What is Chronic Rhinitis?
Chronic Rhinitis refers to a chronically runny or dripping nose. It is typically related to inflammation of the internal lining of the nose. It is considered “chronic” when it has persisted for more than 4 weeks without interruption. It is usually categorized into: (1) Allergic Chronic Rhinitis, and (2) Non-Allergic Chronic Rhinitis.
- Allergic Rhinitis: Chronic Allergic Rhinitis is related to allergens in the environment that stimulate the internal lining of the nose, causing inflammation and irritation. Perennial allergic rhinitis, also known as seasonal allergic rhinitis, may be a result of seasonal allergy issues like hay fever. The internal lining of the nose functions as your body’s first line defense against irritants in the environment, almost like a natural thermostat. Any time the nose detects something in the environment that may cause irritation lower in the respiratory system, it will attempt to humidify and cleanse the air. This results in increased secretions and release of inflammatory chemicals that attempt to remove the irritant. However, sometimes the lining is too sensitive to the environment and may result in chronic inflammation and chronic rhinitis.
- Non-Allergic Rhinitis: Non-allergic rhinitis refers to chronic inflammation related to non-allergic causes. This may be due to reactivity to weather, temperature, medication, age, hormonal changes (pregnancy, aging, menstruation, thyroid conditions), infection (respiratory, sinus), or prior surgery.
What are the symptoms of Chronic Rhinitis?
Chronic Rhinitis is characterized by chronic drainage from the nose, sometimes associated with nasal congestion and difficulty breathing. Depending on the cause of allergic rhinitis, there may be other associated symptoms. For example, allergic chronic rhinitis may be associated with sneezing, watery eyes, itchiness, and/or rash related to allergen exposure. Rhinitis related to sinus infections may be associated with headaches, fevers, fatigue, or thick nasal secretions.
How do you treat Chronic Rhinitis?
Treatment of chronic rhinitis requires treating the underlying cause. Usually treatment involves a combination of oral and topical medications including antihistamines, steroids, and nasal saline irrigations.
- Allergic Rhinitis: The majority of allergy related rhinitis can be treated with nasal saline irrigation, nasal steroids, and oral antihistamines. Additional reduction in environmental exposure may also improve symptoms. In severe cases where medications do not work, allergy testing and immunotherapy may improve symptoms.
- Non-Allergic Rhinitis: Non-Allergic Chronic Rhinitis typically is also treated with oral and nasal medications that target the underlying cause. These include nasal and oral steroids. Non-allergic rhinitis related to infections should target the underlying infection to alleviate symptoms.
What procedures are available for treatment of chronic rhinitis?
For severe cases of chronic rhinitis that do not respond to conservative medical therapy, several procedures are available.
- Deviated Septum. Chronic Rhinitis related to a nasal septum deviation may benefit from corrective deviated septum surgery, known as septoplasty.
- Sinus and Polyps. Chronic rhinitis related to recurrent, chronic, or acute sinus infections with or without nasal polyposis may benefit from endoscopic sinus surgery.
- Nasal Turbinate Surgery. Reducing the size of the nasal turbinates may also improve symptoms related to chronic rhinitis.
- Septal Perforation. Correcting a perforated nasal septum may also reduce chronic nasal discharge and crusting.
- Vidian Neurectomy. Certain procedures involving nerves of the nose may reduce the sensitivity of the nose, thereby reducing inflammation.