Non-Allergic Rhinitis
Rhinitis symptoms not driven by allergies, including irritant and vasomotor triggers.
Overview
Non-allergic rhinitis causes nasal symptoms similar to allergic rhinitis but without IgE-mediated sensitization. It can be triggered by environmental irritants, medications, or hormonal changes.
types
irritant
Triggered by strong odors, smoke, perfumes, cleaning products, or weather changes.
vasomotor
Overreactive nasal blood vessels causing congestion, often triggered by temperature changes or humidity.
medication
Caused by certain medications like ACE inhibitors, beta-blockers, or overuse of nasal decongestants.
hormonal
Related to pregnancy, menstrual cycle, or thyroid disorders.
symptoms
- Nasal congestion
- Runny nose
- Post-nasal drip
- Sneezing (less common than allergic rhinitis)
evaluation
- Detailed history of symptom triggers
- Allergy testing to rule out allergic causes
- Nasal endoscopy to assess anatomy
- Consideration of medication history
treatment
medications
- Nasal saline irrigation
- Nasal corticosteroids (may help with inflammation)
- Nasal antihistamines (azelastine)
- Ipratropium nasal spray (for runny nose)
- Avoidance of triggers when possible
lifestyle
- Identify and avoid irritant triggers
- Use humidifiers in dry environments
- Avoid rapid temperature changes
- Consider air purifiers
referral
Refer to ENT specialist if symptoms persist despite treatment, if there's concern for structural issues, or if additional evaluation is needed.
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