Nonallergic rhinitis Diagnosis and treatment
Diagnosis
Your healthcare professional will likely give you a physical exam and ask you about your symptoms. You'll likely need tests to find out whether something other than nonallergic rhinitis is causing your symptoms.
You may have nonallergic rhinitis if:
- You have a stuffy nose.
- Your nose runs or mucus drips down the back of your throat.
- Tests for other health conditions don't find causes such as allergies or a sinus condition.
Your healthcare professional might have you try a medicine to see whether your symptoms get better.
Checking for allergies
Allergies often cause symptoms such as sneezing and a stuffy, runny nose. You may have some tests to help make sure that allergies are not the cause of your symptoms. You also may need skin or blood tests.
- Skin test. A health professional pricks the skin and exposes it to tiny bits of common allergens found in the air. These include dust mites, mold, pollen, and cat and dog dander. If you're allergic to any of these, you'll likely get a raised bump where your skin was pricked. If you're not allergic, your skin won't have changes.
- Blood test. A lab can test a sample of your blood to find out whether you have an allergy. The lab checks for higher levels of proteins called immunoglobulin E antibodies. These can release chemicals that cause allergy symptoms.
Sometimes, both allergic and nonallergic triggers may cause symptoms.
Checking for sinus conditions
Your healthcare professional also wants to find out whether your symptoms are due to a sinus condition. You might need an imaging test to check your sinuses.
- Nasal endoscopy. This test checks the sinuses with a thin tool that has a camera on the end. The tool is called an endoscope. A health professional passes the endoscope through the nostrils to look inside the nose.
- CT scan. This test uses X-rays to make images of the sinuses. The images are more detailed than those made by typical X-ray exams.
Treatment
Treatment of nonallergic rhinitis depends on how much it bothers you. Home treatment and staying away from triggers might be enough for mild symptoms. Medicines may ease more-severe symptoms. Medicines include:
- Saline nose sprays and nasal irrigation. Saline is a mixture of salt and water. Saline nose spray helps moisturize the nose. It also helps thin mucus and soothes the tissue that lines the inside of the nose. You can buy saline nose spray off the shelf at stores. But a home remedy known as nose irrigation might work even better. It involves using a large amount of saline or a saltwater mixture to help clean out irritants and mucus.
- Antihistamine nasal sprays. Antihistamines treat many health conditions, including allergies. An antihistamine nose spray may ease the symptoms of nonallergic rhinitis too. Your healthcare professional may write you a prescription that lets you buy this type of spray at a pharmacy. These sprays include azelastine (Astepro, Astepro Allergy) or olopatadine hydrochloride (Ryaltris).
Antihistamines taken by mouth often don't work as well for nonallergic rhinitis as they do for allergic rhinitis. These antihistamines include diphenhydramine (Benadryl), cetirizine (Zyrtec Allergy), fexofenadine (Allegra Allergy) and loratadine (Alavert, Claritin).
- Ipratropium nose spray. This prescription spray can ease a runny, drippy nose. Side effects can include nosebleeds and dryness inside the nose.
- Decongestants. These medicines help narrow the blood vessels in the nose and lessen congestion. Side effects can include high blood pressure, heart pounding and feeling restless. You can buy decongestants with or without a prescription. Examples include medicines that have pseudoephedrine (Sudafed 24 Hour) and phenylephrine.
- Steroids. These medicines help prevent and treat swelling linked with some types of nonallergic rhinitis. Side effects can include a dry nose or throat, nosebleeds, and headaches. Your healthcare professional may suggest a steroid nose spray if decongestants or antihistamines don't control your symptoms. Steroid sprays that you can buy off the shelf include fluticasone (Flonase Allergy Relief) and triamcinolone (Nasacort Allergy 24 Hour). Your health professional also can prescribe stronger steroid sprays.
Your healthcare professional may suggest surgery to treat other complications that can happen with nonallergic rhinitis. For example, treatment can include removal of growths in the nose called polyps. Surgery also can fix a condition in which the thin wall between the passages in the nose is off-center or crooked. This is called a deviated septum.
Alternative medicine
Some small studies of nonallergic rhinitis have looked into treatment with the substance that gives hot peppers their heat, called capsaicin. These studies suggest that using capsaicin inside the nose can ease congestion. But it also can irritate the nose and cause side effects such as burning, sneezing and coughing. More research is needed to find out how much capsaicin to use and for how long.
Some studies also have looked at an alternative treatment in which a health professional places thin, sterile needles in the body. This is called acupuncture. Acupuncture has been used to ease pain and other symptoms. But some experts don't suggest using acupuncture for nonallergic rhinitis.
Self-care
Try these tips to ease the symptoms of nonallergic rhinitis:
- Rinse the inside of the nose. Flushing out the nose with saline or a homemade saltwater mixture can help. It works best when you do it daily. You can put the mixture into a bulb syringe or a container called a neti pot. Or you could use the squeeze bottle included in saline kits.
To prevent illnesses, use water that's distilled, sterile, boiled and cooled, or filtered. If you filter tap water, use a filter with a pore size of 1 micron or smaller. Rinse the device after each use with the same type of water. Leave the device open to air-dry.
- Gently blow your nose. Do this often if you have a lot of mucus.
- Add moisture to the air. If the air in your home or office is dry, set up a humidifier device where you work or sleep. Follow the device's instructions on how to clean it.
Or you could breathe in the steam from a warm shower. This helps loosen mucus in the nose. It also makes the head feel less stuffy.
- Drink liquids. Sip plenty of water, juice and caffeine-free tea. This can help loosen the mucus in the nose. Stay away from drinks that have caffeine.
Neti pot
A neti pot is a container designed to rinse the nasal cavity.
Preparing for your appointment
If you have nonallergic rhinitis symptoms, here's some information to help you prepare for your appointment.
What you can do
When you make the appointment, ask if there's anything you need to do ahead of time. For example, you might be told not to take medicine for congestion before the appointment.
Make a list of:
- Your symptoms. Include any that don't seem related to the reason for the appointment. Also note when each symptom began.
- Key personal information. Include recent illnesses, major stresses or recent life changes.
- All medicines, vitamins or supplements you take. Include how much you take.
- Questions to ask your healthcare professional.
For nonallergic rhinitis symptoms, some basic questions to ask your healthcare professional include:
- What could be causing my symptoms?
- What tests do I need?
- How long might my symptoms last?
- What treatments are available, and which do you suggest for me?
- I have other health conditions. How can I best manage these conditions together?
- Are there brochures or other printed materials I can have? What websites do you recommend?
Feel free to ask other questions.
What to expect from your doctor
Your healthcare professional is likely to ask you questions, including:
- Do you have symptoms all the time or do they come and go?
- How serious are your symptoms?
- Does anything seem to improve your symptoms?
- What, if anything, seems to make your symptoms worse?
- What medicines have you tried for your symptoms? Has anything helped?
- Do your symptoms get worse when you eat spicy foods, drink alcohol or take certain medicines?
- Are you often exposed to fumes, chemicals or tobacco smoke?
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