Chronic Rhinitis: What It Is and How to Treat it


 

Some medical conditions are short-lived; once you are infected, you may experience symptoms of the condition for only a few days. Your immune system can fight off some diseases on its own, or you could resort to drugs. Other conditions are chronic; they can last up to a month after you start presenting with symptoms. Chronic rhinitis is an example of a disease that can last for more than four weeks.

What is chronic rhinitis?

The term rhinitis is used to refer to a condition in which the inner lining of your nose becomes inflamed. The inflammation of the nasal lining is long term, hence the term chronic rhinitis. The condition usually lasts more than four weeks, unlike acute rhinitis, which lasts only a few days. Millions of Americans suffer from chronic rhinitis. A total of 77 million people have chronic rhinitis.

Chronic rhinitis is of two types, allergic and non-allergic types. Allergic chronic rhinitis is the most common type of chronic rhinitis, which occurs in 58 million out of the total 77 million Americans with chronic rhinitis. The remaining 19 million people suffer from non-allergic rhinitis.

The two types share some common similarities in the symptoms you will experience and their causes.

Allergic chronic rhinitis

This type of rhinitis is also known as hay fever and occurs due to exposure to an allergen. The allergen binds to an immunoglobulin in your immune system known as IgE. This reaction then causes histamine release that is responsible for the symptoms you will experience. When you have this type of rhinitis, your immune system overreacts to the allergen to which you are exposed.

Symptoms specific to this kind of rhinitis include itchiness in your eyes, throat, and nose and allergic shiners. Allergic shiners refer to the bluish discoloration below the lower eyelids that many people with hay fever usually have. The symptoms of allergic rhinitis are usually seasonal, for most people, symptoms present during the spring and summer. Symptoms can also be perennial, implying that they are recurring.

Causes of allergic rhinitis include:

  • Cold.
  • Dust.
  • Pollen.
  • Animal dander.
  • Mold.

Non-allergic chronic rhinitis.

This type of rhinitis mostly occurs due to triggers in the environment. The triggers differ from person to person and cause symptoms characteristic to the condition. Unlike allergic-type, the symptoms of non-allergic rhinitis are present throughout the year.

Causes of non-allergic rhinitis are many compared to those of allergic rhinitis. The causes range from irritants in the environment, medications, diseases, and changes in your body. They include:

  1. Environmental irritants.

These are the most common causes of non-allergic rhinitis. They include perfume, tobacco smoke, exhaust fumes from vehicles, detergents, wood smoke, latex, dry or cold air, or metal salts.

  1. Medications.

Several classes of medications are known to cause non-allergic rhinitis. Some of the classes include:

  • Nonsteroidal anti-inflammatory drugs (NSAIDs) like aspirin.
  • Beta-blockers used to treat hypertension, such as atenolol.
  • Angiotensin-Converting Enzyme Inhibitors (ACEIs) such as enalapril.
  • Birth control pills.
  • Antidepressants.
  • Decongestant drugs can cause a rebound effect of nasal congestion when used for more than three days.
  • Illegal drugs that require snorting like cocaine.
  1. Diseases.

Conditions like asthma, gastroesophageal reflux disease, and chronic sinusitis can cause non-allergic rhinitis.

  1. Hormonal changes.

The imbalance of certain hormones, such as thyroid hormone, can trigger symptoms of the condition. Hormonal changes during menstrual periods, childbirth, and pregnancy are also a trigger.

  1. Foods.

Spicy food and extremely hot foods also trigger non-allergic rhinitis.

General symptoms of chronic rhinitis.

Both allergic and non-allergic rhinitis share most of the symptoms that chronic rhinitis patients have. The following are some of the symptoms:

  • A running nose.
  • Headaches.
  • Post-nasal drip.
  • Congestion of the nose.
  • Frequent sneezing.
  • Coughing.

What are the treatment options for chronic rhinitis?

There are several treatment options available. However, treatment is effective when the medications are combined with a change in lifestyle. There is also a choice of surgery if the cause of your rhinitis is a change in nose structure.

Medications.

Some of the medications you can use are available over the counter, while others require a prescription.

  • Antihistamines.

These are drugs that block the release of histamine responsible for the symptoms commonly seen in people with rhinitis, like a runny nose and sneezing. In allergic rhinitis, these drugs relieve symptoms like watery eyes and an itchy nose and throat. They include drugs like cetirizine (Zyrtec), loratadine (Claritin), and fexofenadine (Allegra).

  • Nasal decongestants.

These are drugs that relieve nasal congestion. They are usually in the form of nasal drops and are of different classes of drugs such as:

  • Glucocorticoids.

Nasal sprays containing steroids like triamcinolone, budesonide, and fluticasone are commonly used to relieve congestion. For the effectiveness of these drugs, combine them with antihistamines. You will experience relief of symptoms within a few weeks.

  • Anticholinergics.

Anticholinergics block the action of acetylcholine of increasing bodily secretions like sweat, urine, and mucous. Therefore, they reduce nasal secretions to relieve congestion. A drug like ipratropium bromide (Atrovent) can be given as nasal drops for this purpose.

  • Alpha-adrenergic agonists.

These drugs act by constricting blood vessels in your nose to reduce swelling. Commonly used drugs in this class include phenylephrine (Neo-synephrine) and oxymetazoline (Afrin).

You can find some of these medications through a mail order pharmacy so that you can get them delivered instead of making another stop when you’re already not feeling well.

Surgery.

Your doctor will recommend surgery if structural changes like a deviated septum cause your chronic rhinitis. However, surgery is used as the last resort when other treatment options fail to work. Surgery is usually effective when used alone. One popular minimally invasive surgical technique used is ClariFix. This is an invasive cryotherapy device that provides long term relief from chronic rhinitis. Before inserting the device in your nose, the doctor will use anesthesia. The procedure takes less than a minute on each nasal opening.

Lifestyle changes.

The most significant lifestyle change you need to make when you have chronic rhinitis is to avoid the irritant that triggers your rhinitis. You can do this by using an air purifier, using a vacuum that has a HEPA filter, frequently dusting your house, and frequently bathing your pets.

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