Nonallergic rhinopathy
Rhinitis - nonallergic; Idiopathic rhinitis; Nonallergic rhinitis; Vasomotor rhinitis; Irritant rhinitis
Rhinitis is a condition that includes a runny nose, sneezing, and nasal stuffiness. When environmental allergies (such as hayfever) or a cold are not causing these symptoms, the condition is called nonallergic rhinitis. One type of nonallergic rhinitis is called nonallergic rhinopathy. This condition used to be known as vasomotor rhinitis.
The mucosa, or mucous membrane, is a type of tissue that lines the nasal cavity. Mucous membranes are usually moist tissues that are bathed by secretions such as in the nose.
Causes
Nonallergic rhinopathy is not caused by an infection or allergy. The exact cause is unknown. Symptoms are triggered by something that irritates the nose, such as:
- A dry atmosphere
- Air pollution
- Alcohol
- Certain medicines
- Spicy foods, and in some cases, while eating in general
- Strong emotions
- Strong odors, such as perfumes, cleaning products (especially bleach) among others
Symptoms
Symptoms include:
- Runny nose
- Nasal congestion (stuffy nose)
- Sneezing
- Watery nasal drainage
Exams and Tests
Your health care provider will ask about your symptoms, when they occur, and what seems to trigger them.
You will also be asked about your home and work environment. Your provider may look inside your nose to check if the tissues lining your nose are swollen due to inflamed blood vessels.
A skin test may be done to check for specific allergies as a cause of your symptoms.
If your provider determines you can't have skin testing, special blood tests may help with the diagnosis. These tests, known as IgE allergen tests, can measure the levels of allergy-related substances. They also measure total IgE levels, which correlate to allergy or lack of allergy. A complete blood count (CBC) test can measure eosinophils (allergy-type white blood cells) to get a total eosinophil count. This may also help diagnose allergies.
Treatment
The main treatment is simply avoiding the things that trigger your symptoms.
Ask your provider if decongestants or nasal sprays containing an antihistamine are right for you. Corticosteroid nasal sprays may be useful for some forms of nonallergic rhinopathy.
Hi. I'm Dr. Alan Greene and I would like to give you a tip for how to use nasal sprays that contain medications. This is especially useful for the steroid nasal sprays that are used to treat allergies, but also true for the ones used for a cold or other things as well. Now, the middle part of the nose between the two nostrils is called the septum and it's got cartilage in there and a lot of blood vessels where nosebleeds typically come from. And when the medication squirts straight into the septum that can cause side effects - irritation, bleeding, and other things like that. Now most of the time when people use a nasal spray what they will do is either use the same hand for both sides or use one hand for the nostril closest to you and one for the other. I'm going to suggest you do just the opposite of that. You take one hand and squirt into the other nostril. When you do that, you naturally point the stream away from the septum and avoid the side effects. It's a simple trick that works really well.
When to Contact a Medical Professional
Contact your provider if you think you have symptoms of nonallergic rhinopathy.
References
Corren J, Baroody FM, Togias A. Allergic and nonallergic rhinitis. In: Burks AW, Holgate ST, O’Hehir RE, et al, eds. Middleton's Allergy: Principles and Practice. 9th ed. Philadelphia, PA: Elsevier; 2020:chap 40.
Sur DKC, Plesa ML. Chronic nonallergic rhinitis. Am Fam Physician. 2018;98(3):171-176. PMID: 30215894
Yan CH, Hwang PH. Nonallergic rhinitis. In: Flint PW, Francis HW, Haughey BH, et al, eds. Cummings Otolaryngology: Head and Neck Surgery. 7th ed. Philadelphia, PA: Elsevier; 2021:chap 39.
Version Info
Last reviewed on: 5/7/2023
Reviewed by: Stuart I. Henochowicz, MD, FACP, Clinical Professor of Medicine, Division of Allergy, Immunology, and Rheumatology, Georgetown University Medical School, Washington, DC. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
