Allergic and Persistent Rhinitis: What’s the Difference?

Allergic and Persistent Rhinitis: What’s the Difference?

While the symptoms might feel the same – blocked, runny nose, sneezing, reduced sense of smell and nasal irritation – the causes of allergic and persistent (also called non-allergic) rhinitis are very different.

Persistent rhinitis

Persistent rhinitis is inflammation of the inside of the nose that is not due to an allergy. This inflammation blocks the nasal passages and stimulates the mucus glands, causing the nose to run. Blood vessels become swollen and fluid builds up in the tissues of the nose resulting in the characteristic blocked, stuffy nose sensation.

It generally affects people with sensitive nasal blood vessels and while the precise cause is not known, a number of factors may trigger the symptoms, including:

  • Environmental factors such as pollution, smoke, paint fumes, cold temperatures or strong perfume.
  • Viral, bacterial or fungal infections that affect the lining of the nose and throat.
  • Hormonal changes (for example, due to pregnancy or puberty) or medications containing hormones such as the contraceptive pill.
  • Damage to nasal tissues. This may occur during certain types of surgery and can lead to the nasal tissues becoming crusty, inflamed or prone to infection.
  • Overuse of nasal decongestants. These should be used for no longer than seven days or they could exacerbate the problem.
  • Spicy food or alcohol.
  • Certain types of medication, including anti-inflammatories, beta blockers and ACE inhibitors for high blood pressure.
  • Drug abuse, such as snorting cocaine, which can affect the lining of the nose.
  • Certain health conditions such as hypothyroidism.

Allergic rhinitis

As its name suggests, allergic rhinitis is caused by an allergen, such as pollen, dust, mould or animal dander, which triggers the immune system to become oversensitised. The immune system responds to such triggers as though they are harmful, producing antibodies to fight them off.

These antibodies cause the mucous membranes inside the nose to swell and produce mucus. The precise mechanism that causes some people to become oversensitive to allergens is not completely understood but it appears to run in families. Exposure to high levels of allergens at a young age may also increase a person’s risk of allergic rhinitis.

Around one in five people in the UK suffer from this condition, which can vary in severity from mild nasal irritation to a streaming nose and eyes. Common allergens include:

  • Pollen from trees and grasses and spores from mould and fungi.
  • Animal dander (flakes of skin, saliva and urine).
  • House dust mites – These are found in bedding and soft furnishings and feed on dead flakes of human skin. Their excrement can produce an allergic reaction in some people.
  • Environmental allergens – Exposure at work to certain types of dust (for example, wood dust) can trigger allergic rhinitis in some people.

Diagnosis and Treatment of Allergies

Your doctor may use a range of tests to diagnose which type of rhinitis you have, including:

  • A skin prick test which entails pricking the surface of the skin with a needle and introducing a tiny amount of an allergen to see if your skin reacts.
  • A blood test to check for the antibody immunoglobin E, which is produced by your body in response to a suspected allergen.
  • Checking the inside of your nose for nasal polyps, which are harmless swellings that can grow inside the lining of your nose in response to inflammation.

Depending on the type of rhinitis you are experiencing, you may be offered different types of treatment, including:

  • Antihistamines which can help reduce the symptoms of allergic rhinitis by blocking a chemical called histamine that is released by the body in response to attack from an allergen.
  • In the case of allergic rhinitis, the most effective treatment is to avoid the allergens that cause sensitivity, although this is not always possible. However, reducing your exposure as much as possible, such as staying indoors when there is a high pollen count, is advisable.
  • Corticosteroids to reduce inflammation and swelling.
  • Immunotherapy, which involves gradually exposing your body to more and more allergens to desensitise your immune system.
  • Cleaning your nasal passages with a salt water solution to keep them free from irritants. This can be performed at home but you should always use fresh solution.

Allergy advice for you and your family | Berkshire

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