Clinical Immunology/ Respiratory Dz./ Non-Allergic Rhinitis/ Dr.

Batool Al-Haidary

Non-allergic rhinitis
Non-allergic rhinitis involves chronic sneezing or a congested, drippy nose with no apparent cause.
The symptoms of non-allergic rhinitis are similar to those of hay fever (allergic rhinitis), but none
of the usual evidence of an allergic reaction is present.
Non-allergic rhinitis can affect children and adults, but is more common after age 20. Triggers of
Non-allergic 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 Non-allergic rhinitis is made after an allergic cause is ruled out. This may require
allergy skin or blood tests.

Symptoms
If you have Non-allergic rhinitis, you probably have symptoms that come and go year-round. You
may have constant symptoms, or symptoms that last only a short time. Signs and symptoms of
Non-allergic rhinitis may include:

 Stuffy nose
 Runny nose
 Sneezing
 Mucus (phlegm) in the throat (postnasal drip)
 Cough
Non-allergic rhinitis doesn't usually cause itchy nose, eyes or throat — symptoms associated with
allergies such as hay fever.

Causes
The exact cause of Non-allergic rhinitis is unknown.
But, experts do know that Non-allergic 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. One possibility is that the
nerve endings in the nose may be hyper-responsive, in a manner similar to the way the lungs react
in asthma.
But whatever the trigger, the result is the same — swollen nasal membranes and congestion.
There are a number of things known to trigger Non-allergic rhinitis — some resulting in short-lived
symptoms while others cause chronic problems. Non-allergic rhinitis triggers include:
 Environmental or occupational irritants. Dust, smog, secondhand smoke or strong odors,
such as perfumes, can trigger Non-allergic 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.

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 Clinical Immunology/ Respiratory Dz./ Non-Allergic Rhinitis/ Dr. Batool Al-Haidary

 Infections. A common cause of Non-allergic rhinitis is a viral infection — a cold or the flu,
for example.
 Foods and beverages. Non-allergic 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 Non-allergic rhinitis. These include
aspirin, ibuprofen (Advil, Motrin IB, others), and high blood pressure (hypertension)
medications, such as beta blockers.
Non-allergic 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 Non-allergic rhinitis called rhinitis medicamentosa.
 Hormone changes. Hormonal changes due to pregnancy, menstruation, oral contraceptive
use or other hormonal condition such as hypothyroidism may cause Non-allergic rhinitis.

Risk factors
Factors that may increase your risk of Non-allergic rhinitis include:
 Exposure to irritants. If you're exposed to smog, exhaust fumes or tobacco smoke — to
name a few — you may be at increased risk of developing Non-allergic rhinitis.
 Being older than age 20. Unlike allergic rhinitis, which usually occurs before age 20,
often in childhood, Non-allergic rhinitis occurs after age 20 in most people.
 Prolonged use of decongestant nasal drops or sprays. Using over-the-counter
decongestant nasal drops or sprays (Afrin, Dristan, others) for more than a few days can
actually cause more-severe nasal congestion when the decongestant wears off, often called
rebound congestion.
 Being female. Due to hormonal changes, nasal congestion often gets worse during
menstruation and pregnancy.
 Occupational exposure to fumes. In some cases Non-allergic rhinitis is triggered by
exposure to an airborne irritant in the workplace (occupational rhinitis). Some common
triggers include construction materials, solvents, or other chemicals and fumes from
decomposing organic material such as compost.
 Having certain health problems. A number of chronic health conditions can cause or
worsen rhinitis, such as hypothyroidism and chronic fatigue syndrome.
 Stress. Emotional or physical stress may trigger Non-allergic rhinitis in some people.

Complications
Complications from non-allergic rhinitis include:
 Nasal polyps. These are soft, noncancerous (benign) growths that develop on the lining of
your nose or sinuses due to chronic inflammation. Small polyps may not cause problems, but
larger ones can block the airflow through your nose, making it difficult to breathe.

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 Clinical Immunology/ Respiratory Dz./ Non-Allergic Rhinitis/ Dr. Batool Al-Haidary

 Sinusitis. Prolonged nasal congestion due to nonallergic rhinitis may increase your chances
of developing sinusitis — an infection or inflammation of the membrane that lines the
sinuses.
 Middle ear infections. Increased fluid and nasal congestion may lead to middle ear
infections.
 Interrupted daily activities. Non-allergic rhinitis can be disruptive. You may be less
productive at work or school, and you may need to take time off because of symptom flares
or doctor visits.
 Neti pot: Can it clear your nose?
 Nasal spray addiction: Is it real?
 Symptom Checker
 Humidifiers
 Neti pot solution: Can I make my own?
 Upper endoscopy
 CT scan
 Allergy skin tests
 Nasal congestion
 Runny nose
 Cough

Diagnosis
 Physical examination for the chest
 Lung Function Test.
 Skin test to exclude any allergic cases
 Serum Total IgE estimation
 Complete blood count for Eosinophilia detection
 Medical patients history