Rhinitis is the general term for inflammation of the mucous membrane found in the nose. This inflammation causes excess amounts of mucus to be generated, usually resulting in a runny nose or post-nasal drip.
It is type of rhinitis that is caused by an allergic response in the body. Symptoms of can include a runny nose, sneezing, itchy eyes, itchy nose, and congestion. The materials that trigger this allergic response are called allergens, and these can be found both outdoors and indoors.
When outdoor allergens are the culprit, allergic rhinitis is called “hay fever” or seasonal allergies. Common outdoor allergens are the pollens from trees, grasses, and weeds, as well as molds that are found on plants and in the soil. These allergens are highly affected by changing weather conditions.
Perennial allergies are those that last year-round. They are caused by common indoor allergens like animal dander, the remnants of cockroaches, dust mites, and indoor molds.
Non-allergic rhinitis is rhinitis caused by pollution, smoke, strong smells, particles in the air, weather changes, or similar irritants. It can also occur as a result of a thyroid disorder, pregnancy, or as a side effect of certain medications. Non-allergic rhinitis can cause symptoms year-round, including nasal congestion.
Non-allergic rhinitis w/ eosinophilia syndrome (NARES) is characterized by the presence of eosinophils (specific blood cells seen in allergy) in nasal secretions, but negative allergy skin tests. Symptoms and medical treatment are similar to allergic rhinitis. Two factors that affect this condition are environmental changes and nasal polyps.
Rhinitis medicamentosa is a type of rhinitis that results from the overuse of non-prescription nose sprays that work by constricting blood vessels in the lining of the nose. This kind of rhinitis is best treated by stopping the use of the nasal spray that has caused the problem, though this solution may temporarily result in severe congestion. Your AllergyCorp Group doctor may recommend alternative treatments, such as a saline nasal spray or topical corticosteroids to help you through this transition.
It is a form of rhinitis that is a result of structural abnormalities in the nose, specifically the septum – the cartilage in your nose that separates the right and left sides. These abnormalities can be something that you were born with, such as small nasal passages, or the result of an injury, such as a broken nose. Structural rhinitis occurs year-round and can result in increased congestion in only one nostril.
Atrophic rhinitis is an uncommon and distinct clinical syndrome of progressive atrophy of the nasal mucosa. It is characterized by paradoxical nasal congestion and thick, troublesome nasal secretions and complicated by bacterial colonization and infection. Enlargement of the nasal cavities may occur in some forms. Most patients also have concomitant sinusitis, and thus, the disorder is more accurately called atrophic rhinosinusitis. There are primary and secondary forms of this disorder, which affect different populations and have distinct presentations.
Atrophic rhinosinusitis may be categorized into two forms: primary (or idiopathic) and secondary.
The primary form is seen primarily in young people in the developing world. It is associated with mucosal colonization, predominantly with Klebsiella ozaenae as well as other organisms. The primary presenting symptom is foul-smelling nasal discharge.
Secondary atrophic rhinosinusitis is seen with some regularity in the developed world and occurs in patients who underwent prior sinonasal trauma, surgery, radiation therapy, or have certain inflammatory conditions (granulomatous diseases).
Atrophic rhinitis can be quite a problem and can vary greatly in its severity- from a little dryness, to foul smelling crusting and infection. It can be caused by chronic infection or chronic irritation, aggressive surgery or at times we don’t know the cause. The nose works as a filter. The mucous in the nose traps particles- including bacteria, viruses, allergens and others and pushes them down into the stomach where stomach acid can destroy them. The nose also is a humidifier and temperature regulator. By the time inhaled air reaches the back of the throat, it is both 100 per cent humidified and brought to body temperature. With atrophic rhinitis, one or all of these functions are reduced or eliminated.
First, one should try to find the cause of the problem. Unusual infections such as rhinoscleroma, or inflammations such as sarcoidosis can be treated. Symptomatic treatment for atrophic rhinitis aims at replacing or reinforcing the lost functions. Hypertonic saline (extra-salty) nasal rinses are aimed at helping the nose clean itself of the particles discussed above. Topical application of ointment once or twice a day to the anterior part of the nose will help trap particles and moisturize the nasal cavity. Theoretically, these should be water soluble- such as rhinaris nasal gel- but others such as petroleum based triple antibiotic ointments like bacitracin have been used. A room humidifier, kept clean, will help in the heating months.
When there is an infection, we treat with appropriate antibiotics, preferably based on culture. For brief periods one may need oral antibiotics, but generally we rely on antibiotic ointments- such as bactroban, or appropriate antibiotic washes- I don’t recommend continuing on antibiotics topically or using oral antibiotics persistently without another indication. It may lead to getting infections that are resistant to antibiotics.
If you experience rhinitis or hay fever, our specialty staff at the AllergyCorp Group would like to help. Our specialty clinic for Allergy and Asthma has an access to the latest treatments and testing. We see adult and pediatric patients (5 yrs and older). Call AllergyCorp Group today at 910-399-2882 for Wilmington or 910-207-6520 for Whiteville clinic for more info.