Nonallergic rhinitis involves chronic sneezing or a congested, drippy nose with no apparent cause. The symptoms of nonallergic rhinitis are similar to those of hay fever (allergic rhinitis), but none of the usual evidence of an allergic reaction is present.
Nonallergic rhinitis can affect children and adults, but it's more common after age 20. Triggers of nonallergic rhinitis symptoms vary and can include certain odors or irritants in the air, changes in the weather, some medications, certain foods, and chronic health conditions.
A diagnosis of nonallergic rhinitis is made after an allergic cause is ruled out. This may require allergy skin or blood tests.
If you have nonallergic rhinitis, you probably have symptoms that come and go year-round. You may have constant symptoms, or symptoms that last only a short time. Signs and symptoms of nonallergic rhinitis may include:
Nonallergic rhinitis doesn't usually cause itchy nose, eyes or throat — symptoms associated with allergies such as hay fever.
See your doctor if:
The exact cause of nonallergic rhinitis is unknown.
Experts do know that nonallergic rhinitis occurs when blood vessels in your nose expand and fill the nasal lining with blood and fluid. There are several possible causes, including the nerve endings in the nose being hyperresponsive, similar to the way the lungs react in asthma.
Whatever the trigger, the result is the same — swollen nasal membranes, congestion or excessive mucus.
There are many things known to trigger nonallergic rhinitis — some resulting in short-lived symptoms while others cause chronic problems. Nonallergic rhinitis triggers include:
Certain medications. Some medications can cause nonallergic rhinitis. These include aspirin, ibuprofen (Advil, Motrin IB, others), and high blood pressure (hypertension) medications, such as beta blockers.
Nonallergic rhinitis can also be triggered in some people by sedatives, antidepressants, oral contraceptives or drugs used to treat erectile dysfunction. Overuse of decongestant nasal sprays can cause a type of nonallergic rhinitis called rhinitis medicamentosa.
Factors that may increase your risk of nonallergic rhinitis include:
Complications from nonallergic rhinitis include:
Nasal polyps are soft, noncancerous growths on the lining of your nose or sinuses. They often occur in groups, like grapes on a stem.
Sinuses are cavities around nasal passages. If the sinuses become inflamed and swollen, a person may develop sinusitis.
There's currently no surefire way to prevent nonallergic rhinitis. However, a new study suggested that children who ate oily fish or certain polyunsaturated fatty acids may be less likely to develop nonallergic and allergic rhinitis. The reduced risk was seen in children who consumed herring, mackerel or salmon at least once a week.
If you already have nonallergic rhinitis, you can take steps to reduce your symptoms and prevent flare-ups:
Nonallergic rhinitis is diagnosed based on your symptoms and ruling out other causes, especially allergies. Your doctor will perform a physical examination and ask questions about your symptoms.
He or she may also recommend certain tests. There are no specific, definite tests used to diagnose nonallergic rhinitis. Your doctor is likely to conclude your symptoms are caused by nonallergic rhinitis if you have nasal congestion, a runny nose or postnasal drip, and tests for other conditions don't reveal an underlying cause such as allergies or a sinus problem.
In some cases, your doctor may have you try a medication and see whether your symptoms improve.
In many cases, rhinitis is caused by an allergic reaction. The only way to be sure rhinitis isn't caused by allergies is through allergy testing, which may involve skin or blood tests.
In some cases, rhinitis may be caused by both allergic and nonallergic causes.
Your doctor will also want to be sure your symptoms aren't caused by a sinus problem related to a deviated septum or nasal polyps. If your doctor suspects a sinus problem may be causing your symptoms, you may need an imaging test to view your sinuses.
Treatment of nonallergic rhinitis depends on how much it bothers you. For mild cases, home treatment and avoiding triggers may be enough. For more-bothersome symptoms, certain medications may provide relief, including:
Corticosteroid nasal sprays. If your symptoms aren't easily controlled by decongestants or antihistamines, your doctor may suggest a nonprescription corticosteroid nasal spray, such as fluticasone (Flonase) or triamcinolone (Nasacort). Prescription-only corticosteroid nasal sprays are also available.
Corticosteroid medications help prevent and treat inflammation associated with some types of nonallergic rhinitis. Possible side effects include nasal dryness, nosebleeds, headaches and throat dryness.
Over-the-counter oral antihistamines, such as diphenhydramine (Benadryl), cetirizine (Zyrtec), fexofenadine (Allegra) and loratadine (Claritin), typically don't work nearly as well for nonallergic rhinitis as they do for allergic rhinitis.
In some cases, surgical procedures may be an option to treat complicating problems, such as a deviated nasal septum or persistent nasal polyps.
Try these tips to help reduce discomfort and relieve the symptoms of nonallergic rhinitis:
Rinse your nasal passages. Use a specially designed squeeze bottle, such as the one included in saline kits, bulb syringe or neti pot to irrigate your nasal passages. This home remedy, called nasal lavage, can help keep your nose free of irritants. When used daily, this is one of the most effective treatments for nonallergic rhinitis.
To prevent infection, use water that's distilled, sterile, previously boiled and cooled, or filtered using a filter with an absolute pore size of 1 micron or smaller to make up the irrigation solution. Also be sure to rinse the irrigation device after each use with similarly distilled, sterile, previously boiled and cooled, or filtered water and leave open to air-dry.
A neti pot is a container designed to rinse the nasal cavity.
Some small studies have shown repeated applications of capsaicin — the ingredient responsible for the heat in hot peppers — to the inside of the nose can ease nasal congestion. The treatment is often given multiple times on the same day, and relief has been shown to last as long as 36 weeks. But larger studies are needed.
Here's some information to help you prepare for your appointment.
Preparing a list of questions for your doctor will help you make the most of your time together. List your questions from most important to least important. For nonallergic rhinitis, some basic questions to ask your doctor include:
Don't hesitate to ask other questions during your appointment.
Your doctor is likely to ask you a number of questions, including: