This post was written by Stacy Butler, NP, PPG - Allergy, Asthma & Immunology.
Having persisting symptoms without a clear indication of their cause can be immensely frustrating, with each failed attempt to treat the elusive ailment propelling you further into discouragement. This is a common experience for millions of Americans living with non-allergic rhinitis (NAR), a condition characterized by chronic nasal symptoms unrelated to a specific allergen. To help you find relief, we break down the ins and outs of NAR, covering its symptoms, causes, diagnostic procedures and practicable treatment options.
How does NAR differ from allergic rhinitis (allergies)?
Ordinary rhinitis is swelling and irritation in the nose resulting in symptoms such as:
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nasal congestion
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sinus pressure
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headaches
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post-nasal drip
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sneezing
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runny nose
NAR can occur at any age, but it is most commonly seen in individuals over 20 years old, typically between 30 and 60. Unlike allergic rhinitis, which is caused by certain particles in the air like pollen, mold, dust mites, or animal dander, NAR doesn't involve an immune system response. Instead, symptoms are often triggered by environmental irritants, physiological changes and some medications.
This can include:
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Strong scents such as perfume, cologne, smoke, paint fumes, air pollution or smog
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A sudden decrease or increase in temperature, weather-related fronts or changes
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Eating spicy foods or reflux disease (GERD)
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Viral illnesses, especially in children
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Hormone imbalances that occur during menopause, pregnancy or puberty
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Certain medicines, such as NSAIDs, hormones, antidepressants, sedatives and blood pressure medications
How is it diagnosed?
When diagnosing NAR, an allergy specialist will obtain the patient's complete medical history, perform a physical exam, and order a skin prick test or blood work. They may also recommend a sinus scan to rule out infection or other causes of congestion, like nasal polyps.
How is it treated?
NAR is typically a persistent condition that can be lifelong. The best way to decrease symptoms is to avoid potential triggers. If exposure is unavoidable, the following options can lessen the severity of symptoms:
Increase moisture
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Using a humidifier at night or saline nasal rinses can help soothe irritated and dry nasal passages.
Oral medications
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Oral decongestants: Contac Non-Drowsy®, Sudafed® or Sudafed PE®
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Oral antihistamines: Allegra®, Zyrtec® or Claritin®.
Nasal sprays
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Nasal decongestants: Afrin®, Xyzal®, Vicks®, or Sinex®
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Nasal antihistamine: Astepro®
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Corticosteroids: Flonase®, Nasacort® and Zicam®
Check out this video for tips on how to administer nasal sprays.
Additional considerations
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Refrain from taking decongestants daily. Prolonged use can lead to rebound congestion.
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People who have high blood pressure should avoid taking decongestants.
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Individuals with severe reflux should avoid food and beverages that trigger it and see a gastroenterologist for specific recommendations.
Final thoughts
Non-allergic rhinitis can be effectively managed with the right strategies and treatments. If you experience chronic nasal symptoms and suspect that you might have NAR, consult with an allergy specialist. Parkview Health has two allergy, asthma, and immunology practices in Fort Wayne, one in Auburn and one in Columbia City. If you're interested in establishing care with one of our providers, call 260-425-6070, Monday through Friday, from 8 a.m. to 5 p.m.
