Rhinitis (nasal allergy)

What is rhinitis?

Rhinitis is inflammation of the nose. When inflammation occurs lining of the nose can become swollen, red or pale, wet and occasionally painful. Causes of rhinitis include infections including the common cold,  sinusitis, allergy, irritation from chemicals and rare conditions such as autoimmune illnesses including Wegener’s granulomatosis

Rhinitis is diagnosed from the story, the appearance of the nose during endoscopic examination and special allergy tests if appropriate. The allergy tests can include blood tests or skin prick tests.

The treatment for rhinitis depends on the cause of the rhinitis. In the case of a common cold there is no specific cure. The nose will recover in due course over a few days. Decongestants can help but should not be used for more than a few days due to potential damage to the lining of the nose. In the case of allergic rhinitis treatment involves avoiding things that may precipitate an allergic reaction. In the case of Seasonal allergic rhinitis (hay fever) with sensitivity to pollen this would involve reducing exposure by closing windows on a day when pollen counts are high or  using a filter in your car. In the case of a allergic sensitivity to house dust mite allergy and avoidance measures would include: Reducing soft  flooring, low allergy covers for pillow mattress and duvets, artificial filling material for bedding (for example polyester rather than feathers).

Medical  treatments include antihistamine and steroids. Antihistamines can be applied as a spray or taken as a tablet/liquid. Steroids are generally applied as a topical medication to the nose for example nasal spray or drops. Steroids can also be given tablets or an injection but these if taken regularly would be associated with potential significant side effects after prolonged use.  There are specific immune therapeutic treatments reduce allergic reaction specific allergens (substances that because allergy). These include Grazax®  which is a tablet taken every day underneath the tongue for several months in order to induce reduced allergic reaction to grass pollen. Immunotherapy can also be given as an injection to specific items person may be allergic to. This tends to be given for  potentially serious allergies such as  for reactions to peanuts or wasp/bee stings.

Surgical treatments include reduction of the inferior turbinates. The inferior turbinates are one of the air conditioning fins within the nose to help moist and warm and filter. Often in  allergic rhinitis  the inferior turbinates can increase in size and cause blockage. There are many ways of reducing the size of the inferior turbinates. These include diathermy or excision of the inferior turbinate. Inferior turbinate surgery does result in. Of nasal crusting, runny nose, occasional nosebleeds and infections. Once the healing has completed  the nose should  be less blocked. The surgery does not cure an underlying allergy and the nose may continue to run and feel somewhat congested.

The video below shows a nose where the left nose has not been operated.  The right inferior turbinate has been removed. The first half of the video shows the left nasal cavity with the inferior turbinate in place and the second half of the video shows the right nasal cavity. Note that one can see right to the back of the nose on the right side where the inferior turbinate has been removed.