Rhinitis is a common condition many people have to see their primary care physician (GP) or an ENT specialist for. It accounts for a significant amount of time taken off work. In simplistic terms rhinitis may either be allergic (commonly referred to as hay-fever) or non-allergic. Other types of rhinitis may be associated systemic disease (e.g. Wegener’s grannulomatosis, sarcoidosis) or caused by drugs (e.g. beta blockers, oral contraceptives, aspirin and local decongestants). A careful history, examination and sometimes blood tests or a skin prick test help to make the distinction between the various types of rhinitis.
Managing allergic rhinitis is essentially done in a step ladder approach starting with education about allergen management. The other two steps in managing allergic rhinitis are the use of antihistamines (usually non sedating ones) and topical nasal steroid sprays. More recently the benefits of drugs such as montelukast and simpler measures such as using saline douches have been recognised. Desenstisation is a measure not commonly used in the UK because of the risk of anaphylaxis.
Non allergic rhinitis can be managed by avoiding the drugs that cause it or managing the systemic conditions that cause rhinitis. Many times topical nasal sprays may be required in non allergic rhinitis to control symptoms.
Most forms of rhinitis are eventually controlled rather than cured and measures to control the symptoms may need to be employed on a long term basis.