Rhinitis

Rhinitis is defined as inflammation and irritation of the mucous membrane lining the nose (nasal tissue). It can be categorized as allergic rhinitis, non-allergic rhinitis or mixed rhinitis.

Rhinitis is a condition characterized by persistent nasal inflammation, which can be triggered by both allergic and non-allergic factors.

Allergic rhinitis is caused by sensitivity to environmental allergens like pollen, dust, animal dander, or mold, and can occur seasonally, year-round, or with specific exposures. Non-allergic rhinitis, on the other hand, has various causes unrelated to allergens, including viral infections, occupational or environmental irritants, certain medications, hormonal changes (such as pregnancy or thyroid issues), or changes in the nasal lining due to surgery or trauma. Other forms include non-allergic rhinitis with eosinophilia (NARES), gustatory rhinitis from spicy foods, and idiopathic rhinitis, which has no known cause but may involve imbalances in nasal nerve activity.

Stages of Rhinitis

Rhinitis can progress through several stages, often depending on the underlying cause and duration of the condition.

These stages include:

Symptoms such as nasal congestion, runny nose, sneezing, and itching are mild and occur intermittently. Triggers may include seasonal allergens, environmental irritants, or viral infections. Patients typically manage these symptoms with over-the-counter treatments or lifestyle adjustments.

Symptoms become more consistent and may worsen, especially with ongoing exposure to allergens or irritants. Nasal congestion, post-nasal drip, and a reduced sense of smell may occur more regularly, often requiring medical management with nasal sprays or antihistamines.

Symptoms persist for months or even years, causing significant discomfort. Non-allergic factors, such as hormonal changes, occupational exposures, or idiopathic (unknown) causes, may contribute. At this stage, the nasal lining may become permanently inflamed, leading to more severe symptoms like constant congestion and difficulty breathing.

Without proper treatment, rhinitis can lead to complications, such as sinus infections, nasal polyps, or atrophic rhinitis (where nasal tissues are damaged or become non-functional). This stage often necessitates more intensive medical or surgical intervention to manage symptoms and prevent further complications.

Factors, Symptoms, Diagnosing, and Beyond:

What are the common symptoms of rhinitis?

It can cause one or more of the following symptoms: nasal congestion (stuffiness), runny nose, sneezing, nasal itching, post-nasal drip and nasal obstruction/blockage. It can also lead to other symptoms such as cough, itchy throat, watery and itchy eyes, and ear symptoms.

How is rhinitis diagnosed by an ENT specialist?

Diagnosis is based on a thorough history/assessment, complete head and neck examination and possibly other diagnostic tests (ex. Allergy testing, imaging, etc.).

What are the best treatment options for rhinitis?

Treatment options for rhinitis include lifestyle changes, such as avoiding triggers and using environmental controls like HEPA filters and washing bedding in hot water. Medical treatments involve nasal saline rinses, steroid or antihistamine nasal sprays, and allergy immunotherapy. While there is no specific surgery for rhinitis, procedures like septoplasty, inferior turbinate reduction, or posterior nasal nerve neurectomy can help relieve symptoms like nasal congestion and drip.