Non-Allergic Rhinitis

Inflammation of the inside of the nose that is not caused by an allergy

Aetiology

  • Infection - usually viral infection such as a cold
  • Vasomotor rhinitis - caused by parasympathetic overdrive within the nose (autonomic dysfunction)
    • Can be triggered by chemical irritants, changes in weather, excess humidity or a very dry atmosphere, and stress
  • Occupational rhinitis - symptoms only occur in the workplace due to inhaled irritants only being present at work e.g. latex, wood dust
  • Hormonal rhinitis - pregnancy, hormone medication (HRT, contraceptive pill)
  • Drug-induced rhinitis - ACEi, β-blockers, NSAIDs, cocaine

Pathophysiology

  • The lining of the inside of the nose becomes swollen and inflamed, usually because of swollen blood vessels and fluid building up in the tissues of the nose
  • This swelling blocks the nasal passages and stimulates the mucus glands in the nose, resulting in the typical symptoms of a blocked or runny nose

Clinical presentation

  • Rhinorrhoea
  • Sneezing
  • Itchy nose
  • Nasal congestion

Management

  • Depends on cause
  • Supportive management of viral infection
  • Avoidance of triggers if relevant
  • Consider anticholinergics e.g. ipratropium for vasomotor rhinitis

Complications

  • Sinusitis
  • Nasal polyps