Nonallergic Rhinitis

Diagnosis and tests

Your healthcare provider will likely start with a physical exam and a discussion of your symptoms. Tests may be needed to rule out other causes of nasal symptoms.

You may have nonallergic rhinitis if:

• You have a stuffy nose

• Your nose runs or mucus drips down the back of your throat

• Tests for other conditions, such as allergies or sinus problems, do not reveal a cause

Sometimes, your provider may suggest trying a medicine to see if your symptoms improve.

Checking for allergies

Allergies can produce symptoms like sneezing and nasal congestion. Tests may be done to ensure your symptoms are not allergy-related.

• Skin test: Small amounts of common allergens, including dust mites, mold, pollen, and pet dander, are applied to your skin. A raised bump indicates an allergic reaction.

• Blood test: Measures immunoglobulin E (IgE) antibodies in the blood, which can trigger allergy symptoms.

Some people may have both allergic and nonallergic triggers.

Checking for sinus problems

Your provider may want to rule out sinus issues as a cause of symptoms.

• Nasal endoscopy: A thin tool with a camera is inserted through the nostrils to examine the sinuses.

• CT scan: Uses X-rays to create detailed images of the sinuses to detect any abnormalities.

Treatment

Treatment for nonallergic rhinitis depends on symptom severity. Mild cases may improve with home care and avoiding triggers. For more persistent symptoms, medications may be recommended:

• Saline nose sprays: Moisturize the nose, thin mucus, and soothe nasal tissues. Nose irrigation with a larger volume of saline may be even more effective.

• Antihistamine nasal sprays: Prescription sprays such as azelastine or olopatadine can reduce symptoms. Oral antihistamines are less effective for nonallergic rhinitis.

• Ipratropium nose spray: Eases a runny nose; side effects may include dryness or nosebleeds.

• Decongestants: Reduce nasal swelling by narrowing blood vessels; can cause high blood pressure, rapid heartbeat, or restlessness. Examples include pseudoephedrine and phenylephrine.

• Steroid sprays: Reduce inflammation and swelling; over-the-counter options include fluticasone and triamcinolone. Prescription sprays may be stronger.

In some cases, surgery may be recommended to treat structural problems or nasal growths, such as:

• Removing nasal polyps

• Correcting a deviated septum