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Allergic vs Non-Allergic Rhinitis

Allergic vs Non-Allergic Rhinitis

Do you have a runny nose or nasal congestion that does not seem to have an identifiable trigger? Do allergy medications not seem to improve your symptoms? You may have a form of rhinitis, called non-allergic rhinitis, which can often mimic symptoms of allergies (see post from August 7th).

Non-allergic rhinitis typically begins in adulthood and can cause year-round symptoms including a runny or stuffy nose. It can be associated with many different causes including, but not limited to:

  • Hormonal (oral contraceptives, pregnancy, menstrual association, hypothyroidism)
  • Vasomotor/irritant (cold or temperature induced, strong scents/odors, dry air, weather changes, exercise, alcohol-induced)
  • Infections
  • Medication induced (Aspirin, NSAID’s, topical decongestants, hypertensives)
  • Atrophic (Primary or secondary)
  • Occupational (Flour, latex, pet dander)

A type of medication induced non-allergic rhinitis is called rhinitis medicamentosa and is caused by nasal decongestant sprays such as oxymetazoline, when used for long periods of time. This can result in rebound congestion.

Treatment options include:

  • Nasal steroid sprays
  • Nasal antihistamine sprays
  • Nasal ipratropium spray
  • Occasional oral decongestants

Rhinitis in pregnancy can occur. Still, the number one cause is allergic rhinitis and symptoms can worsen in 1/3rd of pregnant patients. However, a non-allergic form of rhinitis can occur called pregnancy induced rhinitis. Pregnancy induced rhinitis occurs in about 1 out of 5 pregnant women (20-30%). It does not occur prior to pregnancy and resolves within 2 weeks postpartum. It typically does not present prior to the second trimester. Risk factors include smoking and house dust mite allergy. The exact cause of this type of rhinitis is unknown. In this case, intranasal steroids are ineffective in pregnancy induced rhinitis and it is not recommended to use oral decongestants during pregnancy. The best treatment options are nasal strips and nasal saline lavages.

Patients that have non-allergic rhinitis do not have allergies and therefore, avoiding allergic triggers may not improve symptoms. Allergy testing is helpful to identify if you have allergies or not to allergens founds in the greater Salt Lake area. Oral antihistamines such as cetirizine or loratadine do not generally improve symptoms either. There are also some anatomical abnormalities which can worsen non-allergic rhinitis including narrow drainage passages, shifted/deviated septum, or other structural issues. Additionally, sometimes evaluation from an ear, nose, and throat specialist is necessary to determine if surgery is required.

Do you or your family members have persistent nasal congestion or runny nose? Allergy Associates of Utah is an allergy, asthma, and immunology specialty clinic serving the greater Salt Lake City, Utah area with 2 convenient locations in Murray and West Jordan. Led by specialists Andrew Smith, MD, MS, and Tara Sarin, MD, the practice strives to help people of all ages and background achieve success. Request an appointment by phone or online at either Allergy Associates of Utah location for expert allergy and immunology care today.

Phone: (801) 263-8700

Phone: (801) 282-8700