Rhinitis

There are two types of rhinitis – allergic and non-allergic. Allergic rhinitis is the most common and many of you will be familiar with the most frequent type, hay fever. For many people, rhinitis symptoms are mild and come and go at times of the year or under certain conditions. However, persistent rhinitis can occur, which generally leaves you feeling unwell most of the time.

Facts about rhinitis:

  • Over 20% of the UK population has one or more allergic disorder, according to Allergy UK.
  • Between 10% and 30% of adults, and as high as 40% of children, suffer with allergic rhinitis
  • Sleep issues are a big problem with allergic rhinitis, affecting 57% of adults and 88% of children
  • Sleep deprivation leads to daytime fatigue, somnolence and decreased cognitive function
  • There is no cure for allergic rhinitis
  • However, following diagnosis, effective treatment is available to manage symptoms
  • Non allergic rhinitis is harder to diagnose, as there is no clear allergen that causes the symptoms
  • Persistent rhinitis refers broadly if you get symptoms for an hour or more per day, more or less every day of the year
  • For either form of rhinitis, a specialist respiratory physician can conduct the necessary diagnosis tests and discuss your treatment options

Symptoms of rhinitis

Rhinitis, both allergic and non-allergic tends to produce similar symptoms. They are typical to that of a cold and may include:

  • Sneezing
  • Itchiness
  • Blocked or runny nose
  • Irritated nose, or mild discomfort
  • Reduced sense of smell

With allergic rhinitis, symptoms are stimulated when exposed to an allergen. To this extent, symptoms may not be persistent and may only appear when you are under certain conditions, or at certain times of the year.

Some people though may experience symptoms of allergic rhinitis all year round. Here, general daily life can be affected, as symptoms cause sleep problems, tiredness and general mood.

In some, rare, cases non-allergic rhinitis may cause a crust to form inside the nose. This can produce a nasty smell or cause bleeding if you try to remove it.

If you are experiencing any symptoms of allergic or non-allergic rhinitis then seek the help of a medical specialist that can help determine treatment options.

What causes allergic rhinitis?

Allergic rhinitis is caused when your body’s natural defences react to an allergen, assuming it is harmful.

This sensitivity in your immune system produces antibodies, which are proteins in the blood designed to fight infections and viruses.

As part of this defence process, the antibodies release chemicals, including histamine, which can cause symptoms such as inflammation of the nose and generation of excess mucus. This is typical of what you experience as a blocked or runny nose, which many cause unusual levels of sneezing.

Common culprits to cause allergic rhinitis

Some people are allergic to just one allergen, where as others may be allergic to several.

Common allergens include:

  • Pollen and spores from grass and trees – known as hey fever
  • Animal skin or their urine or saliva
  • House dust mites
  • Occupational substances such as wood dust, flour or latex

What causes non-allergic rhinitis?

Non-allergic rhinitis is caused by an inflammation and swelling of the lining of the nose. It is usually due to swollen blood vessels and a build-up of fluid in the nasal tissues.

The swelling blocks the passages of the nose and can cause the gland in the nose to produce excessive mucus, like what you experience with a cold.

Common causes of non-allergic rhinitis

  • Infection – a viral, bacterial or fungal infection, can attack the lining of the nose and throat
  • Environmental (vasomotor or autonomic rhinitis) – can be triggered by substances in the environment such as perfume, smoke, paint fumes, weather changes, alcohol, spicy food or stress. This type of non-allergic rhinitis is believed to occur if you have highly sensitive nasal blood vessels.
  • Medication – beta-blockers, NSAIDs and angiotensin-converting enzyme (ACE) inhibitors are a few medications known to cause non-allergic rhinitis
  • Recreational drug misuse – particularly cocaine
  • Overuse of nasal decongestants (rhinitis medicamentosa) – can cause swelling in the nose lining
  • Hormonal imbalance – caused by pregnancy, puberty, the contraceptive pill or HRT
  • Tissue damage in the nose
A specialist consultation gives your health the attention it deserves.

Diagnosing and treating rhinitis

Diagnosing rhinitis, either allergic or non-allergic, is the first step to managing your symptoms and considering your treatment options.

Whilst the symptoms of allergic rhinitis may improve gradually over time, without treatment, symptoms may worsen and it is not likely for the condition to disappear completely.

A consultation with a specialist respiratory physician will discuss your symptoms and carry out some tests that can help assess your symptoms.

Tests for diagnosing allergic and non-allergic rhinitis include:

  • Consultation to discuss your symptoms and family history
  • Allergy testing
  • Skin prick test
  • Blood test
  • Nasal endoscopy – using an endoscope (a thin tube with a light and camera), your doctor can inspect inside your nose to assess abnormalities
  • Nasal inspiratory flow test – measuring air flow when you inhale through your nose
  • CT scan – may be used to capture images inside your body

Particularly for allergic rhinitis, following diagnosis, the best way to manage your symptoms is to avoid your allergens:

  • Avoid keeping pets, or keep them outside and don’t let them in the bedroom. Wash them regularly.
  • Keep homes well ventilated
  • Avoid thick carpets in the house
  • Opt for wooden floors where dust can be cleaned more easily
  • Stay inside when pollen counts are high

Treatments for rhinitis will depend on the severity of your symptoms, as well as the cause.

Common treatment options include:

  • Antihistamines
  • Cleaning nasal passages regularly with warm water or salt solution
  • Medication
  • Corticosteroids
  • Nasal sprays, including:
    • Antihistamine spray
    • Corticosteroid spray
    • Anticholinergic sprays
    • Decongestant sprays
  • Immunotherapy

Seek the right help to feel your best

To feel our best is ultimately everyone’s goal in life.

Often it is only when a condition arises, leaving us feeling unwell, that it becomes clear as to the value of our health.

Expert help is available to help you to better understand, manage and improve symptoms related to your respiratory health.

A specialist consultation gives your health the attention it deserves.