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From Allergic to Non-Allergic: Understanding the Types of Rhinitis & How We Treat Them

Rhinitis, the medical term for a stuffy nose, is a common condition, and it can be caused by a variety of factors. The term "rhinos" means nose, and "itis" means inflammation. Rhinitis is literally inflammation of the nasal passage.

This is not to be confused with sinusitis which is inflammation of the tissues deeper inside the sinus cavities themselves.

As a family ENT clinic in Royal Oak MI for over 50 years, we've treated more nose and sinus issues -- particularly rhinitis -- than we can count. While it's generally nothing to be concerned about, rhinitis can be quite irritating - both figuratively and literally - causing uncomfortable symptoms, and depending on the severity, impacting people's quality of life.

The good news is treatment does exist.

In fact, it can even be addressed at home.

At The Rontal Clinic, we're committed to giving the best medical care and advice to our current and future patients, which is why we think it's so important to share the types of rhinitis, what causes it, and how to manage, treat, or even better -- avoid it.

We want to help you, but only if you really need it. So let's take a look at everything you need to know about rhinitis.

Allergic vs. Non-Allergic Rhinitis: Similar Symptoms, But Different Stimuli

There are two types of rhinitis: allergic and nonallergic rhinitis.

Both of these have the same symptoms and are treated in similar ways. However, they are caused by different stimuli.

Understanding which type of rhinitis a patient has can help them manage their symptoms, or in more severe cases, help us treat them more effectively.

Allergic Rhinitis: When Allergens Overstay Their Welcome

Allergic rhinitis, commonly called hay fever, is a condition in which the lining of the nose becomes inflamed due to allergens.

In the case of allergic rhinitis, the body's immune system recognizes and overreacts to an irritant from the environment that shouldn't warrant such a drastic response from the body.

In layman's terms, allergic rhinitis is nothing more than a congested nose caused by an allergic reaction.

So, what are the causes and symptoms of allergic rhinitis?

Because allergic rhinitis is an allergic response, it should come as no surprise that it is caused by common allergens -- such as tree pollen, grass pollen, ragweed pollen, pet dander, fungi, mold spores, and dust mites.

Allergic rhinitis symptoms are classic allergy symptoms that almost everyone is familiar with, such as a runny nose, congestion, watery, itchy, or red eyes, sneezing, coughing, itchy nose, itchy roof of the mouth, itchy throat, postnasal drip, swollen skin under the eyes, and fatigue.

Is it possible to prevent or avoid allergic rhinitis?

Unfortunately, there is no way to prevent allergic rhinitis. If you have allergies, then you will likely succumb to hay fever.

However, there are ways to mitigate it.

Keeping windows closed during high-pollen periods, wearing glasses or sunglasses outside to keep pollen out of the eyes, and using a saline nasal rinse when you come in from the outdoors to reduce allergens in the nasal and sinus passages -- these are some of the best ways to mitigate allergic rhinitis.

We also recommend thoroughly washing your hands after petting animals, using mite-proof bedding covers to reduce exposure to dust mites, and cleaning your house (vacuuming, mopping, dusting) regularly to lessen indoor allergens.

Nonallergic Rhinitis: Inflammation Without a Clear Cause

Nonallergic rhinitis, like allergic rhinitis, is inflammation of the nose. However, unlike allergic rhinitis, nonallergic rhinitis is not caused by allergens.

The unfortunate truth is that this condition has no clear cause. Some patients report nonallergic rhinitis due to weather changes, while others notice that it occurs if they're exposed to secondhand smoke, fumes in the air, or even strong smells.

Talking to your ENT doctor and discussing your symptoms (as well as your day-to-day lifestyle) can help you determine whether your rhinitis is due to allergies and non-allergic triggers.

So, what are the causes and symptoms of allergic rhinitis? 

The causes of nonallergic rhinitis are far less specific than allergic rhinitis, as it can be caused by a wide variety of various irritants that are far less obvious than pollen.

Some of the more common causes of this type of rhinitis include fumes, perfumes, strong odors, weather changes, medications, hot or spicy foods, long-term health problems, and nasal obstructions (such as a deviated septum or nasal polyps). 

Nonallergic rhinitis has some of the symptoms of allergic rhinitis, but not all. The itchiness, watery eyes, and postnasal drip are almost always associated with allergic rhinitis, as these are symptoms of the allergic reaction at work.

Nonallergic rhinitis symptoms include a stuffy nose, runny nose, sneezing, mucus in the throat, and excessive coughing.

So, how can we prevent non-allergic rhinitis?

While avoiding or lessening exposure to hay fever triggers is relatively simple - they are caused by allergies, after all - avoiding nonallergic rhinitis triggers can be considerably more difficult.

However, by staying cognizant of your rhinitis and when it occurs, you can narrow down your triggers over time to help avoid them.

At The Rontal Clinic, we recommend all our patients keep a log or journal of when the rhinitis symptoms occur and what you were doing at that time. This can help us find patterns in your symptoms, which helps us determine a potential trigger.

Once a trigger is identified, we recommend avoiding those triggers as much as possible. And if you're using nasal decongestants, avoid using them more than a few days at a time -- unless we direct you otherwise.

Rhinitis Diagnosis: Finding the Source of Your Irritation

As an ENT in Royal Oak MI with over 20 years of experience, we know that finding relief from the symptoms that accompany either of the two types of rhinitis is paramount to those suffering from the condition. The path to providing relief to patients begins with diagnosing which of the two types of rhinitis a patient has.

There are three primary tests and/or exams designed to help diagnose rhinitis -- medical history, allergy testing, and a nasal exam. Let's take a closer look: 

Medical exam and history. A thorough medical exam and taking a detailed medical history is the first step to diagnosing rhinitis of either type. Through physical examination and a thorough medical history, we can find clues as to which kind of rhinitis a patient is suffering from.

Allergy testing. Skin prick allergy testing helps determine specific allergens causing the rhinitis, while skin testing helps confirm the presence of an allergen. Blood testing gives us a more thorough look at your allergy by measuring the amount of allergy-causing antibodies in the blood.

Nasal examination. Nasal endoscopy, a CT scan, or both may be recommended by the ENT to further assess a patient's nasal and sinus cavities to ensure that allergic rhinitis is, in fact, the issue and that some other problem isn't the source of the chronic inflammation and discomfort.

At the end of the day, our job is to determine if your rhinitis is being caused by allergens or a third-party factor. If allergens are present, we need to determine what allergens they are, where they're coming from, and how we can reduce symptoms for a more rewarding life.

Rhinitis Treatment: Providing Relief When It's Needed the Most

While treating allergic rhinitis and nonallergic rhinitis can have similar approaches, they are not exactly the same.

For over 50 years, we've been providing allergy treatment in Royal Oak, and during that time, we've never deviated from the idea that both types of rhinitis require different approaches, as do our individual patients.

Tailoring the treatment to the individual and their specific rhinitis is key.

So, how can we treat allergic rhinitis? 

There are a few options for treating allergic rhinitis. These treatments are geared toward reducing the impact of allergens on the patient, thus reducing their allergic response. The goal is to lessen the severity, duration, and frequency of allergic rhinitis.

  • Nasal sprays - Nonprescription nasal decongestant sprays or prescription steroid nasal sprays may be prescribed by the ENT. These may be used alone or in conjunction with one another to help relieve inflammation and congestion.
  • Antihistamines - Oral antihistamines and antihistamine eye drops may be recommended to reduce the body's reaction to allergens that trigger allergic rhinitis.
  • Immunotherapy - Commonly called allergy shots, immunotherapy involves weekly shots that have a small amount of the patient's triggering allergins. Over the course of 3 to 5 years, the concentration of these allergens is increased. This allows the body to become used to the allergens, reducing and sometimes eliminating its allergic response to the triggers.

Alright, what about non-allergic rhinitis?

Treating nonallergic rhinitis is similar to treating allergic rhinitis, as both conditions present with similar symptoms. However, because nonallergic rhinitis doesn't involve allergen triggers, immunotherapy is not needed.

  • Nasal sprays - Like allergic rhinitis, nonallergic rhinitis can be mitigated through nonprescription nasal decongestant sprays or prescription steroid nasal sprays to help reduce the congestion and swelling associated with rhinitis. Saline nose sprays may also be indicated to moisturize the nose and ease inflammation.
  • Antihistamines - Although nonallergic rhinitis doesn't involve allergens, antihistamines can help with the inflammation and congestion associated with this type of rhinitis.
  • Surgery - In nonallergic rhinitis cases where a deviated septum or nasal polyps are causing the irritation leading to the inflammation, corrective surgery may be recommended to correct the issues.

Diagnosing and treating rhinitis can be difficult, especially if no allergens are present, but don't worry -- our team is highly skilled and knowledgeable in this area. With decades of experience treating rhinitis and other nasal/sinus issues, we want you to know that your symptoms are in the best hands possible.

The Rontal Clinic: Where Your Symptoms Are Set Free

As a long-time family ENT clinic in Royal Oak MI, we've been treating all matters of ear, nose, and throat conditions including both types of rhinitis in children and adults for decades. We understand that rhinitis is irritating in more ways than one, and we're always happy when we can help our patients find relief.

At The Rontal Clinic, we understand what that relief means to your day-to-day lifestyle -- it gives you a sense of hope, and a sense of normalcy.

If you're suffering from rhinitis, or a stuffy nose, and you haven't been able to rectify it on your own, schedule a consultation with us by calling our office at (248) 737-4030. We can help you identify the type of rhinitis you have, its cause, and the best way to treat it. We look forward to meeting you soon!