▶️ Rhinitis is a common condition that affects the lining of the nose and causes symptoms such as sneezing, congestion, runny nose, and itching.

– There are different types of rhinitis, depending on the cause and duration of the symptoms. Some of the most common types are:

1). Allergic Rhinitis

– This is caused by an allergic reaction to substances in the air, such as pollen, dust mites, mold, animal dander, or cockroach droppings. It can be seasonal (occurring at certain times of the year) or perennial (occurring throughout the year). Allergic rhinitis affects about 40 to 60 million Americans.

2). Nonallergic Rhinitis

– This is not caused by an allergic reaction, but by other factors that irritate the nose, such as infections, medications, foods, drinks, smoke, fumes, weather changes, hormonal changes, or stress. It can be acute (lasting for a short time) or chronic (lasting for a long time). Nonallergic rhinitis affects about 58 million Americans.

3). Infectious Rhinitis

– This is caused by a viral or bacterial infection of the nose, such as the common cold or sinusitis. It usually lasts for a few days to a few weeks and resolves with or without treatment. Infectious rhinitis is very common and can affect anyone.

CAUSES/RISK FACTORS FOR RHINITIS

– Some of the risk factors for rhinitis are:

• Family history: RLS can run in families, especially if the condition starts before age 40. Researchers have identified sites on the chromosomes where genes for RLS may be present.

• Iron deficiency: Low levels of iron or the incorrect use of iron in the brain are the main causes of RLS. Several conditions may affect iron levels, such as kidney failure, peripheral neuropathy, diabetes, Parkinson's disease, rheumatoid arthritis, and iron deficiency anemia.

• Pregnancy: RLS is common during pregnancy, particularly from week 27 until birth. In most cases, the symptoms disappear within four weeks of giving birth.

• Kidney disease: People with chronic kidney disease or end-stage renal disease may have low iron levels and reduced dopamine production, which can trigger RLS .

• Medications: Some drugs can worsen or cause RLS, such as antihistamines, antidepressants, antipsychotics, lithium, and some anti-nausea drugs .

• Lifestyle factors: Smoking, drinking alcohol, consuming caffeine, and being overweight or obese can increase the risk or severity of RLS.

SYMPTOMS OF RHINITIS

The symptoms of rhinitis are the signs that indicate a problem with the lining of the nose. Some of the common symptoms of rhinitis are:

• Sneezing, which is a reflex action to clear the nose of irritants or allergens.

• Congestion, which is a feeling of stuffiness or blockage in the nose due to swelling of the nasal tissues or excess mucus production.

• Runny nose, which is a discharge of clear, watery, or thick mucus from the nose.

• Itching, which is a sensation of irritation or discomfort in the nose, eyes, ears, or throat.

– These symptoms may vary in severity and frequency, depending on the type and cause of rhinitis. Some types of rhinitis may also cause other symptoms, such as:

• Postnasal drip, which is a flow of mucus from the nose to the back of the throat, causing coughing, sore throat, or bad breath.

• Loss of smell or taste, which is a reduced ability to detect odors or flavors due to inflammation or obstruction of the nasal passages.

• Headache, facial pain, or pressure, which are caused by sinus inflammation or infection.

• Earache, which is caused by fluid buildup or infection in the middle ear.

• Eye symptoms, such as redness, watering, burning, or itching, which are caused by allergic conjunctivitis (inflammation of the eye membranes).

– Rhinitis can affect your quality of life by interfering with your sleep, work, school, and social activities. It can also increase your risk of developing other health problems, such as sinusitis (inflammation of the sinuses), otitis media (infection of the middle ear), asthma (inflammation of the airways), and nasal polyps (growths in the nose). Therefore, it is important to seek medical attention if you have persistent or severe symptoms of rhinitis.

DIAGNOSTIC STEPS FOR RHINITIS

– The diagnosis of rhinitis is usually based on the medical history and physical examination of the patient. Sometimes, additional tests may be needed to confirm the type and cause of rhinitis, such as skin or blood tests for allergies, nasal endoscopy or CT scan for sinus problems, or nasal swabs or cultures for infections.

TREATMENT OF RHINITIS

– The treatment of rhinitis depends on the type and severity of the symptoms, as well as the patient's preferences and goals.

– Some of the general principles of treatment are:

• Avoiding or reducing exposure to the triggers that cause or worsen the symptoms. This may include using allergen-proof covers for bedding and pillows, using air filters or humidifiers in the bedroom, washing hands and clothes frequently, avoiding smoking or secondhand smoke, and avoiding foods or drinks that trigger symptoms.

• Using medications that can help relieve the symptoms and reduce inflammation in the nose. These may include nasal sprays (such as saline, antihistamines, corticosteroids, ipratropium, or decongestants), oral medications (such as antihistamines, leukotriene modifiers, decongestants, or pain relievers), or eye drops (such as antihistamines or mast cell stabilizers).

• Using alternative or complementary therapies that may help improve the symptoms or quality of life. These may include nasal irrigation with saline or salt water solution, acupuncture, herbal remedies, probiotics, or homeopathy.

• Considering immunotherapy (also known as allergy shots or sublingual tablets) for patients with moderate to severe allergic rhinitis that is not well controlled by usual treatments, in patients who cannot tolerate standard therapies or want to avoid long-term medication use, and in patients with allergic asthma. Immunotherapy involves exposing the patient to gradually increasing doses of the allergen over a period of time to induce tolerance and reduce sensitivity.

THE PROGNOSIS OF RHINITIS

– The prognosis of rhinitis depends on the type and cause of the condition, as well as the patient's response to treatment and adherence to preventive measures. Some types of rhinitis may resolve spontaneously or with treatment, while others may persist for a long time or recur frequently.

Some complications of rhinitis may include: nasal polyps (growths in the nose), sinusitis (inflammation of the sinuses), otitis media (infection of the middle ear), sleep apnea (breathing pauses during sleep), asthma (inflammation of the airways), and impaired quality of life.

Some recent studies on rhinitis have focused on:

🔅 The role of microbiome (the collection of microorganisms that live in and on our body) in the development and modulation of allergic rhinitis.

🔅 The efficacy and safety of new medications or formulations for the treatment of allergic rhinitis.

🔅 The impact of climate change and air pollution on the prevalence and severity of allergic rhinitis .

🔅 The association between allergic rhinitis and other chronic diseases such as cardiovascular disease , diabetes , depression, and dementia.

– Rhinitis is a common but complex condition that can affect anyone at any age. It can have various causes and triggers that can influence its symptoms and treatment. By understanding more about rhinitis and its different types, patients can work with their health care providers to find the best management plan for their condition.

▶️ Can nonallergic rhinitis turn into allergic rhinitis?

– Nonallergic rhinitis is a condition that causes nasal symptoms such as sneezing, congestion, runny nose, and itching, but it is not caused by an allergic reaction. Allergic rhinitis is a similar condition, but it is caused by an immune system response to substances in the air, such as pollen, dust mites, mold, or animal dander.

– Nonallergic rhinitis and allergic rhinitis can have overlapping symptoms and triggers, but they have different mechanisms and treatments.

Nonallergic rhinitis does not usually turn into allergic rhinitis, because they are different types of rhinitis with different causes. However, some people may have both nonallergic and allergic rhinitis at the same time or at different times of the year. This is called mixed or combined rhinitis. For example, a person may have nonallergic rhinitis caused by irritants such as smoke or perfume, and also have allergic rhinitis caused by pollen or dust. In this case, the person may experience more severe or persistent symptoms than someone who has only one type of rhinitis.

– The diagnosis of nonallergic rhinitis, allergic rhinitis, or mixed rhinitis can be challenging, because the symptoms are often similar and the triggers can vary from person to person. A thorough medical history and physical examination are essential to determine the type and cause of rhinitis. Sometimes, additional tests may be needed to confirm the diagnosis, such as skin or blood tests for allergies, nasal endoscopy or CT scan for sinus problems, or nasal swabs or cultures for infections.

– The treatment of nonallergic rhinitis, allergic rhinitis, or mixed rhinitis depends on the severity and frequency of the symptoms, as well as the patient's preferences and goals.

Some general strategies to manage rhinitis include:

• Avoiding or reducing exposure to the triggers that cause or worsen the symptoms. This may include using allergen-proof covers for bedding and pillows, using air filters or humidifiers in the bedroom, washing hands and clothes frequently, avoiding smoking or secondhand smoke, and avoiding foods or drinks that trigger symptoms.

• Using medications that can help relieve the symptoms and reduce inflammation in the nose. These may include nasal sprays (such as saline, antihistamines, corticosteroids, ipratropium, or decongestants), oral medications (such as antihistamines, leukotriene modifiers, decongestants, or pain relievers), or eye drops (such as antihistamines or mast cell stabilizers).

• Using alternative or complementary therapies that may help improve the symptoms or quality of life. These may include nasal irrigation with saline or salt water solution, acupuncture, herbal remedies, probiotics, or homeopathy.

• Considering immunotherapy (also known as allergy shots or sublingual tablets) for patients with moderate to severe allergic rhinitis that is not well controlled by usual treatments, in patients who cannot tolerate standard therapies or want to avoid long-term medication use, and in patients with allergic asthma. Immunotherapy involves exposing the patient to gradually increasing doses of the allergen over a period of time to induce tolerance and reduce sensitivity.