Rhinitis is inflammation in the inside of your nose which causes congestion and the production of mucus. This can be of allergic and non-allergic origin.

Non-allergic rhinitis is swelling and inflammation of the inside of the nose usually caused by a virus or bacterial infection. This is usually because swollen blood vessels and fluid in the nose block the nasal passages and stimulate the mucus glands resulting in a blocked or runny nose. Allergenic rhinitis is similar inflammation caused by an allergy.

Common symptoms of allergic and non-allergic rhinitis include a blocked nose, a runny nose (with watery discharge), an itchy nose and sneezing. Other less common symptoms include a loss of smell, an itchy throat, face pain, headache and itchy, watery and red eyes. Rhinitis usually affects both nostrils.

Rhinitis is most commonly caused by a cold or hay fever. However, persistent rhinitis is where the symptoms do not disappear and become long-term. Sometimes the symptoms can be severe which may cause sleeping problems and interfere with day to day living, at which point you should speak to your GP about rhinitis treatment.

Non-allergic and allergic rhinitis symptoms include:

• Blocked and runny and nose
• Sneezing
• Itching, watery eyes
• Persistent symptoms may cause sleep problems and interfere with daily activities

Rarely, non-allergic rhinitis also causes a crust to develop inside the nose, which may be foul-smelling and cause bleeding if it’s removed.

The main causes of non-allergic rhinitis include:

• Infection of the nose or throat (usually viral such as a cold but sometimes bacterial or fungal)
• External factors (e.g. smoke, fumes, perfume, changes in the weather, alcohol, spicy food, stress)
• Medication (e.g. such as beta blockers)
• Drug misuse (e.g. cocaine)
• Overuse of nasal decongestant sprays
• Hormone imbalance (e.g. during pregnancy, puberty or when taking the contraceptive pill)
• Tissue damage (perhaps after earlier surgery)

Allergic rhinitis is the result of an allergic reaction to a trigger such as pollen, dust and certain animals, and may indicate an over-sensitive immune system. This is why it can sometimes be known as seasonal allergic rhinitis. Your body reacts to the allergen by producing antibodies which cause cells inside your nose and throat to become inflamed and allergic rhinitis causes the nose to produce excess mucus.

Allergens may be airborne (e.g. house dust mites, pollen and spores), or due to animals (commonly dogs, cats and rodents) or may be work-related (e.g. flour, latex or wood dust).

If you have mild allergic rhinitis, you could try treating it at home:

• Nasal irrigation or douching using a Neti pot
• Over-the-counter antihistamines or corticosteroid nasal spray or tablets, as prescribed by your GP
• Other prescription medication, including leukotriene receptor antagonist medication

If these allergic rhinitis treatments don’t help, your GP can refer you to a specialist ENT Consultant at Benenden Hospital. They may arrange allergy tests, blood tests or a further examination to eliminate other conditions such as sinusitis or nasal polyps. This may involve looking inside your nose with an endoscope, a small flexible instrument with a camera at the end.

Other tests include a nasal inspiratory flow test (to measure the airflow of your breathing) or Computed Tomography (CT scan).