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Nonallergic Rhinitis: When a runny nose is not related to allergies

Not all runny noses are caused by the common cold or seasonal allergies. There is a condition called nonallergic rhinitis that resembles nasal allergies, but is not a result of an immune response to an allergen.

It produces chronic runny noses with postnasal drip and sneezing without apparent cause. It usually develops in older adults with symptoms occurring all year round.

Rhinitis is inflammation of the nasal mucous membrane with symptoms of congestion, runny nose, itching, postnasal drip, and sneezing. Older adults are more susceptible to rhinitis due to age-related changes in the nasal cavity, such as tissue dryness, altered nasal airflow, and a reduced ability to move mucus and particles out of the airway.

Often, the exact cause of nonallergic rhinitis remains unknown. But the most common types include:

DRUG-INDUCED RHINITIS. Some medications can cause a drippy nose as a side effect, which includes aspirin, ibuprofen (Advil, Motrin) and other non-steroidal anti-inflammatory drugs; antidepressants; blood pressure medicines (beta-blockers); oral contraceptives or erectile dysfunction drugs.

Overusing decongestant nasal sprays (more than 3-5 days) can lead to even more nasal discharge and longer duration of symptoms with the rhinitis becoming less susceptible to the solution (rhinitis medicamentosa.)

ENVIRONMENTAL RHINITIS. This refers to the runny nose due to environmental irritants such as cold air or weather changes; exposure to perfumes, cleaning solutions, laundry detergent, smoke, chlorine, latex and pollutants; exercise; and even emotional or physical stress.

GUSTATORY RHINITIS. Certain foods, especially hot or spicy, can trigger nonallergic rhinitis. Examples include chili powder, curry, hot peppers, hot sauce, horseradish, or onions. In some cases, alcoholic beverages (beer or wine) can be the triggers.

HORMONAL RHINITIS. This type of runny nose occurs due to hormonal changes: puberty, pregnancy, menstruation, lactation, and thyroid disease. Pregnant women can feel more congested during the third trimester and it can continue until the baby is born.

OCCUPATIONAL RHINITIS. Occupations can expose people to inhaled irritants that can lead to both allergic and nonallergic rhinitis. The most common triggers include livestock, pets, flour, foods, cleaning products, electronic equipment, and lab chemicals.

Nonallergic rhinitis closely resembles allergic rhinitis, so it may be hard to tell the two apart.

Unlike allergic rhinitis, nonallergic rhinitis doesn’t respond to allergy medicines or allergy shots (immunotherapy), that’s why it’s important to have allergy testing performed by a specialist to rule out the allergic form.

Treatment is often patient-specific.

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