Rhinitis, inflammation of the membranes lining the nose, is described as allergic or nonallergic. Underlying causes of rhinitis may overlooked by both physicians and patients, leading to suboptimal treatment, as in the case of mistaking allergy for a cold, according a 2001 article in the "Journal of Allergy and Clinical Immunology." To help remedy such errors, a new classification scheme according to time frame was recently developed by the Allergic Rhinitis and its Impact on Asthma workshop, an international expert panel known as ARIA. Both allergic and nonallergic rhinitis can have a negative impact on quality of life. Certain highly effective medications, including nasal steroids, may be used for both kinds of rhinitis, although certain therapies should be reserved for one type.
Identifying Allergic and Nonallergic Rhinitis
Allergic rhinitis--that caused by allergens such as pollens, grass, molds, dust and pet dander--comprises about half of all rhinitis cases, reports the Joint Task Force on Practice Parameters in Allergy, Asthma and Immunology. The diagnosis of allergic or nonallergic rhinitis is confirmed by skin prick or blood tests for allergy. Nonallergic rhinitis is further defined according to its triggering factor, of which there are many. They include smoke, hormones, chemical fumes, spicy foods, weather changes and certain medications, the Mayo Clinic reports.
Time Frame
Rhinitis is described as intermittent--symptoms are present for less than four days a week or for less than four weeks in a row--or persistent, wherein symptoms are present for more than four days a week and for more than four weeks in a row. This classification was developed by ARIA to help standardize analysis of treatment effectiveness.
Symptoms
Both allergic and nonallergic rhinitis are characterized by nasal congestion, sneezing, itching and runny nose. Frequently, mucus in the throat, which is called postnasal drip, is present as well, the Joint Task Force reports. The symptoms of the two differ in that people with allergic rhinitis often have itchy eyes or throat, especially with hay fever, according to the Mayo Clinic. These signs rarely appear in people with nonallergic rhinitis.
Impact
Rhinitis, which may be viewed as a trivial condition, has significant impact on people's quality of life, the Joint Task Force reports. Symptoms disrupt sleep, leading to daytime fatigue and impaired productivity in school or work. The indirect and direct costs related to rhinitis can be substantial, according to the "Journal of Allergy and Clinical Immunology." Complications related to both allergic and nonallergic rhinitis include nasal polyps, chronic sinusitis and middle ear infection, the Joint Task Force and the Mayo Clinic report. ARIA reports that allergic rhinitis is linked to asthma.
Management
Certain medications are used to treat both allergic and nonallergic rhinitis, such as nasal steroids, which are the most effective medication for nasal congestion, and decongestants, which are available over-the-counter, the Mayo Clinic and ARIA report. A negative feature of decongestants is the possibility for rebound congestion, a severe nasal symptom that may occur if a decongestant is used for longer than three days. Simple and inexpensive nasal rinses offer relief for both conditions. Antihistamines, which block histamine, a chemical released during an allergy reaction, are used by all rhinitis sufferers, although they work best for allergic rhinitis, the Mayo Clinic reports. Allergy shots, which are called immunotherapy, should be used only by people with allergic rhinitis.
References
- The Mayo Clinic: Nonallergic Rhinitis
- "Diagnosis and Management of Rhinitis: Complete Guidelines of the Joint Task Force on Practice Parameters in Allergy, Asthma and Immunology"
- "Allergic Rhintiis and Its Impact on Asthma (ARIa) 2008 Update"; Allergy. Bousquet J.
- "Allergic Rhinitis"; Journal of Allergy and Clinical Immunology. 2001
