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Allergic Rhinitis

Also called: Hay Fever, Seasonal Allergic Rhinitis, Sporadic Allergic Rhinitis, Perennial Allergic Rhinitis

- Summary
- About allergic rhinitis
- Types and differences
- Related conditions
- Potential causes
- Signs and symptoms
- Diagnosis methods
- Treatment options
- Prevention methods
- Questions for your doctor

Reviewed By:
Norman Klein, M.D., FAAAAI
Marc J. Sicklick, M.D., FAAAAI, FACAAI

Types and differences of allergic rhinitis

All types of rhinitis Allergies occur when the immune system mistakes a harmless substance as being dangerous and attacksare broken down into two classifications. Rhinitis that lasts for less than six weeks is called acute rhinitis. Rhinitis that continues to persist beyond six weeks is called chronic rhinitis.

Allergic rhinitis is broken up into three categories depending on the frequency and timing of symptoms. These are:

  • Seasonal allergic rhinitis (SAR). Individuals with this type of rhinitis have an immune system that reacts at different times of the year depending on the types of outdoor airborne allergens present. Seasonal allergens typically include tree, grass and weed pollens as well as outdoor molds. The severity of seasonal allergic rhinitis varies by seasons and geographies.

  • Perennial allergic rhinitis (PAR). Individuals with this condition have an immune system that reacts to indoor airborne allergens such as dust mites, indoor molds and animal allergens. Because these allergens are found indoors and do not vary by season, this type of rhinitis affects individuals year-round. In certain locations where pollen or mold is present all year, individuals may suffer from perennial rhinitis outdoors.

  • Sporadic allergic rhinitis. Individuals with this condition have occasional, sporadic episodes of allergic rhinitis caused by exposure to an allergen. Episodes are triggered when the person comes into contact with allergens to which they are not normally exposed. For instance, a person who is allergic to horse hair might have an episode of sporadic allergic rhinitis while visiting a ranch. In addition to airborne allergens like pollen and molds, sporadic allergic rhinitis can also be triggered by food allergies.

The various forms of allergic rhinitis often cause similar symptoms related to the sinuses (allergic sinusitis) and/or eyes (allergic conjunctivitis). In addition, more than one form of allergic rhinitis can occur in the same person.

Not all forms of rhinitis are allergy related. Those not associated with an allergic reaction belong to the general category of non-allergic rhinitis. Non-allergic rhinitis may result from a number of factors, including irritants (e.g., cigarette smoke, pollution, fragrances, paint fumes) or infections.

Occupational rhinitis is a classification sometimes used to describe episodes of allergic rhinitis that are triggered by allergens in the work place. However, occupational rhinitis can be caused by a range of both allergic and non-allergic factors.

Types of non-allergic rhinitis include:

  • Infectious rhinitis. Rhinitis caused by a virus or a bacterial infection, such as the flu or common cold. This condition is not sensitive to a specific allergen. Instead, it is caused by viruses or bacteria. If viral, symptoms usually resolve in three to seven days, but occasionally last longer. If bacterial, antibiotics may be used to treat the infection.

  • Neutrophilic rhinosinusitis. A type of infectious rhinitis commonly triggered by a sinus infection or related condition. It is often associated with viral infections (including colds and the flu). Symptoms usually include postnasal drip and sinus pain.

  • Structural rhinitis. Rhinitis caused by abnormalities in the structure of the nasal septum. These are often the result of an injury or birth condition (such as a crooked nasal passage). The condition is characterized by year-round congestion. Surgery can be effectively used to correct the problem.

  • Hormonal rhinitis. Rhinitis caused by hormone imbalances that occur with conditions such as pregnancy and hypothyroidism. Symptoms experienced during the pregnancy usually disappear after delivery.

  • Drug-induced rhinitis. Rhinitis that results from exposure to a number of medications, including ACE inhibitors, beta blockers, aspirin, some nonsteroidal anti-inflammatory drugs, and oral contraceptives and medications to treat high blood pressure (antihypertensives), erectile dysfunction and some psychiatric conditions. Cocaine use can also cause this condition.

  • Rhinitis medicamentosa. Rhinitis caused by frequent use of over-the-counter nasal sprays. It is characterized by severe nasal congestion. Discontinued use of nasal sprays (temporarily or permanently) will often improve the condition.

  • Eosinophilic rhinitis. Rhinitis caused by weather changes or air pressure variations. It may also be referred to as NARES (non-allergic rhinitis with eosinophilia syndrome). Symptoms are similar to perennial allergic rhinitis (PAR). Therefore, it is often eliminated as a cause of rhinitis before a diagnosis of PAR is made.

  • Gustatory rhinitis. Rhinitis that occurs after eating food, especially foods that are hot in temperature or very spicy. This is not the form of rhinitis associated with food allergies.

  • Vasomotor rhinitis. Rhinitis caused by all factors not covered in other categories. It is sometimes called irritant rhinitis, because symptoms are usually triggered by environmental factors, such as exposure to inhaled irritants, cold air, high humidity, strong odors or even stress. It is characterized by congestion, sneezing and runny nose.

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Review Date: 01-17-2007
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