Types of non-allergic rhinitis
Non-infectious, non-allergic rhinitis implies watery, clear, non-purulent nasal discharge and negative results of the allergy tests. Itching, obstruction and sneezing may also occur. However, there are no specialized tests to diagnose non-allergic rhinitis. In some patients, both allergic and non-allergic rhinitis symptoms occur simultaneously. Non-allergic rhinitis develops in mid-age, whereas allergic rhinitis is common in young population. The non-contagious non-allergic rhinitis, a chronic form of rhinitis, is divided into the following categories:
Drug-induced non-allergic rhinitis is the result of acetylsalicylic acid, β-blockers, chlorpromazine, hydralazine, prazosin and many other medicines.
Changes in hormones may also cause non-allergic rhinitis. Especially, the changes occur during pregnancy, puberty, menstrual cycle and endocrine diseases, causing nasal symptoms. However, symptoms may disappear after these phases are over in some cases. For instance, post delivery, the nasal symptoms resolve completely.
Common symptoms of non-allergic rhinitis with eosinophilia syndrome (NARES) include sudden sneezing (paroxysmal sneezing), excessive watery rhinorrhea and anosmia. The nasal smear features eosinophilia while the result of a skin-prick test is negative. Generally, NARES occur as an isolated disease, but some times, it may happen with nasal polyps, aspirin intolerance and asthma. NARES is called blood eosinophilia non-allergic rhinitis syndrome (BENARS) if amount of blood eosinophilia increases.
Smoke and other substances that create irritation in the respiratory tract’s mucosa may lead to rhinitis. Even emotions, such as stress and honeymoon related emotions, can trigger symptoms of rhinitis and / or aggravate the existing symptoms. Fatigue and spicy foods can also be the cause of the rhinitis.
Sjögren’s syndrome, too many surgical procedures and exposure to radiation can cause atrophic rhinitis. The common symptoms of the atrophic rhinitis are nasal mucosal denudation, which may lead to nasal space expansion, hyposmia, fetor and crusting. Secondary atrophic rhinitis due to surgery, trauma and infection is more common than the primary form.
If parasympathetic stimulation exceeds the required level, autonomic rhinitis symptoms may appear. The most commons symptom of the autonomic rhinitis is rhinorrhea.
Idiopathic rhinitis means hyper-reaction to tobacco smoke, alcohol, fluctuations in humidity or air temperature and the like. The nasal mucosa of the patients suffering from idiopathic rhinitis is generally normal. Polyposis, structural lesions, infection and allergy do not accompany this form of the rhinitis.
Occupational non-allergic rhinitis is ascribed to a broad spectrum of disease-causing agents present in the work environment. Over 200 chemicals and many compounds of these with low molecular weight trigger symptoms of rhinitis.