Nonallergic rhinitis

DEFINITION

Nonallergic rhinitis involves chronic sneezing or having a congested, drippy nose with no apparent cause. The symptoms of nonallergic rhinitis are similar to those of hay fever (allergic rhinitis), but there’s no identified allergic reaction involved. Nonallergic rhinitis can affect children and adults, but is more common after age 20.

Although nonallergic rhinitis is more annoying than harmful, it can make you miserable. Triggers of nonallergic rhinitis symptoms vary and can include certain odors or irritants in the air, changes in the weather, some medications, certain foods, and chronic health conditions. A diagnosis of nonallergic rhinitis is made after an allergic cause is ruled out. This may require allergy skin or blood tests.

CAUSES

Nonallergic rhinitis occurs when blood vessels in your nose expand (dilate), filling the nasal lining with blood and fluid. There are several possible causes of this abnormal expansion of the blood vessels or inflammation in the nose. But, whatever the trigger, the result is the same — swollen nasal membranes and congestion.

Many things can trigger the nasal swelling in nonallergic rhinitis — some resulting in short-lived symptoms while others cause chronic problems. Nonallergic rhinitis triggers include:

• Environmental or occupational irritants. Dust, smog, secondhand smoke or strong odors, such as perfumes, can trigger nonallergic rhinitis. Chemical fumes, such as those you might be exposed to in certain occupations, also may be to blame.
• Weather changes. Temperature or humidity changes can trigger the membranes inside your nose to swell and cause a runny or stuffy nose.
• Infections. A common cause of nonallergic rhinitis is a viral infection — a cold or the flu, for example. This type of nonallergic rhinitis usually clears up after a few weeks, but can cause lingering mucus in the throat (postnasal drip). Sometimes, this type of rhinitis can become chronic, causing ongoing discolored nasal discharge, facial pain and pressure (sinusitis).
• Foods and beverages. Nonallergic rhinitis may occur when you eat, especially when eating hot or spicy foods. Drinking alcoholic beverages also may cause the membranes inside your nose to swell, leading to nasal congestion.
• Certain medications. Some medications can cause nonallergic rhinitis. These include aspirin, ibuprofen (Advil, Motrin IB, others), and high blood pressure (hypertension) medications, such as beta blockers. Nonallergic rhinitis can also be triggered in some people by sedatives, antidepressants, oral contraceptives or drugs used to treat erectile dysfunction. Overuse of decongestant nasal sprays can cause a type of nonallergic rhinitis called rhinitis medicamentosa.
• Hormone changes. Changes in hormones due to pregnancy, menstruation, oral contraceptive use or other hormonal condition such as hypothyroidism can cause nonallergic rhinitis.
• Stress. Emotional or physical stress can trigger nonallergic rhinitis in some people.

SYMPTOMS

If you have nonallergic rhinitis, you probably have symptoms that come and go year-round. You may have constant symptoms, symptoms that last for hours or symptoms that last for days. Signs and symptoms of nonallergic rhinitis may include:

• Stuffy nose
• Runny nose
• Sneezing
• Mucus (phlegm) in the throat (postnasal drip)

Nonallergic rhinitis doesn’t usually cause itchy nose, eyes or throat — symptoms associated with allergies such as hay fever.

When to see a doctor

See your doctor if:

• Your symptoms are severe
• You have signs and symptoms of nonallergic rhinitis that aren’t relieved by over-the-counter medications or self-care
• You have bothersome side effects from over-the-counter or prescription medications for rhinitis