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 with systemic disease (e.g. Wegener’s granulomatosis, 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. Desensitisation 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.