Chronic Rhinitis (cont.)
John P. Cunha, DO, FACOEP
John P. Cunha, DO, is a U.S. board-certified Emergency Medicine Physician. Dr. Cunha's educational background includes a BS in Biology from Rutgers, the State University of New Jersey, and a DO from the Kansas City University of Medicine and Biosciences in Kansas City, MO. He completed residency training in Emergency Medicine at Newark Beth Israel Medical Center in Newark, New Jersey.
William C. Shiel Jr., MD, FACP, FACR
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Melissa Conrad Stöppler, MD
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
In this Article
- Chronic rhinitis and post-nasal drip facts
- Where are the sinuses, and what do they look like?
- What are rhinitis and post-nasal drip?
- What causes rhinitis?
- Is rhinitis always related to allergies?
- What conditions cause an abnormal production of nasal secretions?
- What conditions cause an impaired clearance of nasal secretions?
- How can chronic rhinitis and post-nasal drip be treated?
- What medications can be used to treat rhinitis and post-nasal drip?
- What can be used to treat non-allergic rhinitis?
- Does salt water or nasal irrigation have any role in the treatment of rhinitis and post-nasal drip?
- What are other options for the treatment of rhinitis and post-nasal drip?
- Find a local Ear, Nose, & Throat Doctor in your town
Is rhinitis always related to allergies?
No, rhinitis may have many causes other than allergies.
Non-allergic rhinitis occurs in those individuals in whom an allergic or other cause of rhinitis cannot be identified, and the rhinitis occurs for weeks to months at a time for at least a year. These conditions may not have the other allergic manifestations such as, itchy and runny eyes and are also more persistent and less seasonal.
Forms of non-allergic rhinitis include:
- Idiopathic rhinitis often does not have a specific cause identified, but commonly includes upper respiratory infections.
- Vasomotor rhinitis is thought to occur because of abnormal regulation of nasal blood flow and may be induced by temperature fluctuations in the environment such as, cold or dry air, or irritants such as:
- air pollution,
- tobacco smoke,
- car exhaust,
- strong odors such as, detergents or fragrances, or
- weather conditions (such as the arrival of a weather front).
- Gustatory rhinitis may present predominantly as runny nose (rhinorrhea) related to consumption of hot or spicy food.
- Rhinitis of pregnancy or, generally speaking, hormonal alterations as seen with pregnancy, menopause, and some thyroid changes have been linked to rhinitis.
- Atrophic rhinitis following extensive sinus surgery or from a rare nasal bacterial infection.
- Non-allergic rhinitis with nasal eosinophilia syndrome (NARES) is characterized by a clear nasal discharge. The nasal discharge is found to have eosinophils (allergic cell type), although the patient may not have any other evidence of allergy by skin testing or history or symptoms.
Occupational rhinitis may arise from exposure to irritants at a person's workplace with improvement of symptoms after the person leaves the workplace.
Other causes of rhinitis may be related to:
- certain medications (oral contraceptives, some blood pressure medications, some anxiety medications, some erectile dysfunction medications, and some anti-inflammatory medications), or
- some nasal structural abnormalities (deviated septum, perforated septum, tumors, nasal polyps, or foreign bodies).
Infections, mostly viral, are a common cause of rhinitis. Viral rhinitis is usually not chronic and may resolve by itself.
Sometimes rhinitis may be related to other generalized medical conditions such as:
- acid reflux disease (GERD),
- Wegener's granulomatosis,
- cystic fibrosis, and
- other less common conditions.
Allergies & Asthma
Improve treatments & prevent attacks.