This month GP, Alice Fitzgibbon will cover a condition that is a common complaint – rhinitis, the blocked runny nose.
This condition, called rhinitis, can have multiple symptoms ranging from a blocked nose to constant nose running, sneezing, nasal discomfort, reduced sense of smell or a postnasal drip (the sensation of something running down the back of the throat). These symptoms can be seen in relation to an allergy like pollen as in hayfever, or they can be non-allergic. This article will focus on non-allergic rhinitis.
Non allergic rhinitis can be difficult to diagnose as there is no test for it. Your GP will ask many questions to ensure there are no obvious triggers for the symptoms. People often come to the GP as they are fed up of their persistent symptoms and the effect they are having on their quality of life. Constant congestion, sniffing and snoring can get tiresome after a while.
The symptoms of rhinitis happen because there is inflammation from swollen blood vessels and a build-up of fluid in the tissues that line the nose. The swelling blocks the nasal passages and stimulates mucous production leading to the constantly runny nose. So why does this happen? There are several causes that may be to blame for the development of rhinitis. These include:
- Environmental factors such as exposure to fumes, smoke or extremes of temperature or humidity
- Viral infections that affect the upper respiratory tract (the nose and throat) like the virus causing the common cold
- Hormone imbalances – rhinitis may develop during puberty or pregnancy or even through use of hormone containing medications
- Medication side effects
- Drug misuse – especially when substances are sniffed
- Overuse of decongestant nasal sprays
Rhinitis itself as a condition is not harmful. As I mentioned before, people seek help because it is often upsetting their quality of life. In some cases, avoiding any triggers identified and starting to use a nasal rinse spray made of salty water can really help symptoms settle down. These can be bought over the counter or made up at home.
If symptoms are severe, the GP may prescribe a steroid nasal spray to try and reduce the inflammation. These sprays need to be used on a daily basis and do take 6-8 weeks to fulfil their best effect. I often have patients complain to be that the spray did not work so they stopped using it after a week – this is a waste of time. If you have a steroid nasal spray the best thing you can do it stick with it for last two months before writing it off!
In some cases, non-allergic rhinitis can be linked to other problems such as nasal polyps, sinusitis (inflammation or infection of the sinuses) and middle ear infections. The treatment for nasal polyps will still include nasal steroids. Sinusitis and middle ear infections can often be managed with painkillers; occasionally antibiotics may be prescribed to help with longer lasting infections.
Non-allergic rhinitis is a common condition but generally not a serious one. Managing exposure to triggers and sticking with the steroid nasal spray as a treatment should hopefully help control the symptoms. If despite treatment, the problems are continuing, then a closer look at your nose and sinuses may be required by an Ear, Nose and Throat specialist and your GP can refer you for this if necessary.
For further information on rhinitis from the NHS visit https://www.nhs.uk/conditions/allergic-rhinitis/