Chronic Rhinitis: What Causes It & Can It Be Cured?

Chronic rhinitis refers to the persistent inflammation of the lining of your nasal passages. It is a long-lasting condition that can cause many symptoms that you might find hard to manage.

Acute rhinitis is similar to chronic rhinitis, but there are some major differences between the two. Acute rhinitis is short-term and normally lasts for only a couple of weeks. Chronic rhinitis, on the other hand, typically lasts for at least 12 weeks.

Acute rhinitis is also often caused by infections such as the common cold, whereas chronic rhinitis is usually brought on by specific triggers such as allergies, environmental factors or hormonal changes.

Another important distinction between the two is that acute rhinitis usually clears up on its own or with the help of antibiotics. However, chronic rhinitis requires ongoing treatment and management.

Symptoms of chronic rhinitis

There are many symptoms of chronic rhinitis that impact your overall quality of life. These can include:

• Nasal congestion – a ‘stuffy’ or blocked nose is very common due to the inflammation of your blood vessels and tissues within the nose
• Rhinorrhoea – a runny nose which produces excess mucus
• Sneezing
• Itchiness within the nose, throat or ears
• Reduced or lost sense of smell
• Fatigue
• Coughing
• Postnasal drip
• Worsening of other health conditions such as asthma 

These symptoms are persistent in chronic rhinitis and can have an emotional impact as well as a physical one. Apart from the physical discomfort that these symptoms can bring, they can also disturb your sleep, impact your social life and even your productivity.

Losing your sense of smell can also decrease your sense of taste, making eating and drinking much more difficult. They can lead to other health conditions too, which can make daily life harder.

Therefore, seeking treatment for the symptoms of chronic rhinitis is essential.

Types of chronic rhinitis

There are four main types of chronic rhinitis — non-allergic, allergic, atrophic and mixed.

Allergic rhinitis, or hay fever, occurs because of an allergic response to an allergen such as dust, pollen or pet dander. When your body detects the allergen, your immune system overreacts and causes symptoms of rhinitis to occur.

Non-allergic rhinitis, on the other hand, is brought on when your body develops the same symptoms, but without being caused by an allergic response.

Mixed rhinitis is the most common type of chronic rhinitis and involves a combination of non-allergic and allergic rhinitis.

Atrophic rhinitis occurs inside the tissues of your nose when it atrophies (thins). Over time, the tissue becomes hard and when air flows through, your nostrils widen. This then causes your nasal passages to become too dry, leading to the development of the condition.

Whether it be an allergic trigger, environmental factor or underlying health condition, there is often an underlying cause behind chronic rhinitis.

Inflammation can play a significant role in chronic rhinitis, for instance, developing in the lining of your nose and causing associated symptoms.

Allergic rhinitis is also often caused by allergens such as pollen, dust, mould and pet dander. When these allergens in the air enter your body, they bind with something called immunoglobulin E (IgE) which causes your body to release histamine to defend against the allergen. This histamine release then leads to the symptoms associated with chronic rhinitis.

Non-allergic rhinitis doesn’t involve your immune system and is thought to develop when the blood vessels inside your nose begin to expand. This leads to congestion and swelling, as well as other rhinitis symptoms.

Non-allergic rhinitis can be caused by irritants such as:

• Detergent
• Perfumes
• Strong odours
• Pollution
• Smoke
• Dry weather conditions
• Upper respiratory infections like the common cold
• Certain medications such as beta blockers
• Hormonal changes
• Stress
• Structural abnormalities
• Other medical conditions such as asthma or chronic sinusitis

The diagnostic process for chronic rhinitis encompasses many different assessments and tests to ensure an accurate diagnosis.

As a first step, your medical history will be taken into account. A rhinologist (a doctor who specialises in problems with your nose and sinuses) will sit down with you to discuss your symptoms in more detail, including when they started, how long they've lasted and any patterns that you have noticed.

Information about any past medical conditions, allergies or family history will also be taken into account to help understand why chronic rhinitis has developed.

Your rhinologist will then perform a physical examination of your nasal passages and sinuses to check for signs of inflammation, congestion and changes in your mucus. This is usually done with a computed tomography (CT) scan or nasal endoscopy (a thin tube with a camera attached inserted into your nasal passage).

If you are affected by postnasal drip, your throat may be checked. Similarly, your ears can be checked in case there is congestion or fluid accumulation.

To confirm if your chronic rhinitis is caused by allergens or not, allergy testing will also often be performed. This can either be via a skin prick test — where small amounts of allergens are introduced to the skin and any sensitivities or reactions are analysed — or an allergen-specific blood test where a sample is analysed for allergen-specific antibodies.

While chronic rhinitis is not always curable, it can be effectively managed with the right strategies.

There are a number of top tips and effective ways to cope with chronic rhinitis. These include:

• Avoiding known allergens
• Avoiding irritants such as pollution
• Using an air purifier
• Staying hydrated
• Stopping smoking
• Nasal irrigation (rinsing your nasal passages out with a saline solution)

Understanding the underlying cause of your chronic rhinitis is crucial to ensuring you take the right approach when managing your symptoms.

Treating chronic rhinitis will depend on the type you have. Using antihistamines, for example, won’t do anything against non-allergic rhinitis. Therefore, your treatment needs to be tailored to your exact needs.

Allergic chronic rhinitis is typically treated using antihistamines to suppress the histamine release or immunotherapies like allergy injections or tablets to desensitise your immune system to the allergen. Combining these with allergen avoidance tactics can make a big difference.

Other chronic rhinitis treatments include nasal corticosteroids and decongestants.

Nasal corticosteroids usually come in the form of nasal sprays and are used to reduce inflammation and alleviate congestion. Decongestants, both oral and nasal, can provide short-term relief from congestion.

ClariFix

ClariFix is an innovative treatment that we offer at OneWelbeck. ClariFix permanently reduces symptoms of chronic rhinitis with cryotherapy and is advised if other lines of treatment haven’t worked.

We perform ClariFix as an outpatient procedure and it is done by placing a small amount of liquid nitrogen into the back of your nose. The treatment takes around half an hour and you can return to regular activities right away.

In order to identify the right treatment for your needs, it’s important to consult with a rhinologist who can help understand your exact needs and identify which type of rhinitis you have.

Here at OneWelbeck, we offer a personalised, comprehensive approach to treating chronic rhinitis. Our team of experienced rhinologists and allergists are dedicated to your wellbeing and tailor their approach based on your needs.

Don’t let chronic rhinitis control your life — book a consultation with us today to discover how we can help manage your condition. Your wellbeing is our priority and we’re here to help you breathe easy once again.