Rhinitis (Nasal Allergies)

What Is Rhinitis?

The word rhinitis means “inflammation of the nose.” The nose produces a fluid called mucus. This fluid is normally thin and clear. It helps to keep dust, debris, and allergens out of the lungs. Mucus traps particles like dust and pollen, as well as bacteria and viruses.

Mucus usually drains down the back of your throat. You’re not aware of this most of the time because it is a small amount and is thin. When the nose becomes irritated, it may produce more mucus, which becomes thick and pale yellow. The mucus may begin to flow from the front of the nose as well as the back. Substances in the mucus may irritate the back of the throat and cause coughing. Postnasal drip occurs when more mucus drains down the back of the throat.

What Causes Rhinitis?

Irritants or allergens (substances that provoke an allergic response) may cause rhinitis. The cells of your body react to these irritants or allergens by releasing histamine and other chemicals. Rhinitis is often a temporary condition. It clears up on its own after a few days for many people. In others, especially those with allergies, rhinitis can be a chronic problem. Chronic means it is almost always present or recurs often. Rhinitis can last for weeks to months with allergen exposure.

What Are the Types of Rhinitis?

There are several types of rhinitis:

  • Allergic rhinitis is caused by allergies to substances called allergens.  
     

  • Seasonal allergic rhinitis is sometimes called “hay fever.” But, people with seasonal allergic rhinitis do not have to have a fever and do not have to be exposed to hay to develop this condition. It is an allergic reaction to pollen from trees, grasses, and weeds. This type of rhinitis occurs mainly in the spring and fall when pollen from trees, grasses, and weeds are in the air.
     

  • Perennial allergic rhinitis is caused by allergens that are present all year long. The primary causes of this type of rhinitis are allergies to dust mites, mold, animal dander, and cockroach debris.
     

  • Non-allergic rhinitis is not caused by allergens. Smoke, chemicals, or other irritating environmental conditions may provoke non-allergic rhinitis. Hormonal changes, physical defects of the nose (like a deviated septum), and the overuse of nose sprays may also cause it. Sometimes medications cause it. Often, the cause of this type of rhinitis is not well understood. But it is common in patients with non-allergic asthma. The symptoms are similar to allergy symptoms.
     

  • Infectious rhinitis is possibly the most common type of rhinitis. It is also known as the common cold or upper respiratory infection (URI). Colds occur when a cold virus settles into the mucous membranes of the nose and sinus cavities and causes an infection.

What Are the Symptoms of Rhinitis?

Rhinitis symptoms include:

  • Itching in the nose and eyes

  • Sneezing

  • Stuffy nose (congestion)

  • Runny nose

  • Mucus (phlegm) in the throat (postnasal drip)

Is It Allergies or a Cold?

Sometimes it can be hard to tell the difference between allergies and the common cold. There are more than a hundred strains of cold viruses. Each tends to become widespread at certain times of the year, which is why you may mistake a cold for a seasonal allergy. Allergies occur at the same time every year and last as long as the allergen is in the air (usually 2-3 weeks per allergen). Allergies cause itching of the nose and eyes along with other nasal symptoms. Colds last about one week and have less itching of the nose and eyes.

What Are the Treatments for Allergic Rhinitis?

The first and best option is to avoid contact with substances that trigger your nasal allergies (allergens). When prevention is not enough, consider using over-the-counter or prescription medicines:

  • Antihistamines are taken by mouth or as a nasal spray. They can relieve sneezing and itching in the nose and eyes. They also reduce a runny nose and, to a lesser extent, nasal stuffiness.

  • Decongestants are taken by mouth or as a nasal spray or drops. They help shrink the lining of the nasal passages which relieves nasal stuffiness. These nose drops and sprays should be taken short-term.

  • Nasal corticosteroids are used in nasal spray form. They reduce inflammation in the nose and block allergic reactions. They are the most effective medicine type for allergic rhinitis because they can reduce all symptoms, including nasal congestion. Nasal corticosteroids have few side effects.

  • Leukotriene receptor antagonists block the action of important chemical messengers other than histamine that are involved in allergic reactions.

  • Cromolyn sodium is a nasal spray that blocks the release of chemicals that cause allergy symptoms, including histamine and leukotrienes. This medicine has few side effects.

Nasal allergy symptoms may disappear completely when the allergen is removed or after the allergy is treated. Talk to your pharmacist and health care provider about what is best for you. Many people with allergies do not get complete relief from medications. They may be candidates for immunotherapy. 

 

Immunotherapy is a long-term treatment that can help prevent or reduce the severity of allergic reactions and change the course of allergic diseases by modifying the body’s immune response to allergens.

How Can I Prevent Allergic Rhinitis?

The first and best option is to avoid contact with allergens. Other prevention tips are:

  • Don’t touch or rub your nose.

  • Wash your hands often with soap and water.

  • Use a vacuum with asthma & allergy friendly® filter to reduce allergen exposure while vacuuming.

  • Wash your bed linens and pillowcases in hot water and detergent to reduce allergens.

  • Use dust-mite proof covers for pillows, comforters, duvets, mattresses, and box springs.

  • Keep pets out of the bedroom to reduce pet dander allergen in your bedding.

  • Wear sunglasses and a wide-brimmed hat to reduce pollen getting into your eyes.

  • Keep windows closed during high pollen and mold seasons. 

SNORING

Snoring is very common among adults.  During sleep, the airway muscles in the throat relax.  As you breathe in, the airway vibrates, making noise.  Snoring frequently results from turbulent airflow and narrowing in the nose or throat that creates noise while you breathe during sleep. 

Sleep is vital for life, just like eating and breathing.  Sleep allows your body to rest.  It is believed that during sleep your brain performs important functions, such as storing memory and processing brain chemicals. In a way, your body goes on “auto-pilot” while you sleep.  Your brain regulates automatic functions for you, such as breathing, heart rate, and blood pressure.  Although sleep is a complex process that is not fully understood, it is known that a good night’s sleep is important for optimal health and functioning.

Causes

For some people, the cause of snoring is unknown.  However, there are several reasons why snoring may occur.  Snoring may result from deformities or obstructions in the air passages in the nose.  Nasal polyps or a deviated septum are common causes of snoring.  Nasal polyps are growths that may result from irritation, such as from allergies or cigarette smoking.  The septum is the cartilage that gives the nose its shape and divides it in half.  A deviated septum means that the cartilage is off-center, having shifted to the left or right.  A deviated septum can obstruct airflow and create noises during breathing.  Additionally, nasal congestion from a cold or allergies can lead to snoring.

 

The airway in the throat may be narrowed and cause snoring.  Enlarged tonsils, adenoids, and obesity can reduce the airway space in the throat.  Alcoholic beverages, sleeping pills, and antihistamine medication can contribute to snoring because they relax the throat muscles.  Women may experience snoring during the last month of pregnancy. 

Symptoms

Snoring causes noise when you breathe during sleep.  You may snore every night or every so often.  Snoring may be very loud or not so loud.  Your snoring may be so loud that it wakes you up from your sleep.  Some people may not realize that they snore until other household members let them know about it.

Diagnosis

You should contact your doctor if your snoring is bothersome, affects your sleep quality, or you suspect that you have sleep apnea.  Your doctor will review your medical history and ask you some questions about your sleep patterns.  Your doctor will carefully examine the structures in your nose and throat.  You may be referred to a sleep study center so that your doctor can learn more about your sleep patterns and identify sleep disorders, such as sleep apnea.

Treatment

In many cases, snoring may resolve with lifestyle changes.  It can be helpful to lose weight and not consume alcohol or medications that can contribute to snoring.  It can be helpful to sleep on your side.


Over-the-counter products, such as nasal strips and special pillows, may help to keep the airway open during sleep and prevent snoring.  Your dentist can create a mouthpiece for you to wear at night to position your jaw to help keep the airway open.  Your doctor may recommend that you wear a continuous positive airway pressure (CPAP) nasal device to help keep your airway open at night.  CPAP is used as a treatment for snoring, as well as sleep apnea.


Surgery may be used to remove nasal polyps or correct a deviated septum.  Surgery may also be used to treat structural deformities on the roof of the mouth and the back of the throat.  In some cases, injections may be used to increase the firmness of the palate at the roof of the mouth.

Prevention

You may prevent snoring by reducing the risk factors that you can control, such as maintaining a healthy weight and not drinking alcohol before bedtime.  Sleeping on your side may help.  Some doctors suggest sewing a tennis ball on the back of your nightshirt to train you to roll off your back and onto your side.

There are several risk factors for snoring such as,

Nasal obstructions, such as polyps, congestion, or a deviated septum can cause snoring.
Throat obstructions, including enlarged tonsils, adenoids, or extra tissue can cause snoring.
Obesity increases the risk of snoring, particularly in people with large neck sizes.
Women may experience snoring during their last month of pregnancy.
Consuming alcohol before going to sleep increases the risk of snoring because alcohol causes the throat muscles to relax.
Certain medications, such as sleeping pills, muscle relaxants, and antihistamines, can relax the throat and contribute to snoring.
Sleeping on your back increases the risk of snoring.  Sleeping on your side may reduce snoring.
The risk of snoring increases with age.  Your throat muscles become more relaxed as you get older.

Complications

Snoring can be a symptom of sleep apnea, a sleep disorder in which people stop breathing during their sleep.  If your partner or household members have heard you snore, stop breathing, and gasp for air, you may have sleep apnea and should contact your doctor.  Other signs of sleep apnea include daytime drowsiness and headaches upon awakening.  Untreated sleep apnea can be life-threatening and result in stroke, heart attack, or death.