Although sometimes viewed as trivial, chronic rhinitis--inflammation of the nasal membrane over a sustained time period--places a heavy burden on sufferers, causing complications and higher medical costs, reports the Joint Task on Practice Parameters for Allergy in the "Journal of Clinical Allergy & Immunology." It causes children to miss schools and adults to lose work days.
Time Frame
Chronic rhinitis is defined as that lasting more than four days in a row for more than four weeks in a row, explains Allergy and Its Impact on Asthma, or ARIA, an international expert panel.
Types
There are many forms of chronic rhinitis, explains the Joint Task Force. Vasomotor rhinitis--that with no known cause--is the most common type. Chronic rhinitis caused by perennial allergens is prevalent in parts of the country having pollen most of the year. Rare forms include drug-induced and hormonal rhinitis. NARES--nonallergic rhinitis with eosinophilia, a certain type of white blood cells--typically affects middle-aged people.
Diagnosis
Getting the right diagnosis is especially important in people with chronic rhinitis, explains the Joint Task Force. This is because many anatomic problems cause similar symptoms including tumors, enlarged tonsils and deviated nasal septum. In certain people, fiber optic nasal endoscopy, which is examination of the nasal passage with a narrow flexible tube, or rhinomanometry, the measurement of airflow and pressure with a pressure tap, may need to be performed for diagnosis.
Impact on Children
The impact of chronic rhinitis on children is particularly severe, according to "Clinical Reviews in Allergy and Immunology." It interferes with daily functioning in school and with sleep. Children often tolerate nasal blockage and other symptoms much more easily than adults. Chronic rhinitis negatively affects them socially and psychologically. If not managed, it alters normal growth of the child's face and oral cavity.
Treatment
Many medicines are used to treat chronic rhinitis with the choice depending on the symptoms, according to the Joint Task Force. Nasal steroids and antihistamines are used to relieve nasal stuffiness and runny nose. If runny nose is the only symptom, an anticholinergic is the first choice. A key element of treatment is avoiding exposure to irritants that trigger symptoms.
Expert Insight
Prompt treatment of rhinitis by a board-certified allergist improves patients' quality of life, reports "Annals of Allergy." These specialists counsel people how to avoid triggers and prescribe medications that work.
References
- "Allergy"; Allergic Rhinitis and its Impact on Asthma (ARIA) 2008 Update; Bousquet J
- "Journal of Clinical Immunology"; The Diagnosis and Management of Rhinitis: An Updated Practice Parameter; Wallace DV; August 2008
- "Clinical Reviews in Allergy and Immunology"; Chronic Rhinitis in Children; Pearlman D; November 2008
- "Annals of Allergy"; Treatment of Chronic Rhinitis by an Allergy Specialist Improves Outcome
