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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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OKC named 4th most challenging city for spring allergies

3-15-2023 – Today, the Asthma and Allergy Foundation of America (AAFA) released its annual Allergy Capitals™ report for 2023. The report identifies the most challenging cities for pollen allergies in the 100 most populated metropolitan areas in the continental United States. Cities are ranked based on tree, grass, and weed pollen scores, over-the-counter allergy medicine use, and availability of board-certified allergists/immunologists.

Oklahoma City was ranked fourth and Tulsa was fifth. Wichita, Kansas, took the top spot based on its high tree and grass pollen scores, higher-than-average use of allergy medicines, and limited number of allergy/immunology specialists per patient.

The top 20 Allergy Capitals for 2023 are 1. Wichita, KS; 2. Dallas, TX; 3. Scranton, PA; 4. Oklahoma City, OK; 5. Tulsa, OK; 6. Sarasota, FL; 7. Cape Coral, FL; 8. Orlando, FL; 9. Des Moines, IA and 10. Greenville, SC.  Oklahoma was sixth in 2022 while Tulsa was 21st.

AAFA began identifying annual Allergy Capitals 20 years ago in 2003. Since that first report, pollen counts have worsened. This year’s report once again highlights the significant impact that climate change has on public health – specifically, for people with pollen allergies. Rising temperatures result in longer growing seasons, leading to higher pollen concentrations in many areas of the country.

“We are experiencing longer and more intense allergy seasons because of climate change. For people with asthma, allergies can trigger an asthma attack,” says Kenneth Mendez, CEO and president of AAFA. “About 81 million people in the U.S. have seasonal allergic rhinitis, which is most often caused by pollen allergies. If we don’t take immediate action on the climate crisis, pollen production will only intensify. This means more allergy and asthma attacks and additional strain on our health systems.”

The National Climate Assessment from the U.S. Global Change Research Program confirms that climate change is a major threat to public health. Longer and more intense pollen seasons caused by climate change particularly impact people with allergies and asthma. From 1990-2018, the plant-growing season extended an average of 20 days and produces about 21 percent more pollen, putting people with pollen allergies at risk of more symptoms for longer periods. Allergies can also trigger asthma episodes or attacks. Around 60-80 percent of the nearly 26 million people in the U.S. with asthma have allergic asthma.

“As pollen counts spike, we often see spikes in emergency room visits for asthma,” Mendez says. “Around 3,600 people per year die from asthma, so it is important to address and manage asthma and allergy triggers where you live.”

Black, Hispanic, and Indigenous populations bear the disproportionate burden of air pollution, asthma, allergies, and climate change. This is the result of a long history of discriminatory housing and environmental policies in the U.S. that have pushed people of color to live in undesirable neighborhoods with greater environmental and social risks. As a result of systemic racism in U.S. policies, governance, and culture, racial and ethnic minority populations are more vulnerable to the health impacts of climate change.

“AAFA’s Allergy Capitals™ report serves as a national call-to-action on climate change due to its impacts on individual and community health,” says Melanie Carver, chief mission officer of AAFA. “While there are steps individuals can take to manage their symptoms, it is imperative for communities to build their climate resiliency, improve their city planning, and take action on health disparities impacting higher risk populations.”

For people who are impacted by pollen allergies, there are options available to prevent or treat allergy symptoms. Treatment options include over-the-counter or prescription allergy medicines. Medications are most effective when started before a person’s allergy season begins.

“The Oklahoma City area has pollen all four seasons of the year, so many allergy sufferers don’t get much of a break,” said Bret Haymore, MD, board-certified allergist with the Oklahoma Allergy & Asthma Clinic.

Haymore recommends seeing an allergist who can find out what your allergy triggers are and make a treatment plan to best help manage them.

For more information, visit the OAAC website at www.oklahomaallergy.com to view the addresses for all Oklahoma Allergy and Asthma Clinic locations.  To make an initial appointment or to request more information, please call (405) 235-0040.

Spring Allergy Chart

 

The post OKC named 4th most challenging city for spring allergies appeared first on Oklahoma Allergy and Asthma Clinic.

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