Chronic rhinitis is an inflammation of the nose: the most common symptoms are sneezing, narrowed or stuffy nose, itching and a nose running from both nostrils.
Sometimes there is a scratching in the throat, the patient no longer perceives the smells properly and has a headache. In addition, the eyes are reddened, he often has increased lacrimation and itchy eyes.
The most common cause is a runny nose, but an allergic form or “hay fever” is also very common.
Allergic rhinitis is not contagious.
If rhinitis persists, symptoms appear over a long period of time; a technical definition of persistent rhinitis is based on the duration of symptoms that manifest for an hour or more on all days of the year.
However, there is a wider range of variation: in many cases, the symptoms are present for a few hours almost every day, but in other patients the symptoms do not have a regular course.
What are the risk factors for non-allergic rhinitis?
A risk factor increases the likelihood of developing a disease: for example, obesity significantly increases the risk of developing type 2 diabetes mellitus and is a risk factor for this disease.
Risk factors for non-allergic rhinitis include:
- Irritants – People who inhale tobacco smoke, smog, exhaust fumes, and other irritants are more likely to develop non-allergic rhinitis, especially people who work with aviation fuels or solvents in the chemical industry.
- Abuse or prolonged use of decongestant nasal sprays or drops – People who use over-the-counter decongestant nasal sprays or nasal drops for many days are at greater risk of developing severe nasal congestion.
- Gender – Women are more prone to nasal congestion during the menstrual cycle and pregnancy.
- Other conditions – patients suffering from lupus, cystic fibrosis, asthma or other endocrine disorders are more likely to develop non-allergic rhinitis.
What are the causes of non-allergic rhinitis?
Viral rhinitis – the inner wall of the nasal cavities or throat becomes inflamed when a virus infects the corresponding cells; active inflammation activates mucus production, the patient often sneezes and has a runny nose.
Vasomotor rhinitis – the blood vessels inside the nose narrow and dilate to control the production and flow of mucus. Sometimes the blood vessels are hypersensitive, then they dilate greatly when exposed to certain environmental factors. This leads to nasal obstruction and an excess of mucus formation. These environmental “trigger” factors include cigarette smoke, paint fumes, perfumes, chemical irritants in general, fluctuations in humidity, a drop in temperature, consumption of alcohol or spicy foods, and stress.
Atrophic rhinitis – lesions develop in the lining of the turbinates, that is, the three bony structures within the nasal cavities.
Hypertrophic rhinitis (or chronic obstructive) – is characterized by thickening of the mucous membrane, submucosa, periosteum and nasal bones. The most serious change is the hypertrophy of the turbinates, especially the lower ones.
The clinical picture is aggravated if the stenosis (narrowing of the ducts through which the air passes) occurs bilaterally, while with the monolateral one, the air can still pass.
Drug-induced rhinitis – is caused by the excessive use of decongestant nasal drugs, but can also be caused by the abuse of cocaine. Nasal decongestant medications reduce inflammation and mucosal swelling, but if the patient uses these medications continuously for five to six days, the inner wall of the nose may become inflamed again.
Signs and symptoms of chronic rhinitis
Symptoms of non-allergic rhinitis are irregular throughout the year: they can be constant and sometimes last for hours or days.
The signs and symptoms of non-allergic rhinitis are:
- nasal congestion;
- runny nose;
- mucus or catarrh in the throat;
- bad breath (halitosis);
- People with tinnitus may experience worsening of humming and whistling in the ear.
Patients with chronic rhinitis often breathe through their mouths. This leads to poorer filtering of the air and thus particles are inhaled, which can lead to coughing and promote infections.
Non-allergic rhinitis usually does not cause itching of the nose, eyes or throat; these are symptoms linked to an allergy, such as hay fever.
Symptoms are aggravated with a bacterial or viral infection of the upper respiratory tract: inflammation of the throat (pharyngitis), laryngitis (laryngitis), sore throat, runny nose, etc., which can also cause fever, purulent rhinitis and lymph node enlargement.
Diagnosis of chronic rhinitis
Non-allergic rhinitis is diagnosed on the basis of the patient’s symptoms and by excluding other causes, primarily allergies. The doctor will perform a physical examination and take an accurate medical history. In addition, he recommends some examinations to the patient, even if there are no specific examinations to diagnose non-allergic rhinitis.
The doctor diagnoses non-allergic rhinitis if the patient has nasal congestion, runny nose or catarrh in the throat and the examinations do not indicate any other conditions that explain these symptoms, for example, an allergy or a sinus problem.
In some cases, the doctor prescribes a medication to the patient to see if the symptoms improve.
Often, rhinitis is caused by an allergic reaction: to know if rhinitis is caused by an allergy, it is necessary to perform blood tests or allergy tests on the skin.
Skin test – To detect whether the patient’s symptoms are caused by a particular allergen, a small amount of the most common airborne allergens is applied to it, such as dust mites, pollen, mold, dog and cat hair. If the patient is allergic to a particular allergen, wheals and redness appear in the place where the examination was carried out, while the skin remains normal if there is no allergy.
Blood tests – The blood tests show the immune system’s response to the most common allergens. This involves measuring certain antibodies in the blood known as immunoglobulin E or IgE. The blood sample is examined in a laboratory to detect hypersensitivity to some allergens.
How is it treated? Therapy of chronic rhinitis
Medications for non-allergic rhinitis are:
Nasal antihistamines – Prescription medications such as desloratadine (Dasselta or Aerius) and loratadine (Loraderm) can relieve catarrh in the throat, nasal congestion, and sneezing in a matter of minutes. These drugs are most effective when used regularly.
For children, the antihistamine diphenhydramine (Dolestan), prescribed by doctors, is suitable.
Nasal corticosteroids – Daily use of products such as fluticasone (Avamys) and mometasone (Nasonex) relieves the patient’s symptoms, but it takes days or weeks for the full effects of the medication to be felt. Often, patients use a combination of nasal antihistamines and nasal corticosteroids.
Ipratropium for nasal use – Ipratropium bromide (Atrovent) is one of the best remedies to treat nasal discharge caused by some foods and drinks.
Decongestants – Decongestants taken orally, for example, pseudoephedrine, provide relief from nasal congestion; these medications are only recommended if antihistamines and nasal corticosteroids do not improve symptoms. Decongestant nasal sprays, oxymetazoline (Wick Sinex) and phenylephrine, should not be used for more than two or three days in a row, as they can lead to nasal congestion due to a “rebound effect” or setback.
Surgical intervention for chronic rhinitis
In some cases, surgery to remove nasal polyps or correct a deviation of a nasal septum improves the effectiveness of drugs taken by patients with non-allergic rhinitis.
Among the modern techniques of surgical correction of hypertrophy of the turbinates is the reduction of the submucosa by laser.
The operation is considered an independent therapy only if other therapies have not succeeded in reducing the symptoms of rhinitis.
Natural remedies for chronic rhinitis
Those who are affected by non-allergic rhinitis are not allowed to smoke and also do not allow family members to smoke in the apartment. Other ways to reduce “trigger” factors:
- Avoid using stoves and fireplaces if they cause symptoms.
- Avoid detergents, detergents, household sprays, perfumes, and fragrance products if they cause symptoms.
- Ask family members, friends and co-workers not to use perfumed products if they cause symptoms.
- Avoid any chemical substance or materials that cause sneezing or a runny nose.
If non-allergic rhinitis is caused by a necessary drug, the doctor may prescribe an alternative remedy.
Many patients with non-allergic rhinitis perform nasal rinses with extraordinary success: they rinse the nose with a saline solution once or several times a day.
For nasal irrigation for rhinitis, you can use a syringe with a balloon, the nasal jug “Jala Neti”, nasal douches or nebulizers.
With each nasal rinse, the patient rinses through each nostril at least 200 ml (about <>/<> cup) of a saline solution, which can be purchased at the pharmacy or prepared at home. It is important to use distilled, sterilized or previously boiled water. The dishwasher should always be rinsed well after use and then allowed to dry open.
If the patient performs one or two nasal rinses a day, he can almost completely remove the mucus or catarrh from the throat. Also, this procedure is used to rinse and clean the sinuses before applying a medical nasal spray.
How long does it take to treat chronic rhinitis?
Persistent rhinitis is a chronic disease that requires regular long-term treatment to prevent symptoms and recurrences: rhinitis can also disappear completely over time. Therapy should be suspended every six months to see if symptoms recur. In this case, it may become necessary for the patient to take medication again.
However, if a patient suffers from permanent rhinitis caused by an allergy, the symptoms will pass after the source of the allergy has been eliminated without the need to take any medication.