Chronic rhinitis is a recurrent nasal blockage/discharge that doesn’t resolve on its own, and symptoms arise from the constant irritation or inflammation of the inner lining of the nose. When the nasal linings become inflamed, it causes nasal congestion and mucus production increases resulting in a runny nose and post-nasal drip (mucus in the throat). Post-nasal drip is one of the most common characteristics of chronic rhinitis, and over a prolonged period, it may lead to a chronic sore throat, a chronic cough, or throat clearing.
How does chronic rhinitis affect the nasal cavity?
Within a normal nasal cavity, the nasal nerves help regulate the nasal activity, turbinates warm and moisturize air as it flows through the nose, and normal mucus production helps protect against infectious agents. With chronic rhinitis, the nasal nerves send too many signals, inflamed turbinates contribute to congestion and stuffy nose, and excessive mucus can drip down the throat and cause a runny nose.
Symptoms of chronic rhinitis:
- Congestion
- Mouth breathing
- Sinus pressure
- Sinus infections
- Runny nose
- Postnasal drip
- Chronic cough
- Sore throat
What causes chronic rhinitis?
Rhinitis has many possible causes and is categorized into three areas including:
- Allergic Rhinitis
- Non-Allergic or Vasomotor Rhinitis
- Mixed Rhinitis (a combination of allergic and non-allergic)
What is Allergic Rhinitis?
With allergic rhinitis (hay fever) symptoms often occur due to an allergic reaction to an allergen. The most common allergens include seasonal pollens (from trees, grasses, and weeds), as well as perennial indoor allergens, such as dust mites, pet dander, and some molds. Other allergens may include some workplace irritants. Food is not a common cause of allergic rhinitis in adults, but certain foods may cause nasal symptoms in some young children.
Symptoms generally include sneezing, runny nose, nasal congestion and itching of the nose and throat. Nasal discharge is usually clear and watery. If you only have symptoms at certain times of the year, you most likely have allergic rhinitis. However, if the allergen is pet dander or house dust, you would have symptoms year-round, which is referred to as perennial allergic rhinitis.
Treatment for allergic rhinitis usually includes allergy medicine or immunotherapy (allergy shots).
What is Non-Allergic Rhinitis?
Non-allergic rhinitis is a medical term used to describe individuals who have symptoms like nasal allergies but don’t have any identifiable cause for it. People who have non-allergic rhinitis do not respond to allergy treatments and allergy testing is negative. Unlike allergic rhinitis, non-allergic rhinitis doesn’t involve the immune system. And non-allergic rhinitis rarely causes an itchy nose, eyes or throat as the allergic form does.
Vasomotor rhinitis is associated with changes in the central nervous system’s control of the blood vessels in the nose. This overactive nerve in the nose stimulates the lining of the nose to become congested, runny, and have postnasal drip. As a result, people are more sensitive to various factors including changes in humidity or exposure to chemicals (i.e., fumes, smoke, or wind).
What else can cause rhinitis?
Other causes of chronic rhinitis may include nasal obstructions, such as a deviated septum, a nasal polyp, or a foreign body (particularly in children), which can lead to congestion. Sinus infections may also lead to nasal congestion and produce a colored nasal discharge.
How is chronic rhinitis diagnosed?
The diagnosis of chronic rhinitis is based largely on symptomatic criteria. Your ENT doctor will ask you questions about your symptoms and will examine your nose.
As part of your initial assessment, your doctor may order a sinus x-ray to see if a sinus infection is present. Allergy skin testing may also be done to determine if certain allergens are triggering some or all of your nasal symptoms.
How is chronic rhinitis treated?
Medications & Non-Invasive Remedies
To treat your chronic rhinitis, your doctor may prescribe medications such as nasal antihistamines, nasal corticosteroids, or oral antihistamines to help alleviate your symptoms. There are also some home remedies like nasal irrigation that can help, as well as some over-the-counter nasal decongestant sprays.
If you have specific triggers that cause your symptoms, your doctor may advise you to avoid those triggers–things such as wood-burning stoves and fireplaces, cleaning agents and household sprays, perfumes, and scented products. Additionally, you may be advised to quit smoking or not to be around people who smoke, especially if this is one of your triggers.
In-Office Procedures
If you don’t respond to medical management of your symptoms, your doctor may prescribe ClariFix treatment (this treatment is only available by prescription) or RhinAer.
