The diagnosis of nonallergic rhinitis is made after eliminating allergic or IgE-mediated causes.
The most common cause of nonallergic rhinitis is an acute viral infection.
Less common chronic causes include
Vasomotor rhinitis
Hormonal rhinitis
pregnancy, oral contraceptive use, and hypothyroidism.
Pregnancy-induced rhinitis generally improves after delivery.
Symptom improvement after hypothyroidism treatment remains unclear.
Non-allergic rhinitis with eosinophilia syndrome
Occupational rhinitis (irritant subtype)
Rhinitis medicamentosa
Repetitive use of topical alpha-adrenergic decongestant sprays (for five to seven consecutive days) may induce rebound nasal congestion after withdrawal (rhinitis medicamentosa).
Extensive use may cause inflammatory mucosal hypertrophy and chronic congestion.
The mucosa becomes red and inflamed with occasional bleeding.
Discontinuation of the topical decongestant resolves the problem, although many patients find this process difficult
Drug-induced rhinitis
aspirin
oral contraceptive pill
ACE inhibitors
methyldopa
vasoconstrictor nasal sprays
Vasomotor rhinitis
is characterized by prominent symptoms of nasal obstruction, rhinorrhea, and congestion.
may be caused by autonomic stimulation
2 types
“Runners,” who demonstrate “wet” rhinorrhea
“Dry” patients, who exhibit nasal obstruction and airflow resistance with minimal rhinorrhea
These symptoms are excessive at times and are exacerbated by
certain odors (e.g., perfumes, cigarette smoke, paint fumes, inks)
alcohol
spicy foods (gustatory rhinitis)
emotions and sexual arousal
environmental factors – temperature, barometric pressure changes, and bright lights.
