Coping With Chronic Rhinitis

Mom wiping runny nose
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Chronic rhinitis is best described as a set of symptoms that persists for months or even years. These symptoms usually consist of a runny nose, an itchy nose, sneezing, congestion or post-nasal drip. Depending on the root cause of your rhinitis it may be further classified as allergic or non-allergic.

Coping With Chronic Allergic Rhinitis

Allergic rhinitis is a common condition and even when you are able to identify a trigger for your symptoms the condition can still become chronic in nature. This may be because you have multiple allergies and the triggers are difficult to avoid because you do not respond well to treatment or other factors.

In addition to nasal symptoms, many people with allergic rhinitis suffer from itchy or watery eyes. Controlling the symptoms of chronic allergic rhinitis is important to prevent complications such as chronic sinusitis, or nasal polyps.

If your specific allergies have not yet been identified this can be an important first step in managing your condition. This is often done by a specialist called an immunologist but can also be ordered by an ear, nose, throat doctor (otolaryngologist) or even a general practitioner. The most common culprits for year-round (perennial) chronic rhinitis are dust, mold and pet dander.

Once your allergy triggers have been identified you should take measures to avoid them if possible. For example, if you are allergic to dust mites regular cleaning and reducing the humidity in your home may be helpful. If you are allergic to pet dander keeping your pets out of your bedroom at night can help to control your symptoms. 

Your symptoms may also be controlled with medications such as antihistamines. Many different antihistamines are currently available over-the-counter in the United States including diphenhydramine, loratidine, cetirizine, and fexofenadine. Newer antihistamines such as fexofenadine tend to be less sedating than older antihistamines such as diphenhydramine. It's a good idea to consult your doctor or pharmacist before taking an antihistamine. Make sure you inform them of any allergies you have as well as other medications you might be taking.

Nasal decongestants can be used in addition to antihistamines to help control your symptoms. While oxymetazoline is available over-the-counter it may be more likely to cause rebound congestion than prescription nasal decongestants. Rebound congestion is also referred to as nasal spray addiction. It is a condition that can occur when decongestants (specifically those that contain steroids) are used longer than 3 days at a time. Talk to your doctor about the best option for you regarding a nasal decongestant.

You may also wish to try a neti pot or a cool mist humidifier to help you to control symptoms. These are available at most drug stores and can help to thin your secretions, relieving symptoms such as congestion and postnasal drip.

You should also be aware that symptoms such as a fever, extreme fatigue, foul-smelling nasal discharge, facial pain or toothaches can be symptoms of a sinus infection, a common complication of allergic rhinitis. If you have these symptoms you should see a doctor since additional treatment may be needed (such as antibiotics).

Coping With Chronic Non-Allergic Rhinitis

You've probably guessed but non-allergic rhinitis is rhinitis that is not caused by an allergy or an infection. This condition may also be called non-infectious rhinitis, vasomotor rhinitis, idiopathic rhinitis or intrinsic rhinitis. Also, according to which study you are reading your symptoms may have to last up to a year to truly be considered chronic.

Chronic non-allergic rhinitis is characterized by the same symptoms as allergic rhinitis, specifically nasal symptoms such as congestion and runny nose. However, people with non-allergic rhinitis rarely experience eye symptoms. People with this condition may also be extremely sensitive to strong odors. Coping with non-allergic rhinitis can be tricky since pinning down a cause for your symptoms can be difficult. 

Other conditions that cause similar symptoms include rebound congestion caused by nasal spray addiction, medication side effects, and laryngopharyngeal reflux.

It's worth noting that even though people with non-allergic rhinitis have negative skin testing for allergies some studies show that up to half of people with the condition have localized allergic reactions (mainly in the nasal passageways). There are many other theories as to what causes this condition, many including abnormalities in the nervous system.

Even though it can be hard to pin down the exact cause of your symptoms some triggers have been identified. These include cold weather or extreme temperature changes, eating spicy foods, and exposure to chemicals or other substances that may be irritating (for example air pollution). You may need to keep a journal to help to identify things that trigger your symptoms so that you can do your best to avoid these triggers. 

Medications can be used to cope with the symptoms of chronic non-allergic rhinitis but most people with this condition find oral antihistamines unhelpful. Medications that may be helpful include intranasal glucocorticoids like fluticasone, an intranasal antihistamine called azelastine and a medication called ipratropium. These medications are available in the United States by prescription. Your doctor can help you to decide if any or a combination of these medications is right for you.

Over-the-counter oral decongestants such as pseudoephedrine or phenylephrine may or may not be helpful in controlling your symptoms. Just make sure you consult your doctor or pharmacist before trying these and be aware of decongestants that can cause rebound congestion when used longer than 3 days at a time.

Other things that may help you to cope with chronic non-allergic rhinitis may include using a cool mist humidifier and drinking plenty of water to help thin your secretions. You can also try using an over-the-counter saline nasal spray, or try nasal irrigation using a neti pot, bulb syringe or other devices. These are sold at most pharmacies. 

Homeopathic remedies have been helpful for some people in controlling symptoms but the evidence of their effectiveness if very limited. These may include remedies such as capsaicin nasal spray with eucalyptol or acupuncture. You may wish to try some of these therapies if medications have not been effective in controlling your symptoms. However, be aware that there is not enough positive research for these treatments to be recommended at this time.

In some cases surgery may be beneficial such as reducing the turbinates, repairing a deviated septum or removing nasal polyps. 

Depending on the root cause of your non-allergic rhinitis you may be at risk for developing complications such as sinus infections or nasal polyps. If you experience symptoms such as facial pain, toothaches, severe headaches, extreme fatigue, foul-smelling nasal discharge or a fever you should see a physician. 

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