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Nonallergic Rhinitis


Disease: Nonallergic Rhinitis Nonallergic Rhinitis
Category: Ear, nose, larynx diseases
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Disease Definition:

People with nonallergic rhinitis have a runny and blocked nose that is not getting better. If these symptoms occur repeatedly, the inside layers of the nose swell because of the expanding of the blood vessels. Moreover, the mucus glands in the nose get stimulated causing a drippy congested nose. Nonallergic rhinitis is a common problem that affects both children and adults, and its symptoms are familiar to those of allergic rhinitis (hay fever), but there is no allergic reaction involved.

Nonallergic rhinitis is more annoying than harmful because it can make people miserable. Causes of nonallergic rhinitis symptoms differ among people including:


  • Certain irritations or odors in the air
  • Changes in the weather
  • Chronic health conditions
  • Certain medications and foods

A diagnosis of this disorder is made after an allergy is excluded, and this might demand blood or allergy skin tests.

Work Group:

Prepared by: Scientific Section

Symptoms, Causes


People with nonallergic rhinitis are likely to have symptoms that come and go throughout the year, and they might have progressive symptoms that last for hours or days. Signs and symptoms of this disorder might include runny blocked nose and postnasal drip in which mucus exists in the throat. Nonallergic rhinitis does not cause symptoms connected with allergies like hay fever such as an itchy nose, eyes or throat.

One should see the doctor if the symptoms of this disorder are severe, are not relieved by self-care or over-the-counter medications, or if he/she has annoying side effects from the prescriptions or over-the-counter medications for rhinitis.


When the blood vessels in the nose dilate and fill the nasal lining with blood and fluid, nonallergic rhinitis develops. The inflammation in the nose or the irregular expansion of the blood vessels that cause nonallergic rhinitis may be the result of several conditions. However, all of those conditions will cause the same thing, which is congestion and swollen nasal membranes.

Although some of the conditions that cause nonallergic rhinitis may end up causing only short-lived symptoms, others may end up causing chronic problems. Some of those conditions may be:

Environmental or occupational irritants:
In some cases, nonallergic rhinitis may be triggered by chemical fumes that people are exposed to in certain occupations. While in other cases, the trigger may be strong odors such as perfumes, dust, secondhand smoke or smog.

Weather changes:
A runny or stuffy nose may be caused by the swelling of the membranes inside the nose due to temperature or humidity changes.

A viral infection such as cold or flu is one of the common causes of nonallergic rhinitis. Although this type clears up after a few weeks, it may cause lingering mucus in the throat called postnasal drip. In some cases, this type may cause ongoing discolored nasal discharge, facial pain and pressure (sinusitis). This means that the condition has become chronic.

Foods and beverages:
The membranes inside the nose may swell, causing nasal congestion, after drinking alcoholic beverages including beer and wine. Nonallergic rhinitis may also occur after eating hot or spicy foods.

Certain medications:
A type of nonallergic rhinitis called rhinitis medicamentosa may be the result of the overuse of decongestant nasal sprays. Sometimes, drugs that are used in treating erectile dysfunction, antidepressants, oral contraceptives or sedatives may trigger nonallergic rhinitis in some people. Additionally, hypertension medications, such as beta blockers and NSAIDs, such as ibuprofen and acetylsalicylic acid (Aspirin); are some of the medications that can end up causing nonallergic rhinitis.

Hormone changes:
Nonallergic rhinitis may be the result of the hormonal changes that occur during menstruation, pregnancy, a hormonal condition such as hypothyroidism or the use of oral contraceptives.

Sometimes, nonallergic rhinitis may be triggered by emotional or physical stress.

Additionally, having certain health problems, such as lupus, asthma, hormonal disorders and cystic fibrosis may increase a person’s risk of developing nonallergic rhinitis.



Some of the complications that nonallergic rhinitis may cause include:

Chronic sinusitis:
Sinusitis is the infection or inflammation of the membrane lining the sinuses. The risk of developing this complication increases with prolonged nasal congestion caused by nonallergic rhinitis. Sinusitis, which causes pain, swelling and tenderness around the eyes, nose, cheeks or forehead, is considered to be chronic in case it lasts for more than 12 consecutive weeks.

Nasal polyps:
Chronic inflammation may cause development of these soft and benign growths on the lining of the nose or sinuses. The airflow through the nose may be blocked if a polyp grows large enough, making it difficult to breathe.

Interrupted daily activities:
People with nonallergic rhinitis may become less productive and miss work or school if their symptoms flare up or if they need to visit the doctor.

Middle ear infections:
Middle ear infections may be the result of increased fluid and nasal congestions.


The type of treatment needed for nonallergic rhinitis will depend on its severity. Staying away from triggers and applying home treatments may be enough for mild cases, while for more severe cases medications may be needed, such as:

Saline nasal sprays:
This may help in flushing the nose of irritants and helping thin the mucus and soothe the membranes in the nose. A homemade saltwater solution can also be used for the same purpose..

Oral decongestants:
Some of the over-the-counter or prescription medications that help narrow the blood vessels and so reduce congestion in the nose include phenylephrine, and pseudoephedrine-containing drugs.

Antihistamine nasal sprays:
These sprays have proven to reduce the symptoms of nonallergic rhinitis, despite the fact that oral antihistamines don’t. One example of a prescription antihistamine spray is azelastine.

Anti-drip anticholinergic nasal sprays:
A nasal spray that can help in case a runny, drippy nose is the main symptom is ipratropium, which is usually used as an asthma inhaler medication.

Corticosteroid nasal sprays:
The inflammation that is associated with some types of nonallergic rhinitis can be prevented and treated with corticosteroid medications. A person should be prescribed a corticosteroid nasal spray such as mometasone or fluticasone, in case decongestants or antihistamines have failed in controlling the symptoms.

Decongestant nasal sprays:
Because these medications may cause recurrence of congestion with symptoms that are worse than before when they are stopped, they shouldn’t be used for more than three to four days. One example is oxymetazoline.
In some rare cases, if persistent nasal polyps or deviated nasal septum are some of the complications of nonallergic rhinitis, surgery may be an option.

Additionally, clemastine, loratadine and diphenhydramine are some of the nonprescription antihistamines that work well for allergic rhinitis, but not as much for nonallergic rhinitis.


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