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Rhinitis – Causes, Symptoms and Treatment
Rhinitis is an inflammation of the nasal mucosa that commonly causes a runny nose, sneezing, and nasal congestion. It can be allergic or non-allergic in origin.
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Rhinitis is an inflammation of the nasal mucosa that commonly causes a runny nose, sneezing, and nasal congestion. It can be allergic or non-allergic in origin.
What is Rhinitis?
Rhinitis refers to inflammation of the mucous membrane lining the nasal cavity. It is one of the most common conditions affecting the upper respiratory tract and can be acute or chronic. Depending on the underlying cause, several distinct forms are recognized, including allergic and non-allergic rhinitis.
Causes
The causes of rhinitis vary depending on the type:
- Allergic rhinitis: Triggered by allergens such as pollen, house dust mites, pet dander, or mold spores. The immune system overreacts to these otherwise harmless substances.
- Infectious rhinitis: Caused by viruses (e.g., rhinoviruses, influenza viruses) or, less commonly, bacteria. This is the most familiar form, commonly known as the common cold.
- Non-allergic rhinitis: Can be triggered by irritants such as tobacco smoke, air pollution, cold air, spicy foods, or hormonal changes (e.g., during pregnancy).
- Medication-induced rhinitis (rhinitis medicamentosa): Develops from overuse of topical decongestant nasal sprays.
- Vasomotor rhinitis: Caused by hyperreactivity of the blood vessels in the nasal mucosa in response to various triggers.
Symptoms
Typical symptoms of rhinitis include:
- Runny or blocked nose (nasal congestion)
- Sneezing, often in rapid succession
- Itching in the nose, eyes, or throat
- Watery or mucous nasal discharge
- Reduced sense of smell
- In allergic rhinitis, red and watery eyes (allergic rhinoconjunctivitis) are also common
- General malaise and headache in the infectious form
Diagnosis
Rhinitis is typically diagnosed through:
- Medical history: Detailed assessment of symptoms, their frequency, and potential triggers
- Physical examination: Inspection of the nasal mucosa using rhinoscopy
- Allergy testing: Skin prick test or blood test (specific IgE) if allergic rhinitis is suspected
- Nasal endoscopy: In chronic or unclear cases to assess the nasal cavity in detail
Treatment
Treatment depends on the cause and severity of rhinitis:
Allergic Rhinitis
- Antihistamines (oral or as a nasal spray) to relieve symptoms
- Intranasal corticosteroid sprays as the first-line treatment for persistent allergic rhinitis
- Allergen immunotherapy (desensitization): A long-term treatment to reduce sensitivity to the triggering allergen
- Avoidance of known allergens
Infectious Rhinitis
- Symptomatic treatment with short-term decongestant sprays, saline rinses, and adequate fluid intake
- Antibiotics only when a bacterial infection has been confirmed
Non-Allergic and Vasomotor Rhinitis
- Avoidance of triggers such as irritants and tobacco smoke
- Nasal corticosteroids or ipratropium nasal spray in cases with significant symptoms
Prognosis
Acute rhinitis, particularly when caused by cold viruses, typically resolves on its own within 7 to 10 days. Chronic or allergic rhinitis requires consistent long-term management. With timely and appropriate treatment, the prognosis is generally good. However, untreated allergic rhinitis may increase the risk of developing bronchial asthma.
References
- Bousquet J. et al. - Allergic Rhinitis and its Impact on Asthma (ARIA) Guidelines 2020 Revision. Journal of Allergy and Clinical Immunology, 2020.
- World Health Organization (WHO) - Chronic respiratory diseases: Rhinitis. Available at: https://www.who.int
- Fokkens WJ. et al. - European Position Paper on Rhinosinusitis and Nasal Polyps (EPOS) 2020. Rhinology, 2020.
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