Inflammation of the inside of the nose that is not caused by an allergy

Aetiology

• Infection - usually viral infection such as a cold
• Vasomotor rhinitis - caused by parasympathetic overdrive within the nose (autonomic dysfunction)
  • Can be triggered by chemical irritants, changes in weather, excess humidity or a very dry atmosphere, and stress
• Occupational rhinitis - symptoms only occur in the workplace due to inhaled irritants only being present at work e.g. latex, wood dust
• Hormonal rhinitis - pregnancy, hormone medication (HRT, contraceptive pill)
• Drug-induced rhinitis - ACEi, β-blockers, NSAIDs, cocaine

Pathophysiology

• The lining of the inside of the nose becomes swollen and inflamed, usually because of swollen blood vessels and fluid building up in the tissues of the nose
• This swelling blocks the nasal passages and stimulates the mucus glands in the nose, resulting in the typical symptoms of a blocked or runny nose

Clinical features

• Rhinorrhoea
• Sneezing
• Itchy nose
• Nasal congestion

Management

• Depends on cause
• Supportive management of viral infection
• Avoidance of triggers if relevant
• Consider anticholinergics e.g. ipratropium for vasomotor rhinitis