Rhinitis

Dealing with a runny nose and constant sneezing? It could be rhinitis! This condition causes the lining inside your nose to become inflamed, bringing on a host of pesky symptoms. In this blog, we break down what rhinitis is, its causes, the symptoms to watch for, and practical tips for managing it effectively. 

What is Rhinitis?

Rhinitis happens when the inside of your nose gets irritated or inflamed, leading to symptoms like sneezing, itching, and congestion.  It can be classified into two main types: 

1. Allergic Rhinitis: Often referred to as hay fever, allergic rhinitis occurs when the immune system overreacts to allergens such as pollen, dust mites, mold, or pet dander. 
2. Nonallergic Rhinitis: This type is not triggered by allergens. It can be caused by viral infections (such as the common cold), environmental factors (like pollution), hormonal changes, certain medications (e.g., decongestant nasal sprays), or food and alcohol. 
   

Symptoms of Rhinitis 

The symptoms of rhinitis can vary depending on whether it is allergic or nonallergic. However, some common symptoms include: 

• Runny or stuffy nose 
• Sneezing 
• Itchy nose, eyes, or throat 
• Postnasal drip 
• Coughing 

These symptoms can range from mild to severe and may affect daily activities and quality of life. 

Diagnosing Rhinitis

If you suspect you have rhinitis, it's important to see an ENT or an ear, nose and throat specialist for a proper diagnosis. The diagnosis typically involves: 

• A review of your medical history and discussions about your symptoms and any potential triggers or allergens. 
• A physical examination of your nasal passages and throat. 
• Skin or blood tests to identify specific allergens (in cases of suspected allergic rhinitis). 
  

Management and Treatment Options of Rhinitis 

Here’s a look at the treatment options for rhinitis: 

1. Medications

The first line of treatment for rhinitis often involves medications, which can help alleviate symptoms effectively: 

Antihistamines 

These are commonly used to reduce sneezing, itching, and runny nose. Over-the-counter options like loratadine (Claritin) and cetirizine (Zyrtec) are widely available.

Nasal Corticosteroids 

Sprays such as fluticasone (Flonase) and mometasone (Nasonex) are effective in reducing inflammation and congestion.

Decongestants 

Both oral and nasal spray decongestants can provide temporary relief from nasal congestion, but should be used cautiously to avoid rebound congestion. 

Leukotriene Receptor Antagonists

Medications like montelukast (Singulair) can help manage allergic rhinitis symptoms.

Ipratropium bromide nasal spray 

This anticholinergic medication works by reducing nasal secretions, helping to alleviate symptoms such as a runny nose in cases of allergic or non-allergic rhinitis. It is often used when other treatments, like antihistamines or decongestants, are insufficient. The spray provides localized action with minimal systemic absorption, making it suitable for patients who may be sensitive to oral medications. 

2. Nasal Irrigation

Saline nasal rinses can help clear mucus and allergens from the nasal passages, providing relief from congestion and promoting overall nasal health. 

3. Surgical Options 

For patients with persistent rhinitis symptoms that do not respond to conservative treatments, surgical options may be considered. 

Posterior Nasal Nerve Ablation (RhinAer or Neuromark)

Posterior Nasal Nerve Ablation is a minimally invasive procedure that targets the posterior nasal nerve, which plays a key role in nasal congestion and rhinitis symptoms. This procedure employs devices such as RhinAer or Neuromark to apply controlled radiofrequency energy to the nerve, effectively reducing symptoms like persistent runny nose and nasal congestion. It is particularly advantageous for patients who have not responded well to conventional medical treatments.

Posterior Nasal Nerve Resection or Vidian Neurectomy 

Another surgical option for treating rhinitis is posterior nasal nerve resection or vidian neurectomy. This procedure involves the surgical removal of the vidian nerve, which innervates the nasal mucosa. By disrupting the nerve's signaling, this surgery can lead to a reduction in nasal secretions and congestion. While this approach can be effective, it is typically reserved for patients with severe symptoms that do not respond to other treatments. 

4. Immunotherapy

For those with allergic rhinitis, immunotherapy may be an option. This treatment gradually exposes patients to specific allergens through allergy shots or sublingual tablets, helping to build tolerance and reduce symptoms over time. 

When to See a Doctor for Rhinitis 

If your symptoms persist despite treatment or you experience complications such as sinus infections or sleep disturbances, it's important to seek medical advice from an ear, nose, and throat specialist. They can offer tailored recommendations and explore other potential causes of your symptoms.

FAQs about Rhinitis

How is nonallergic rhinitis different from allergic rhinitis? 

Nonallergic rhinitis is not triggered by allergens and does not involve the immune system. It can be caused by environmental irritants, infections, or certain medications. 

Can rhinitis be cured?

While there is no cure for rhinitis, its symptoms can be effectively managed with lifestyle changes, medications, and in some cases, immunotherapy. 

Is rhinitis contagious?

Allergic rhinitis is not contagious. However, if rhinitis symptoms are due to a viral infection, such as a cold, it can be contagious.

Can children have rhinitis?

Yes, children can have both allergic and nonallergic rhinitis. Proper diagnosis and management are important for minimizing impact on their daily activities. 

Medical Reviewers

Last Review Date: March 2025

Content Reviewer:

• Dr. Thomas Higgins, MD, MSPH