Chronic rhinitis is a common disorder that affects persons of all ages. The usual symptoms – runny nose, congestion, sneezing and itchy watery eyes – may appear occasionally or almost all the time, and can range from mild to distressing. This guide explains what causes chronic rhinitis and what your doctor can do to help relieve the annoying symptoms.
Recurrent nasal blockage/discharge that doesn’t resolve on its own is called chronic rhinitis . It often results from irritation or inflammation in the nose. When it is caused by an allergic reaction, it is called allergic rhinitis; otherwise, it is called nonallergic rhinitis.
Allergic rhinitis: The symptoms of allergic rhinitis – commonly called “hay fever” – include sneezing, runny nose, nasal congestion and itching of the nose and throat. The nasal discharge from allergic rhinitis is usually clear and watery. If the discharge is white, green, yellow or bloody, a sinus infection may also be present.
You may also have symptoms of allergic conjunctivitis , such as itchy, red watery eyes. The substances that cause allergic rhinitis and/or conjunctivitis are called allergens .
The most common allergen is wind borne pollen produced by trees, grasses, and weeds. Other allergens include pet dander, house dust, indoor and outdoor molds, and some workplace irritants. Foods are not a common cause of allergic rhinitis in adults, but certain foods may cause nasal symptoms in some young children.
Nonallergic rhinitis: This type of rhinitis affects many people, but its cause is often unknown. Symptoms include nasal congestion and/or runny nose, but itching is not usually as severe as in allergic rhinitis.
Nonallergic rhinitis is associated with changes in the central nervous system’s control of the blood vessels in the nose. These changes make the nose more sensitive to various factors including emotional upsets, changes in humidity, or exposure to chemicals, fumes, smoke, drafts, or wind.
Occasionally, nonallergic rhinitis occurs during pregnancy, but may disappear after childbirth. Some medications, including aspirin and birth control pills, may also cause nasal symptoms.
Nasal obstruction, such as that caused by a deviated septum, nasal polyps, or a foreign body, (particularly in children), can lead to congestion. Sinus infections may also lead to nasal congestion and produce a colored nasal discharge. These infections may cause pain or pressure where the sinuses are located – in the cheeks and forehead and near the eyes – as well as on the top or sides of the head.
Asking questions about your symptoms and examining your nose will be the first steps your doctor will take to determine the type of rhinitis you have. For example, if your symptoms occur only at certain times of the year, you most likely have “hay fever” to pollen. Year-round symptoms are less likely to be caused by an allergy, except if the allergic reaction is caused by continuous exposure to pet dander or house dust.
Sinus x-ray films may also be needed to see if sinus infection is present. Allergy skin tests may be used to find out whether certain allergens are responsible for triggering some or all of your nasal symptoms.
If you are allergic to one or more substances, then the best treatment is to avoid them. But it is impossible to avoid many substances, such as pollen.
Antihistamines and prescription nasal sprays may be helpful for allergic rhinitis. If they do not bring your symptoms under control, your doctor may suggest allergen immunotherapy (allergy shots) to increase your tolerance to the allergens identified by skin tests.
Nonallergic rhinitis also may be treated with medicines, such as decongestants, prescription nasal sprays and, sometimes, saline (salt water) nasal sprays. Allergy shots do not help nonallergic rhinitis . Decongestant sprays that you can buy without a prescription should not be used longer than a few days. These sprays may become habit-forming, and overuse might actually worsen your symptoms.
If you have a sinus infection, your doctor may prescribe an antibiotic. If your rhinitis symptoms are caused by nasal obstruction, such as a deviated septum, surgery may be necessary.
*Adapted from the Journal of Respiratory Diseases