Rhinitis is the medical term for swollen nasal mucosa resulting in nasal congestion, runny nose, sore throat, snoring, nasal quality to the voice, post-nasal drainage and cough. The cause of rhinitis is either allergic or non-allergic. Allergic rhinitis more frequently begins at a younger age, has sneezing and itchy nose/palate/eyes as symptoms, occurs in families with allergies and is accompanied by other allergic conditions in the patient (e.g. asthma, eczema, food allergy). Non-allergic rhinitis is typically year round rather than seasonal in nature, precipitated by non-specific irritants such as fumes, strong odors and smoke, and begins at any age.

Classification of non-allergic causes of rhinitis:

Non-allergic rhinitis is a broad category of rhinitic individuals who do not have an allergic etiology to their condition. The following breakdown of non-allergic rhinitis is helpful:

1. Infectious - Local invasion by microorganisms (bacteria), virus or fungus can produce nasal inflammation and symptoms of rhinitis as described above.
2. Medication induced - A number of medications can produce nasal symptoms: Inderal, aspirin, non-steroidal anti-inflammatory agents (Advil, Motrin, etc.), oral contraceptives, tricyclic antidepressants and over the counter nose sprays.
3. Anatomic - Anatomic abnormalities such as a deviated septum, enlarged adenoids in children and nasal polyps can produce nasal congestion.
4. Irritant induced - Such things as odors, fragrances, cigarette smoke, fumes, weather changes (e.g. cold fronts, barometric pressure) or pollution can stimulate the same kind of nasal symptoms as seen in a person with allergies. These are not allergies, but rather stimulants to nerve endings in the nose.
Other known causes - Altered metabolism due to pregnancy or hypothyroidism can lead to rhinitis. Finally, rare conditions such as vasculitic diseases, tumors and granulomatous diseases cause rhinitic symptoms.

Complications:

If rhinitis is not treated, infection can develop in the throat, ears, and sinuses because of the alteration of the normal nasal function and flow of secretions. Tonsils and adenoids may become enlarged and diseased, and growths called polyps may develop in the nose. Fluid can also build up in the ear -- a condition called serous otitis media. This condition is particularly common in babies and young children. Post-nasal drip can lead to cough in normal individuals and bronchospasm in patients with asthma.

Treatment:

Depending on what type of non-allergic rhinitis you have, there may be specific therapy (e.g. antibiotics for bacterial rhinitis). For the majority of patients, however, treatment involves a combination of nasal saline, antihistamines (for sneezing, itchy and watery components), oral decongestants (nose spray decongestants can cause worsening congestion if used regularly), intranasal cromolyn (over the counter called Nasalcrom) and intranasal corticosteroids (do not have side effects found with oral steroids).

Nasal saline soothes irritated nasal mucosal tissue, liquefies tenacious mucus, augments natural flow of nasal secretions, reduces nose bleeding and improves the sense of smell. Saline can be administered as follows:

1. commercial buffered saline spray (Ocean, Salinex, etc.) - Two sprays in each nostril 3-4 times a day.
2. bulb syringe - Fill a one-quart glass jar with tap water (or bottled water). You do not need to boil water. Add 2-3 tbsp. of pickling/canning salt, not table salt as it contains large numbers of additives. Add 1 tsp. Arm & Hammer^® Baking Soda (pure bicarbonate). Mix and store at room temperature, discard after one week. If too strong, decrease the salt to 1-1½ tbsp. Pour the amount you plan to use in a clean bowl so as to avoid contaminating your jar by inserting your used syringe. Express saline via a bulb syringe into alternating nostrils by placing your head sideways with ear held down over a sink so that saline goes in the lower nostril. You may blow or spit out the saline solution. It will not harm you if you swallow a little.
3. 3) Water Pik saline flush - One of the most effective ways of delivering saline to the nose. Use a rubber tipped nasal adapter for the Water Pik. Mix solution as above. Use 1-2 times per day. If you are unable to obtain the Water Pik equipment locally, call 800-253-3599 (Ethicare products) for a full line of supplies.