Will you please describe the symptoms of rhinitis? Thank you.
Reply: -------------------------
Rhinitis refers to inflammation of the mucosal lining of the nasal passages. Typically there is associated swelling of the lining and hypersecretion from the mucous glands located within the lining. The swelling results in obstruction or blockage of airflow through the nose, the so-called "stuffy nose". The hypersecretion from mucous glands result in either a "runny nose" or post-nasal drip. In certain cases, post-nasal drip can lead to other respiratory tract symptoms including sneezing,sore throat, cough, frequent throat clearing, hoarseness, or wheezing. When nasal airflow obstruction is severe, discomfort can be felt in the sinus cavities.
There are many causes of rhinitis the most common of which is the common cold or viral upper respiratory infections. Another common cause of rhinitis is allergy which typically produces seasonal symptoms of watery nasal drainage, sneezing, itching and watering of the eyes, and nasal congestion. Non-allergic and non-infectious forms of rhinitis also occur and are typically referred to as vasomotor rhinitis which is usually associated with perennial symptoms of nasal obstruction and nasal drainage.
The medical management of rhinitis is directed toward the main bothersome symptoms. Nasal airflow obstruction is commonly treated with topical or systemic decongestants. Topical decongestants work extremely well for acute nasal airflow obstruction but shouldn't be used in a continuous fashion for any longer than 3-5 days to avoid a phenomenon known as "rebound" rhinitis or rhinitis medicamentosa. Such topical agents include Afrin (oxymetazoline) or Neo-synephrine sprays. Systemic decongestants also are used to treat nasal blockage and are available both over-the-counter (ex. Sudafed) or by prescription (ex. Entex, Duratuss, guiaifed, etc.). Profuse watery nasal discharge such as that seen in allergy or vasomotor rhinitis is usually treated with antihistamines which are also available either over-the-counter (ex. Benadryl) or by prescription (ex. Claritin, Seldane, etc.). However, one should avoid antihistamines if thick nasal drainage is present such as that seen in infectious rhinitis. Many decongestant medications contain an ingredient known as a mucolytic (guaiafenesin) which is also contained in expectorant medications and is designed to make secretions thinner. In severe or chronic cases of rhinitis, steroids are often used, usually in a topical form(Nasacort, Rhinocort, Flonase, etc.). Many sinus or nasal medications are combination medications containing a number of agents that act differently and it is important to understand what the active ingredients are intended to do. All of these medications including over-the-counter as well as prescription medicines have potential side effects of which everyone should be aware. Decongestants for example contain ingredients which may adversely affect blood pressure or cause insomnia and antihistamines may cause drowsiness to name a couple of such side effects.
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Steve Dankle, MD
Otolaryngology-Head and Neck Surgery
Milwaukee, Wis
NOTICE: OFCN is not engaged in the rendering of professional medical services. The information contained on this system or any other OFCN system should not supplant individual professional consultation. It is offered exclusively as a community education service. Advice on individual problems must be obtained directly from a professional.
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