Understanding Rhinitis
Florida Gulf Coast Ear Nose & Throat_Hearing
May 23, 2023
Florida - Southwest
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What is Rhinitis?
Rhinitis is an incredibly common condition, affecting more than 20 million adults and more than 7 million children in the United States each year. Rhinitis means inflammation of the nose and is characterized by symptoms resulting from inflammation of the nasal mucous membrane. Rhinitis is frequently confused with sinusitis (inflammation of the sinus spaces), and most people who think they have sinusitis are really suffering from chronic rhinitis.
Symptoms
Nasal congestion
Difficult breathing
Sneezing
Runny nose
Post-nasal drainage
Itchy nose
Headaches
Description
Rhinitis features inflammation and swelling of the mucous membranes, a moist tissue that lines the nasal cavity. The purpose of this membrane is to trap dust, pollen, bacteria, viruses and other particles in a thin fluid called mucus. Tiny hairs called cilia move the particles down the throat. This keeps the air that goes into your lungs clean and free of debris.
When this membrane becomes irritated, it can cause reactions such as thickened mucus, swelling, stuffy nose, difficulty breathing, sneezing and headaches. While rhinitis usually isn’t serious, its symptoms can negatively impact sleeping, exercising, and other daily activities.
Rhinitis can be acute or chronic. Acute rhinitis is temporary, lasting a few days in most people. In others, chronic rhinitis can last weeks or months, and often recurs.
Allergic Rhinitis
Most commonly, rhinitis is caused by an allergen. An allergen is a substance that a person’s immune system recognizes as foreign or dangerous. As a result, the immune system reacts by making a type of antibody (a protein intended to neutralize the foreign substance) called Immunoglobulin E (IgE) to defend against the allergen. This reaction leads to the release of inflammatory chemicals such as histamine. When an allergen is the cause, it is called allergic rhinitis.
Allergic rhinitis can be seasonal or perennial. Seasonal allergic rhinitis is caused by an allergen that appears at a certain time of the year, such as tree pollen in the spring, grass pollen in the summer, and weed pollen and mold spores in the fall. Perennial allergic rhinitis can exist year-round from exposure to certain foods and medicines, pets and other animals, and dust mites in carpeting and upholstery.
Southwest Florida is in a tropical climate zone. While allergens here do have seasonal variation, the growing season is 12 months long, making perennial symptoms much more common than in more northern climate zones.
Most commonly, rhinitis is caused by an allergen. An allergen is a substance that a person’s immune system recognizes as foreign or dangerous. As a result, the immune system reacts by making a type of antibody (a protein intended to neutralize the foreign substance) called Immunoglobulin E (IgE) to defend against the allergen. This reaction leads to the release of inflammatory chemicals such as histamine. When an allergen is the cause, it is called allergic rhinitis.
Allergic rhinitis can be seasonal or perennial. Seasonal allergic rhinitis is caused by an allergen that appears at a certain time of the year, such as tree pollen in the spring, grass pollen in the summer, and weed pollen and mold spores in the fall. Perennial allergic rhinitis can exist year-round from exposure to certain foods and medicines, pets and other animals, and dust mites in carpeting and upholstery.
Southwest Florida is in a tropical climate zone. While allergens here do have seasonal variation, the growing season is 12 months long, making perennial symptoms much more common than in more northern climate zones.
Evaluation of Rhinitis at Florida Gulf Coast ENT
When you visit Florida Gulf Coast ENT with suspected rhinitis, your physician will ask you about your symptoms, including when they began, the severity, frequency, known triggers, and progression. Your physician will want to know what treatments you’ve tried and if they’ve been successful, and will ask about your medical history and any prior allergy testing, lab testing or imaging.
Your physician will examine the inside of your nose to evaluate the color of your nasal membrane, the amount, color and consistency of mucus, and look for swelling and any abnormalities that could be causing or contributing to your symptoms, such as a deviated septum or nasal polyps. Your physician may perform a nasal endoscopy, which uses a small camera and light to visualize the sinus openings and the back of the nose all the way to the nasopharynx and throat.
Depending on what is seen in the physical exam, additional tests may be performed, such as allergy tests, pulmonary function tests, lab testing, x-rays or CAT scans. Florida Gulf Coast ENT can perform a number of these diagnostic tests in the office for your convenience.
Once a diagnosis of rhinitis is made, your physician will develop a personalized treatment plan to help you reduce or eliminate known causes and triggers and control your symptoms with avoidance measures, environmental control, medications, immunotherapy or surgery.
Treatment of Allergic Rhinitis
Treatment of allergic rhinitis is based on the type and severity of symptoms, in addition to a person’s age, other medical conditions, daily medications, and overall health. A personalized treatment plan is required to manage allergy problems, as each individual experiences their allergy symptoms differently. Your physician at Florida Gulf Coast ENT can help you determine appropriate treatment.
Initial Treatments for Allergic Rhinitis
Allergy testing with counseling and avoidance of the substances that trigger the allergies.
Nasal irrigation flushes saline (a saltwater solution) through your nasal cavity to remove allergens and excess mucus, and to moisten the mucous membranes. This can be done with a squeeze bottle or with a number of different irrigation devices found at your local pharmacy.
Antihistamines reduce or block histamine, the major inflammatory chemical your body produces in reaction to an allergen. These medications can help with itchiness, runny nose, and sneezing, but are less effective at easing congestion. Antihistamines are available as tablets, capsules, liquids, nasal sprays, and eyedrops. They are available in both prescription and over-the-counter (OTC) formulas.
Nasal corticosteroid sprays reduce nasal inflammation and swelling and excess mucus, making it easier to breathe. They also ease congestion, runny nose, sneezing, and itching. They are available in both prescription and over-the-counter (OTC) formulas.
Decongestants reduce congestion by shrinking swollen blood vessels and nasal tissue. They don’t ease sneezing or itching symptoms. Decongestants are available as tablets, liquids, nasal drops, and nasal sprays. They are available in prescription and over-the-counter (OTC) formulas. Some are available without a prescription but must be obtained from behind the pharmacy counter. Decongestants can have adverse effects on blood pressure and heart function. They should be used with caution or under doctor supervision.
Procedural Options for Allergic Rhinitis
Allergy immunotherapy is the best long-term alternative for chronic allergic rhinitis symptoms. There are no procedures that will cure allergies, but some can reduce specific allergic rhinitis symptoms, including improved breathing and decreased sense of congestion. The procedures may reduce sense of ear fullness and pressure, facial pressure, and may reduce nasal drainage. The options include both surgical and less invasive in-office procedures.
Inferior Turbinoplasty
Nasal obstruction is commonly caused by enlargement of structures in the nose called the turbinates. Most people have never heard of the turbinates, but almost everybody has complained about their turbinates numerous times in their life. These structures are full of glandular tissue that can expand like a grape or shrink like a raisin. A very successful and minimally invasive procedure, called a turbinoplasty, removes the glandular tissue from the turbinate, reducing its size, prohibiting further growth, and reducing obstruction in the nasal cavity. The procedure is over 90% successful at improving breathing and nasal congestion, is well-tolerated and performed easily in the office, and has few
Intranasal Ablations
Intranasal ablation procedures work on specific areas of swelling in the nasal cavity to improve the openness of the nasal cavities and sinuses. Ablations decrease the glandular tissue that causes nasal obstruction, congestion, and drainage. Ablations to some of the nasal nerves can decrease the stimulation of the glands to produce mucus, reducing nasal drainage. This works especially well in individuals who frequently feel thin watery drainage running out of their nose, a condition frequently worsened by eating. Some of the most common ablation procedures are known as the Rhinaer and Clarifix procedures. The physicians at Florida Gulf Coast ENT have access to multiple ablation devices that restrictions or risks following the can treat each individual’s needs.
Balloon Sinuplasty
While typically performed specifically for chronic sinusitis, balloon sinuplasty can benefit patients with chronic rhinitis who are prone to more frequent nasal infections. Balloon sinuplasty opens the sinus drainage tracts to allow for better drainage and equalization of pressure. It can be performed safely and easily in the office with minimal post-procedure restrictions or risks.
Rhinoplasty
Typically a cosmetic procedure, some external and cosmetic nasal defects can significantly affect nasal breathing. Florida Gulf Coast ENT has physicians who specialize in rhinoplasty for both functional and cosmetic reasons.
Septoplasty
The nasal septum (the cartilage and bone in the middle of the nose that should divide the nose into two equal halves) is one of the most common reasons for chronic nasal obstruction. As we age, and in response to specific nasal or facial trauma, this cartilage and bone begins to shift away from the center, narrowing the breathing passages. Septoplasty surgery can provide significant improvement in nasal breathing and reduce the number of sinus infections in certain individuals. It is typically performed at a surgery center or hospital under general anesthesia. However, some deviations can be improved with in-office procedures. In-office balloon assisted septoplasty is becoming a more common procedure. It's currently not covered by insurance, but is a less invasive option that can be performed in the office to improve nasal breathing.
NON-ALLERGIC RHINITIS
Non-allergic rhinitis is caused by something other than an allergic reaction. A diagnosis of non-allergic rhinitis is made after an allergic cause is ruled out. Even if you do have allergies, non-allergic rhinitis can develop from other causes, including:
Nasal blockages
Bacterial infections and viruses
Certain medications
Certain foods and beverages, including alcohol
Odors or irritants in the air
Weather or temperature changes
Aging
Hormonal changes or pregnancy
Inflammation or irritation in the nose unrelated to allergy Other health conditions
Treatment of Non-Allergic Rhinitis
Your physician at Florida Gulf Coast ENT can help rule out allergic rhinitis and help determine the cause for non-allergic rhinitis. If a cause can be determined, that trigger should be avoided as much as possible, or treated appropriately if it's another medical condition such as an infection. Often, the cause of non-allergic rhinitis can’t be determined, but your physician can help you control the symptoms. While there are fewer medication options for treating non-allergic rhinitis, there are some office procedures that may help to alleviate the symptoms. The physicians at Florida Gulf Coast ENT have access to all available technologies that might improve breathing and drainage in those who suffer from non-allergic rhinitis.
RELATED CONDITIONS
There are many other conditions that feature symptoms similar to those of rhinitis. These conditions may or may not exist concurrently with rhinitis. It’s important to talk to your physician at Florida Gulf Coast ENT about your symptoms to determine the particular condition and treatment.
Asthma
Sinusitis
Conjunctivitis
Dermatitis
Eustachian tube dysfunction Nasal polyps
Sleep disturbance
- To view the original version of this article visit floridagulfcoastent.com/uploads/RhinitiseReport-sm.pdf
- Seniors Blue Book was not involved in the creation of this content.
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