Rhinitis--inflammation of the membranes in the nose--is characterized by at least one of the following symptoms: runny or stuffy nose, itching or sneezing. People with chronic rhinitis may have the same symptoms, but the various types of rhinitis have important differences and often require specific therapy, reports Dr. Nozad in the journal "Clinical and Molecular Allergy."
Defining Chronic Rhinitis
Rhinitis is considered chronic if it lingers for more than four consecutive weeks, with symptoms present at least four days a week during that time, stipulates ARIA, the Allergy and its Impact on Asthma workshop, an international panel of experts that develops guidelines for treatment. Clinicians use the term "persistent"--which means "chronic" in layman's terms. This definition standardizes groups for clinical studies and enables accurate assessment of therapy.
Types
Many types of chronic rhinitis plague sufferers, reports the Joint Task Force on Practice Parameters for Allergy and Immunology in the "Journal of Allergy & Clinical Immunology." They include perennial allergic rhinitis, or allergy to a substance that is present year-round, such as a pet or mold in the home. Vasomotor rhinitis--which is not immunologic, infectious or associated with high white blood cell count--is a common type. Occupational rhinitis--chronic rhinitis due to a chemical, allergen or irritant in the workplace--is under-reported by workers. Many people are unaware that chronic rhinitis can be caused by certain drugs, such as blood pressure medicine or oral contraceptives.
Proper Diagnosis
An effective diagnosis of chronic rhinitis requires determining the pattern and seasonality of the symptoms, explains the Joint Task Force on Practice Parameters. Careful questioning regarding precipitating factors should be done, including drugs that are taken and symptoms at work. An allergy test should be performed to determine whether the rhinitis is allergy-related.
Management
Management of chronic rhinitis should be individualized and based on the duration and severity of symptoms, reports the Joint Task Force. The first medicine selected should control the patient's main symptom. Patient preference should also play a role in choosing medication. Another important part of managing chronic rhinitis is finding and treating associated complications, such as asthma or sleep-disordered breathing.
Avoidance
The ideal management of chronic rhinitis includes avoidance when practical, according to the Joint Task Force. This includes eliminating exposure to common triggers such as furry animals and insect droppings. Removing moisture sources and using bleach can reduce exposure to mold. Dust mites can be controlled by covering bedding and using a HEPA vacuum cleaner. Controlling humidity helps as well.
References
- "Journal of Allergy & Clinical Immunology"; The Diagnosis and Management of Rhinitis: An Updated Practice Parameter; Wallace DV; August 2008
- "Clinical and Molecular Allergy"; Non-allergic Rhinitis: A Case Report and Review; Nozad CH. February 2010
- "Allergy"; Allergic Rhinitis and its Impact on Asthma (ARIA) 2008 Update; Bousquet J, 2008
