What is Chronic Rhinitis?
Chronic Rhinitis is a persistent condition where the nasal passages remain inflamed, causing a runny or stuffy nose: it is considered “chronic” when it has persisted for more than 4 weeks without interruption. This inflammation can be triggered by allergens like pollen, dust, and mold or irritants such as smoke, tobacco smoke, spicy foods and temperature changes. People with a history of allergies, asthma, or chronic sinusitis are more prone to developing this condition.
The Different Types of Rhinitis
Chronic rhinitis can be categorized into allergic and non-allergic types. The symptoms, including nasal congestion, postnasal drip, and sneezing, can significantly impact a person’s quality of life. Diagnosis often involves reviewing the patient’s medical history and conducting tests to identify underlying causes, with the goal of reducing inflammation and improving nasal function.
- Allergic Rhinitis: Chronic Allergic Rhinitis is related to allergens in the environment that stimulate the internal lining of the nose, causing inflammation and irritation. Perennial allergic rhinitis, also known as seasonal allergic rhinitis, may be a result of seasonal allergy issues like hay fever. The internal lining of the nose functions as your body’s first line defense against irritants in the environment, almost like a natural thermostat. Any time the nose detects something in the environment that may cause irritation lower in the respiratory system, it will attempt to humidify and cleanse the air. This results in increased secretions and release of inflammatory chemicals that attempt to remove the irritant. However, sometimes the lining is too sensitive to the environment and may result in chronic inflammation and chronic rhinitis.
- Non-Allergic Rhinitis: Non-allergic rhinitis refers to chronic inflammation related to non-allergic causes. This may be due to reactivity to weather, temperature, medication, age, hormonal changes (pregnancy, aging, menstruation, thyroid conditions), infection (respiratory, sinus), or prior surgery.
Common Chronic Rhinitis Symptoms
Chronic Rhinitis is characterized by chronic drainage from the nose, sometimes associated with nasal congestion and difficulty breathing. Depending on the cause of allergic rhinitis, there may be other associated symptoms. For example, allergic chronic rhinitis may be associated with sneezing, watery eyes, itchiness, and/or rash related to allergen exposure. Rhinitis related to sinus infections may be associated with headaches, fevers, fatigue, or thick nasal secretions.
How do you Treat Chronic Rhinitis?
Treatment of chronic rhinitis requires treating the underlying cause. Usually treatment involves a combination of oral and topical medications including antihistamines, steroids, and nasal saline irrigations.
Allergic Rhinitis Treatment
For patients with allergic rhinitis, treatment often includes nasal irrigation, nasal corticosteroids, and oral antihistamines to reduce inflammation and control symptoms.Additional reduction in environmental exposure may also improve symptoms, such as using air purifiers and avoiding exposure to allergens. Severe cases may require blood tests to identify specific allergens, immunotherapy or allergy testing to tailor treatment plans.
Non-Allergic Rhinitis Treatment
Treatment for non-allergic rhinitis typically involves using nasal and oral decongestants, nasal sprays, and other medications targeting the specific triggers or underlying conditions. For example, nasal decongestants can alleviate congestion, while antihistamines may help manage symptoms related to non-allergic triggers like smoke or strong odors. Nasal irrigation with saline sprays can also be beneficial in maintaining clear nasal passages and reducing inflammation. Non-allergic rhinitis related to infections should target the underlying infection to alleviate symptoms.
Effective treatment of chronic rhinitis requires addressing the underlying cause, often involving a combination of medications, nasal sprays, and lifestyle changes.
What Procedures are Available for Treatment of Chronic Rhinitis?
For severe cases of chronic rhinitis that do not respond to conservative medical therapy, several procedures are available.
Chronic Rhinitis Surgery Options
- Deviated Septum: Patients with chronic rhinitis due to a deviated septum may benefit from septoplasty, a corrective surgery to realign the nasal airway.
- Sinus and Polyps: For those with chronic sinusitis or nasal polyps, endoscopic sinus surgery can alleviate obstruction in the sinus cavities and reduce chronic inflammation.
- Nasal Turbinate Surgery: Reducing the size of the nasal turbinates can also help decrease nasal congestion and improve airflow.
- Septal Perforation: Repairing a perforated nasal septum can reduce symptoms such as chronic nasal discharge and crusting.
Are the Non Surgical Alternatives for a Chronic Runny Nose?
Yes, there are several non-surgical alternatives for managing chronic rhinitis and alleviating the symptoms of a chronic runny nose. These treatments focus on reducing inflammation, controlling symptoms, and preventing exposure to known triggers.
- Nasal Sprays and Nasal Corticosteroids: Nasal sprays, particularly those containing corticosteroids, are highly effective in reducing nasal inflammation and relieving symptoms like nasal congestion and postnasal drip. These sprays work by decreasing the inflammatory response in the nasal passages, providing long-term relief for patients with both allergic and non-allergic rhinitis.
- Oral Antihistamines and Decongestants: Oral antihistamines are a cornerstone of treatment for allergic rhinitis, as they block the effects of histamine, a chemical released during an allergic response. Oral decongestants can also help alleviate nasal congestion by shrinking the blood vessels in the nasal passages, improving airflow.
- Nasal Irrigation: Nasal irrigation with saline solutions is a simple and effective way to cleanse the nasal passages and remove mucus, allergens, and irritants. Regular use of nasal irrigation can help prevent the buildup of allergens and reduce chronic inflammation.
- Environmental Control and Allergen Avoidance: Reducing exposure to allergens and irritants is crucial for managing chronic rhinitis. Using air purifiers, keeping windows closed during high pollen seasons, and regularly cleaning bedding and carpets can help minimize exposure to common allergens like dust mites and pollen.
These non-surgical treatments can significantly improve the quality of life for patients with chronic rhinitis by effectively managing symptoms and preventing complications. It’s essential for patients to work closely with their healthcare providers to develop a personalized treatment plan that addresses their specific triggers and symptoms.
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