Rhinitis

Rhinitis is inflammation of the nasal mucosa, typically presenting with nasal congestion, rhinorrhea, sneezing, and nasal itch. Symptoms may be seasonal or perennial and can lead to sleep disturbance and reduced quality of life. Most cases are triggered by an immune-mediated process, but nonallergic, infectious, and occupational forms occur.

Allergic rhinitis is an IgE-mediated condition driven by exposure to aeroallergens such as pollen, dust mites, and animal dander. Nonallergic rhinitis includes vasomotor, gustatory, drug-induced, hormonal, and atrophic subtypes. Infectious rhinitis is usually viral and commonly termed a cold. Occupational rhinitis arises from workplace exposures.

Diagnosis relies on history and physical examination, with nasal endoscopy performed when needed. Testing such as skin prick or serum-specific IgE helps identify aeroallergens in suspected allergic rhinitis. Imaging is not routinely required. The differential diagnosis includes chronic rhinosinusitis with or without nasal polyps, nasal polyps, and the common cold.

Management emphasizes trigger avoidance, saline nasal irrigation, and symptomatic pharmacotherapy. Intranasal corticosteroids are first-line for many patients and can be used for prolonged periods when appropriate. Antihistamines (oral or intranasal) and decongestants may be used for short periods to relieve symptoms. Allergen immunotherapy, delivered subcutaneously or sublingually, is an option for eligible individuals with allergic rhinitis who do not respond adequately to conventional therapy.

Rhinitis is usually a chronic condition that can be well controlled with appropriate treatment and avoidance strategies; it may coexist with asthma and other upper-airway disorders.