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Non-Allergic Rhinitis (Vasomotor)

Non-Allergic Rhinitis (Vasomotor)

Non-allergic rhinitis is a chronic condition that can occur at any age but is more common in adults. The most common symptoms are nasal congestion, post-nasal drainage, and headache, although runny nose, sneezing and itching of the nose may occur in some non-allergic individuals. Many non-allergic patients have recurrent sinusitis and middle ear infections or middle ear fluid collection.

Initial evaluation requires that surgical conditions (growths in the nose, crooked nasal septum, etc.) and general medical conditions (thyroid disease, pregnancy, etc.) are not responsible for the chronic symptoms. We recommend that ever patient have a family practitioner, internist, or pediatrician to follow them for their general medical care. If the history and physical examination are not positive for surgical or general medical problems, the patient most likely has the most common nasal problem of non-allergic or allergic nasal disease.

Non-allergic rhinitis is a very difficult topic to fully understand. The actual defect resulting in the symptoms commonly found is not known. We do know that the difficulty arises in the inability to correctly change the size of blood vessels and the quantity of mucus produced by mucus glands in the nose. Under normal circumstances the nose warms or cools the air entering the nose to 98 degrees F., increases the humidity to at least 80%, and filters unwanted substances resulting in relatively clean air at 98 degrees F. and 80% humidity entering the lungs regardless of current environmental conditions. These changes occur almost instantly with each breath. The non-allergic individual has lost the ability to make the necessary changes either from an ineffective blood vessel and mucus gland controlling mechanism, temperature and humidity sensing mechanism, or both. The end result is inappropriate blood vessel size and/or excess mucus production which can result in nasal congestion, post-nasal drainage, and headaches.

Many individuals with non-allergic nasal disease will have a significant amount of irritation, inflammation, and hyperreactivity in the nose contributing to the persistent, chronic nature of the disease.

Nasal allergy on the other hand usually presents with runny nose, sneezing, and itching but some patients can also have nasal congestion, post-nasal drainage, and headaches. With nasal allergy we usually see definite problems at certain seasons of the year or a correlation with exposures to dust, animal dander, mold or mildew exposures and in some patients’ extreme reactions to certain foods. Allergy symptoms also involving the eyes usually are redness, itching and watering of the eyes.

It is possible for an individual to have problems with both non-allergic rhinitis and allergic rhinitis, and this makes the problems at times more difficult to clearly diagnose and treat.

Several tests can be used to differentiate non-allergic rhinitis from allergic rhinitis. Skin testing, as one might expect, displays positivity in patients with allergic rhinitis, whereas a negative skin test will be obtained in patients with non-allergic rhinitis. In addition, the blood IgE levels and eosinophils (the allergy cell) are elevated in patients with allergic rhinitis but not in non-allergic rhinitis.

Non-allergic rhinitis often is triggered by drafts, temperature changes (especially cold air), by scented cosmetics (both men’s and women’s cosmetics), by cigarette and tobacco smoke, as well as fireplace smoke, scented or perfumed soaps. Many types of aerosol sprays, even scented deodorants can cause problems. Paint fumes, insecticides, bug sprays,
varnishes, and even the odor from new clothing, carpeting or furniture can cause problems. Kerosene, lighter fluids, oil and gas fumes can cause problems. House dust may act as an irritant, and should be avoided.

Do not overuse over-the-counter decongestant sprays or nose drops because these can cause “rebound” nasal congestion. All nasal decongestant sprays should be discontinued following 3 days of continuous use. Medications will be prescribed to help with this problem. A good part of the treatment is avoiding known problems and exposures, and working by trial and error to find medications that work best in your case. Medications that may be tried include: Astelin© nasal spray, decongestants, decongestant-antihistamine combinations, intranasal steroid sprays, and possibly an atropine-derivative nasal spray (Atrovent©).

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Do you have the winter sniffles?

5 ways you can manage indoor winter allergies

Do you suffer from itchy eyes, a runny nose or a scratchy throat during winter? Do you often find yourself coughing, sneezing and having trouble breathing? Chances are you may have indoor allergies.

Allergens are not just found outside in trees or grass. The indoors can host many triggers like mold in pipes, pet allergens, and dust mite and cockroach allergens.

Indoor allergies are a year-round problem, but you’ll notice them more during the winter because you spend more time at home. Also, because of the colder weather, you’re likely keeping doors and windows shut to keep the cold out. By doing that, you’re also sealing allergens indoors with you, and your heating system will recirculate the indoor air and any allergy triggers.

You don’t have to accept indoor allergies as an inevitable fact of the winter season. Using these five tips from the American College of Allergy, Asthma and Immunology (ACAAI), you can be proactive and manage your winter allergies.

1. Clean regularly
It may seem like a simple solution, but cleaning house is one of the easiest ways to deal with indoor winter allergies. Dust, mold, pet dander and dust mite and cockroach droppings can hide anywhere and cause sneezing, coughing and congestion.

To limit your exposure to these indoor allergens, keep a regular cleaning schedule. Dust and vacuum frequently, especially under and behind furniture, where allergens can easily build up. Wipe down counters and other surfaces that you use often. During the holidays, wipe off holiday decorations, especially if you’ve stored them in areas where dust and mold proliferate.

2. Reduce pet allergy triggers
It can be difficult to balance your love for your pets and indoor allergy management. Just like you, your pets are spending more time indoors, increasing your exposure to pet dander and saliva.

While you may enjoy snuggling with your pets before bed, keeping them out of the bedroom will help with any allergies you experience at night that can disrupt your sleep. During the day, keep the door to your bedroom closed, so your furry family members aren’t tempted to go in.

When petting your cat or dog, make sure to wash your hands afterward, so you don’t accidentally touch your face and provoke an allergic reaction. Finally, remember to groom your pets regularly to reduce indoor air allergens.

3. Protect your bedding from dust mites
According to the ACAAI, dust mites live and multiply in warm, humid places and are often found in pillows, mattresses, carpeting and upholstered furniture. Even if your home is visibly clean, dust mite allergen particles are too small to be seen.

Use mite-proof zippered cases for your mattress and pillows to limit your exposure to dust mites. Every week, wash and change your sheets, blankets and other bedding in hot water to eliminate any lingering dust mite droppings.

4. Find and prevent indoor mold
Did you know that there are roughly 1,000 species of mold in the U.S.? Many molds aren’t visible to the naked eye, and mold spores can cause allergic reactions when they become airborne. Because mold can grow in your basement, bathroom, under the sink and anywhere with running water, avoiding mold allergens can be difficult.

If you suspect you have indoor mold, it’s best to contact a professional who can find and clean up existing mold in your home. To prevent mold from growing inside your home, quickly stop and clean up any leaks. Also, make sure to reduce moisture and humidity in bathrooms and kitchens. If humidity control is a problem, consider a dehumidifier.

5. Find an allergist
Consulting an allergist is the best way to identify and treat your winter indoor allergies.

“Allergists are the best trained medical professionals to treat allergies and asthma,” said Kathleen May, MD, ACAAI president. “They can help you get tested, get treated and get better so you can enjoy the holiday season and beyond.”

After a consultation, your allergist may perform tests to diagnose your allergies and identify potential causes. An allergist can also prescribe antihistamines and other allergy treatments to give you relief from your allergic symptoms.

Using these five tips, you can better manage your indoor allergies this winter so you can enjoy the cozy colder months without suffering from allergies. 

About ACAAI
ACAAI is a professional medical organization of more than 6,000 allergists-immunologists and allied health professionals, headquartered in Arlington Heights, Ill. The College fosters a culture of collaboration and congeniality in which its members work together and with others toward the common goals of patient care, education, advocacy, and research. ACAAI allergists are board-certified physicians trained to diagnose allergies and asthma, administer, and provide patients with the best treatment outcomes. For more information and to find relief, talk to your OAAC provider.

The post Do you have the winter sniffles? appeared first on Oklahoma Allergy and Asthma Clinic.

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