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Affects up to 30% of adults.
It results in pale, edematous turbinates that may be misdiagnosed as nasal polyps.
In patients with rhinitis nasal congestion may fluctuate in severity and alternate from side to side with exaggeration of nasal cycle of congestion and the congestion in each nasal passage, causing a alternating nasal resistance.
The presence of hyposmia suggest chronic rhinosinusitis with or without polyps rather than rhinitis.
Rhinitis, also known as coryza, refers to irritation and inflammation of the mucous membrane inside the nose.
It is an umbrella term of multiple causes: such as occupational, smoking, gustatory, hormonal, senile, atrophic, medication-induced,local allergic rhinitis, non-allergic rhinitis with eosinophilia syndrome, and idiopathic, non-infectious perennial allergic rhinitis, or non-infectious non-allergic rhinitis.
Common symptoms of rhinitis are a stuffy nose, runny nose, sneezing, and post-nasal drip.
Nasal inflammation is caused by viruses, bacteria, irritants or allergens.
The most common kind of rhinitis is allergic in nature.
Allergic rhinitis is usually triggered by airborne allergens such as pollen and dander.
Aside from sneezing and nasal itching, allergic rhinitis may cause coughing, headache, fatigue, malaise, and cognitive impairment.
The allergens effective the nasal cavity may also affect the eyes, causing watery, reddened, or itchy eyes and puffiness around the eyes.
Nasal inflammation results in the generation of large amounts of mucus, producing a runny nose, as well as a stuffy nose and post-nasal drip.
In allergic rhinitis, the inflammation is caused by the degranulation of mast cells in the nose.
Degranulating mast cells release histamine and other chemicals, initiating an inflammatory process that can cause symptoms outside the nose, such as fatigue and malaise.
Infectious rhinitis may, occasionally, lead to pneumonia, either viral or bacterial.
With infectious rhinitis sneezing causes the expelling of bacteria and viruses from the respiratory tract.
In the United States, about 10–30% of adults are affected annually with allergic rhinitis.
Mixed rhinitis refers to patients with nonallergic rhinitis and allergic rhinitis.
Mixed rhinitis may represent between 50 and 70% of all acute rhinitis patients.
There are 3 types of rhinitis: infectious, includes acute and chronic infections, nonallergic-includes idiopathic, hormonal, atrophic, occupational, gustatory rhinitis, rhinitis medicamentosa , and allergic rhinitis, triggered by pollen, mold, animal dander, dust, Balsam of Peru, and other inhaled allergens.
Rhinitis is commonly caused by a viral or bacterial infections , including the common cold.
The common cold is caused by Rhinoviruses, Coronaviruses, and influenza viruses, adenoviruses, human parainfluenza viruses, human respiratory syncytial virus, enteroviruses other than rhinoviruses, metapneumovirus, measles virus, or by bacterial sinusitis, which is commonly caused by Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis.
Nonallergic rhinitis or vasomotor rhinitis, refers to rhinitis that is not due to an allergy.
Causes include vasodilation due to an overactive parasympathetic nerve response.
The diagnosis is made upon the exclusion of allergic causes.
In vasomotor rhinitis, nonspecific stimuli, including changes in environment- temperature, humidity, barometric pressure, or weather, airborne irritants, dietary factors, sexual arousal, exercise, and emotional factors trigger rhinitis.
Drinking alcohol may cause rhinitis.
In populations, particularly those of European descent, a genetic variant in the gene that metabolizes ethanol to acetaldehyde, ADH1B, is associated with alcohol-induced rhinitis.
Aspirin and other non-steroidal anti-inflammatory drugs (NSAIDs), particularly those that inhibit cyclooxygenase 1 (COX1) can worsen rhinitis and asthma symptoms in individuals with a history of either one of these diseases.
It is suspected these non-allergic triggers cause dilation of the blood vessels in the lining of the nose, which results in swelling and drainage.
Non-allergic rhinitis co-existing with allergic rhinitis, and is ref2242ed to as mixed rhinitis.
Vasomotor rhinitis appears to involve neurogenic inflammation.
Overexpression of transient potential receptors or non-neuronal nasal epithelial cells influence the nasal airway hyper-responsiveness to non-allergic irritant environmental stimuli,such abs extremes of temperature, changes in osmotic or barometric pressure.
Vasomotor rhinitis is significantly more common in women than men.
Some believe that hormone imbalance plays a role in vasomotor rhinitis.
In general, age of onset of vasomotor rhinitis occurs after 20 years of age.
Allergic rhinitis can be developed at any age.
Individuals with vasomotor rhinitis typically experience symptoms year-round,.
Vasomotor rhinitis symptoms may be exacerbated in the spring and autumn when rapid weather changes are more common.
Estimated that 17 million United States citizens have vasomotor rhinitis.
The antihistamine azelastine nasal spray, may be effective for vasomotor rhinitis.
Fluticasone propionate or budesonide steroidsin nostril spray form may also be used for symptomatic treatment.
The antihistamine cyproheptadine is also effective, probably due to its antiserotonergic effects.
Allergic rhinitis may follow when an allergen such as pollen, dust, or Balsam of Peru is inhaled by an individual with a sensitized immune system, triggering antibody production.
The antibody production binds to mast cells, which contain histamine, which is released when they are stimulated by allergens
Histamine release is associated with itching, swelling, and mucus production.
Physical findings in allergic rhinitis include: conjunctival swelling and erythema, eyelid swelling, lower eyelid venous stasis, lateral crease on the nose, swollen nasal turbinates, and middle ear effusion.
Patients with a negative skin-prick allergy test, and blood tests for allergies, may still have allergic rhinitis, from a local allergy in the nose: local allergic rhinitis.
A patch test may be used to identify if a substance is causing the rhinitis.
Rhinitis medicamentosa is a form of drug-induced nonallergic rhinitis which is associated with nasal congestion brought on by the use of certain oral medications..
Medications involved include primarily sympathomimetic amine and 2-imidazoline derivatives and topical decongestants including oxymetazoline, phenylephrine, xylometazoline, and naphazoline nasal sprays that constrict the blood vessels in the lining of the nose.
Chronic rhinitis is a form of atrophy of the mucous membrane and glands of the nose.
Rhinitis sicca refers to a chronic form of dryness of the mucous membranes.
Chronic rhinitis is associated with polyps in the nasal cavity.
Pathological changes in non-allergic rhinitis include: nasal airway epithelial metaplasia in which goblet cells replace ciliated columnar epithelial cells in the nasal mucous membrane, mucin hypersecretion by goblet cells and decreased mucociliary activity.
In non-allergic rhinitis: there is an imbalance between sympathetic and parasympathetic nasal mucous membrane activity.
Clinically, nasal secretions are not adequately cleared with nasal congestion, sinus pressure, post-nasal dripping, and headache. being manifested.
There is an association of rhinitis with asthma developing later in life.
Vasomotor rhinitis is differentiated from viral and bacterial infections by the lack of purulent exudate and crusting, and can be differentiated from allergic rhinitis because of the absence of an identifiable allergen.
The management of rhinitis depends on the underlying cause.