium nasal spray can provide relief and/or be a protective measure. If nasal congestion is a major problem, nasal steroids, nasal antihistamines, or decongestant pills may be used. Decongestant pills should be used with caution in those with high blood pressure as they can affect heart rate and blood pressure as well as cause sleeplessness and jitteriness.
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/immunologist can assist by making an accurate diagnosis and developing an effective treatment plan for you.
This is a handout from the Asthma and Allergy Affiliates reviewing current understanding of non-allergic rhinitis including irritant triggers that lead to exacerbations. These handouts are intended for our patients and are not a substitute for discussing your (or your child’s) unique situation with one of our physicians.