Allergy Asthma Immunol Res.  2011 Jul;3(3):148-156. 10.4168/aair.2011.3.3.148.

Management of Rhinitis: Allergic and Non-Allergic

• Tran NP
• Vickery J
• Blaiss MS

• KMID: 1803320
• DOI: http://doi.org/10.4168/aair.2011.3.3.148

Abstract

Rhinitis is a global problem and is defined as the presence of at least one of the following: congestion, rhinorrhea, sneezing, nasal itching, and nasal obstruction. The two major classifications are allergic and nonallergic rhinitis (NAR). Allergic rhinitis occurs when an allergen is the trigger for the nasal symptoms. NAR is when obstruction and rhinorrhea occurs in relation to nonallergic, noninfectious triggers such as change in the weather, exposure to caustic odors or cigarette smoke, barometric pressure differences, etc. There is a lack of concomitant allergic disease, determined by negative skin prick test for relevant allergens and/or negative allergen-specific antibody tests. Both are highly prevalent diseases that have a significant economic burden on society and negative impact on patient quality of life. Treatment of allergic rhinitis includes allergen avoidance, antihistamines (oral and intranasal), intranasal corticosteroids, intranasal cromones, leukotriene receptor antagonists, and immunotherapy. Occasional systemic corticosteroids and decongestants (oral and topical) are also used. NAR has 8 major subtypes which includes nonallergic rhinopathy (previously known as vasomotor rhinitis), nonallergic rhinitis with eosinophilia, atrophic rhinitis, senile rhinitis, gustatory rhinitis, drug-induced rhinitis, hormonal-induced rhinitis, and cerebral spinal fluid leak. The mainstay of treatment for NAR are intranasal corticosteroids. Topical antihistamines have also been found to be efficacious. Topical anticholinergics such as ipratropium bromide (0.03%) nasal spray are effective in treating rhinorrhea symptoms. Adjunct therapy includes decongestants and nasal saline. Investigational therapies in the treatment of NAR discussed include capsaicin, silver nitrate, and acupuncture.

Keyword

Allergic rhinitis; nonallergic rhinitis; intranasal corticosteroids; immunotherapy; intranasal antihistamines; oral antihistamines

MeSH Terms

Acupuncture
Adrenal Cortex Hormones
Allergens
Capsaicin
Cholinergic Antagonists
Eosinophilia
Estrogens, Conjugated (USP)
Histamine Antagonists
Humans
Immunotherapy
Ipratropium
Leukotriene Antagonists
Nasal Decongestants
Nasal Obstruction
Odors
Pruritus
Quality of Life
Rhinitis
Rhinitis, Allergic, Perennial
Rhinitis, Atrophic
Silver Nitrate
Skin
Smoke
Sneezing
Therapies, Investigational
Tobacco Products
Weather
Adrenal Cortex Hormones
Allergens
Capsaicin
Cholinergic Antagonists
Estrogens, Conjugated (USP)
Histamine Antagonists
Ipratropium
Leukotriene Antagonists
Nasal Decongestants
Silver Nitrate
Smoke

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