Nonallergic Rhinitis overview

Nonallergic rhinitis is a medical term that describes a set of symptoms that resemble an allergy but that occur without a known cause. It produces symptoms such as:

Postnasal drip

Runny nose

Sneezing

Stuffy nose

Usually, it develops in adulthood, and symptoms last year-round.

Unlike allergic rhinitis, nonallergic rhinitis does not involve the immune system. About 58 million Americans have allergic rhinitis. By comparison, 19 million have nonallergic rhinitis.

Nonallergic rhinitis can cause just as much misery as allergic rhinitis. It can also be associated with the same complications, such as:

Sinusitis, which is inflammation or swelling of the tissue that lines the sinuses

Eustachian tube dysfunction. Eustachian tubes connect the middle ears to the back of the throat

Chronic ear infection, known as otitis media

Loss of smell or anosmia

Asthma

Obstructive sleep apnea

Both types of rhinitis are associated with:

Decreased production at work

Increased doctor visits

Side effects from treatment, such as drowsiness, nosebleed, and nasal dryness

Because the two are so similar, it's often necessary to perform allergy tests and blood tests to tell them apart.

Causes of Nonallergic Rhinitis

Often, what causes nonallergic rhinitis is unknown. And the condition is often confirmed only after other conditions such as allergic rhinitis or infection are ruled out.

Environmental irritants are common triggers of nonallergic rhinitis. Some are found in the home and others are more common in the workplace.

Examples of what can trigger symptoms include:

Car exhaust

Chlorine

Cigarette smoke

Cleaning solutions

Glues

Hair spray

Latex

Laundry detergents

Metal salts

Perfume

Smog

Wood dust

When such triggers cause nonallergic rhinitis, they also often cause asthma.

Some medications can trigger non-allergic rhinitis. Examples include:

NSAIDs -- nonsteroidal anti-inflammatory drugs such as aspirin andibuprofen

Oral contraceptives

Blood pressure medicines such as ACE inhibitors and beta-blockers

Antidepressants

Tranquilizers

Drugs used to treat erectile dysfunction

Foods and beverages may also sometimes be triggers. Examples include:

Hot foods, such as soup

Spicy foods

Alcoholic beverages, especially beer and wine

Other triggers include:

Illegal drugs. Cocaine and other snorted street drugs often cause chronic nonallergic rhinitis.

Weather changes. Sudden changes in weather or temperature can trigger nonallergic rhinitis. Skiers, for instance, often develop a runny nose. And some people are affected by any cold exposure. In some cases, people even start sneezing after leaving a cold, air-conditioned room.

Hormone changes. Nonallergic rhinitis often occurs during periods of hormonal imbalance. For instance, it may occur during puberty,menstruation, or pregnancy. It usually starts during the second month of pregnancy and lasts until childbirth. Hormonal conditions such as hypothyroidism can also trigger symptoms.

Treatment of Nonallergic Rhinitis

Nonallergic rhinitis can't be cured. But it can be controlled by:

Avoiding rhinitis triggers

Using home remedies such as nasal irrigation

Taking over-the-counter and prescription medications

Allergy shots -- immunotherapy -- are not used to treat nonallergic rhinitis.

If you have nonallergic rhinitis, it's important that you not smoke and not allow smoking in your home.

Other strategies to reduce exposure to triggers include:

Avoid wood-burning stoves and fireplaces if they cause symptoms.

Avoid cleaning agents, household sprays, perfumes, and scented products if they cause symptoms.

Ask family, friends, and co-workers not to use scented products that cause symptoms.

Avoid any chemical or material that tends to make you sneeze or have a runny nose.

Talk to your doctor about the medications you now take. If your nonallergic rhinitis is triggered by a medicine you need, your doctor may suggest a substitute.

Many people with nonallergic rhinitis benefit from performing nasal irrigation. This refers to rinsing of the nostrils with a salt water -- saline -- solution one or more times a day. Over-the-counter products for doing this include bulb syringes, neti pots, and bottle sprayers.

During each irrigation, rinse each nostril with at least 200 mL (about 3/4 cup) of commercially or home-prepared solution.

It's important to note that, according to the CDC, if you are irrigating, flushing, or rinsing your sinuses, use distilled, sterile, or previously boiled water to make up the irrigation solution. It’s also important to rinse the irrigation device after each use and leave open to air dry.

When performed once or twice a day, nasal irrigation may especially help treat postnasal drip. It's also a helpful technique to clear the sinuses before using medicated nasal sprays.