Nonallergic Rhinitis -

Nonallergic rhinitis involves sneezing or a stuffy, drippy nose. It can be a long-term problem, and it has no clear cause. The symptoms are like those of hay fever, also called allergic rhinitis. But nonallergic rhinitis isn’t caused by allergies.

Nonallergic rhinitis can affect children and adults. But it’s more common after age 20. Factors that trigger the symptoms vary from person to person. The triggers can include some:

Dust, fumes and other irritants in the air.
Weather changes.
Medicines.
Hot or spicy foods.
Long-term health problems.

Health care providers often first make sure a person’s symptoms aren’t caused by allergies. So you may need skin or blood tests to find out if you have allergic rhinitis.

Nonallergic rhinitis symptoms often come and go year-round. Your symptoms might include:

Stuffy or runny nose.
Sneezing.
Mucus in the throat.
Cough.

Nonallergic rhinitis most often doesn’t cause an itchy nose, eyes or throat. That symptom is linked with allergies such as hay fever.

When to see a doctor

See your health care provider if you:

Have serious symptoms.
Haven’t gotten relief from home remedies or medicines you bought at a store without a prescription.
Have bad side effects from medicines.

The exact cause of nonallergic rhinitis is unknown.

But experts do know that nonallergic rhinitis happens when blood vessels in the nose expand. These blood vessels fill the tissue that lines the inside of the nose. Many things could cause this. For instance, the nerve endings in the nose might react to triggers too easily.

But any cause brings on the same result: swelling inside the nose, congestion or lots of mucus.

Triggers of nonallergic rhinitis can include:

Irritants in the air. These include dust, smog and cigarette smoke. Strong odors such as perfumes also can cause the symptoms to start. So can chemical fumes, including fumes some workers might get exposed to at their jobs.
Weather. Changes in temperature or humidity can trigger swelling in the lining of the nose. This can cause a runny or stuffy nose.
Infections. Illnesses caused by a virus often cause nonallergic rhinitis. These include a cold or the flu.
Foods and drinks. Nonallergic rhinitis can happen when you eat. Hot or spicy foods are the main triggers. Drinking alcohol also can cause the tissue that lines the inside of the nose to swell. This can lead to a stuffy nose.
Some medicines. These include aspirin and ibuprofen (Advil, Motrin IB, others). High blood pressure medicines such as beta blockers also can cause symptoms.
Medicines that have a calming effect, called sedatives, can trigger nonallergic rhinitis too. So can medicines for depression. Birth control pills and medicines that treat erectile dysfunction also can trigger the symptoms. And using decongestant nose spray or drops too often can cause a type of nonallergic rhinitis called rhinitis medicamentosa.
Hormone changes. These can be due to pregnancy, periods or birth control use. Hormone problems that may trigger nonallergic rhinitis include a condition that happens when the thyroid gland doesn’t make enough thyroid hormone. This is called hypothyroidism.
Issues linked with sleep. Lying on your back while you sleep can trigger nonallergic rhinitis. Acid reflux that happens overnight also can be a trigger.

Things that can make you more likely to get nonallergic rhinitis include:

Breathing in some types of unclean air. Smog, exhaust fumes and tobacco smoke are a few of the things that can raise the risk of nonallergic rhinitis.
Being older than age 20. Most people who get nonallergic rhinitis are 20 or older. That makes it different from allergic rhinitis, which people often have when they’re younger than 20.
Using nose sprays or drops for a long time. Don’t use store-bought decongestant drops or sprays oxymetazoline (Afrin, Dristan, others) for more than a few days. A stuffy nose or other symptoms might get worse when the decongestant wears off. This is often called rebound congestion.
Getting pregnant or having periods. Congestion in the nose often gets worse during these times due to hormone changes.
Being exposed to fumes at work. In some lines of work, fumes from supplies can cause nonallergic rhinitis to start. Some common triggers include construction materials and chemicals. Fumes from compost also can be a trigger.
Some health problems. Some long-term health problems can cause nonallergic rhinitis or make it worse. These include diabetes and a problem that happens when the thyroid gland doesn’t make enough thyroid hormone.

Nonallergic rhinitis might be linked to:

Nasal polyps. These are soft growths that form on the tissue that lines the inside of the nose. Polyps also can form on the lining of the spaces inside the nose and head, called sinuses. Polyps are caused by swelling, also known as inflammation. They’re not cancer. Small polyps might not cause problems. But larger ones can block the airflow through the nose. That makes it hard to breathe.
Sinusitis. This is swelling of the sinuses. Long-term congestion in the nose due to nonallergic rhinitis can raise the risk of sinusitis.
Trouble with daily life. Nonallergic rhinitis might affect your work or school grades. You also might need to take time off when your symptoms flare or when you need a checkup.

If you have nonallergic rhinitis, take steps to ease your symptoms and prevent flare-ups:

Learn your triggers. Find out what factors cause your symptoms or make them worse. That way you can stay away from them. Your health care provider can help you learn your triggers.
Don’t use decongestant nose sprays or drops for too long. Using these medicines for more than a few days at a time can make your symptoms worse.
Get treatment that works. If you’ve tried a medicine that doesn’t help enough, talk to your health care provider. A change to your treatment plan may be needed to prevent or ease your symptoms.

Your health care provider will likely give you a physical exam and ask you about your symptoms. You’ll need tests to find out if something other than nonallergic rhinitis is causing your symptoms.

You may have nonallergic rhinitis if:

You have a stuffy nose.
Your nose runs or mucus drips down the back of your throat.
Tests for other health problems don’t find causes such as allergies or a sinus problem.

In some cases, your provider might have you try a medicine to see whether your symptoms get better.

Checking for allergies

Allergies often cause symptoms such as sneezing and a stuffy, runny nose. Some tests can help make sure that your symptoms aren’t caused by an allergy. You may need skin or blood tests.

Skin test. The skin is pricked and exposed to tiny bits of common allergens found in the air. These include dust mites, mold, pollen, and cat and dog dander. If you’re allergic to any of these, you’ll likely get a raised bump where your skin was pricked. If you’re not allergic, your skin won’t have changes.
Blood test. A lab can test a sample of your blood to find out if you have an allergy. The lab checks for higher levels of proteins called immunoglobulin E antibodies. These can release chemicals that cause allergy symptoms.

Sometimes, symptoms may be caused by both allergic and nonallergic triggers.

Checking for sinus problems

Your provider also will want to find out if your symptoms are due to a sinus problem. You might need an imaging test to check your sinuses.

Nasal endoscopy. This test checks the sinuses with a thin tool that has a camera on the end. The tool is called an endoscope. The endoscope is passed through the nostrils to look inside the nose.
Computerized Tomography (CT) scan. This test uses X-rays to make images of the sinuses. The images are more detailed than those made by typical X-ray exams.

Treatment of nonallergic rhinitis depends on how much it bothers you. Home treatment and staying away from triggers might be enough for mild cases. Medicines may ease worse symptoms. These include:

Saline nose sprays. Saline is a mixture of salt and water. Saline nose spray helps moisturize the nose. It also helps thin mucus and soothes the tissue that lines the inside of the nose. You can buy saline nose spray off the shelf at stores. But a home remedy known as nose irrigation might work even better. It involves using a large amount of saline or a saltwater mixture to help clean out irritants and mucus.
Antihistamine nasal sprays. Antihistamines treat many health problems, including allergies. An antihistamine nose spray may ease the symptoms of nonallergic rhinitis too. Your provider may write you a prescription that lets you buy this type of spray at a pharmacy. These sprays include azelastine (Astepro, Astepro Allergy) or olopatadine hydrochloride (Patanase).
Antihistamines taken by mouth often don’t work as well for nonallergic rhinitis as they do for allergic rhinitis. These antihistamines include diphenhydramine (Benadryl), cetirizine (Zyrtec Allergy), fexofenadine (Allegra Allergy) and loratadine (Alavert, Claritin).
Ipratropium nose spray. This prescription spray can ease a runny, drippy nose. Side effects can include nosebleeds and dryness inside the nose.
Decongestants. These medicines help narrow the blood vessels in the nose and lessen congestion. Side effects can include high blood pressure, heart pounding and feeling restless. Decongestants can be bought off store shelves or with a prescription. Examples include drugs with pseudoephedrine (Sudafed 24 Hour) and phenylephrine.
Steroids. These medicines help prevent and treat swelling linked with some types of nonallergic rhinitis. Side effects can include a dry nose or throat, nosebleeds, and headaches. Your provider may suggest a steroid nose spray if decongestants or antihistamines don’t control your symptoms. Steroid sprays that you can buy off the shelf include a fluticasone (Flonase Allergy Relief) and triamcinolone (Nasacort Allergy 24 Hour). Stronger steroid sprays also can be prescribed.

Your health care provider may suggest surgery to treat other problems that can happen with nonallergic rhinitis. For example, growths in the nose called polyps may need to be removed. Surgery also can fix a problem where the thin wall between the passages in the nose is off-center or crooked. This is called a deviated septum.

References

Lieberman PL. Chronic nonallergic rhinitis. https://www.uptodate.com/contents/search. Accessed Dec. 17, 2020.
AskMayoExpert. Nonallergic rhinitis. Mayo Clinic; 2020.
Nonallergic rhinitis. Merck Manual Professional Version. https://www.merckmanuals.com/professional/ear,-nose,-and-throat-disorders/nose-and-paranasal-sinus-disorders/nonallergic-rhinitis#. Accessed Dec. 17, 2020.
Nonallergic rhinitis (vasomotor rhinitis) definition. American Academy of Allergy, Asthma & Immunology. https://www.aaaai.org/Tools-for-the-Public/Allergy,-Asthma-Immunology-Glossary/Nonallergic-Rhinitis-Vasomotor-Defined. Accessed Dec. 19, 2020.
Crisci CD, et al. A precision medicine approach to rhinitis evaluation and management. Current Treatment Options in Allergy. 2020; doi:10.1007/s40521-020-00243-1.
Sur DKC, et al. Chronic nonallergic rhinitis. American Family Physician. 2018;98:171. https://www.aafp.org/afp/2018/0801/p171.html. Accessed Dec. 19, 2020.
Ferri FF. Non-allergic rhinitis. In: Ferri’s Clinical Advisor 2023. Elsevier; 2023. https://www.clinicalkey.com. Accessed Dec. 14, 2022.
Medical review (expert opinion). Mayo Clinic. Jan. 9, 2023.
Is rinsing your sinuses with neti pots safe? U.S. Food & Drug Administration. https://www.fda.gov/consumers/consumer-updates/rinsing-your-sinuses-neti-pots-safe. Accessed Jan. 9, 2023.

Book your appointment TODAY!

Search on the closest Doctor to your location and book based on specialty. EARN 10 POINTS more with CuraPOINT.

BOOK

Edit Template

Nonallergic Rhinitis

When to see a doctor

Checking for allergies

Checking for sinus problems

Related Topics

Diabetes and Exercise

Exercise, Lifestyle, And Your Bones

How to Avoid Overheating During Exercise

Book your appointment TODAY!

Find a healthcare provider near you

Call for support

Feel free to message us!

About Us

Additional Links

AI Tools

Change the habbits