Rinitis

Rinitis is a common inflammatory condition of the nasal mucosa characterized by symptoms such as nasal congestion, rhinorrhea, sneezing, and itching. It can be allergic or non-allergic. Allergic rhinitis is IgE-mediated and triggered by environmental allergens such as pollen, dust mites, animal dander, or mold. It is seasonal (hay fever) or perennial. Non-allergic rhinitis includes vasomotor rhinitis, occupational rhinitis, drug-induced rhinitis, and hormonal or irritant-induced forms; symptoms resemble allergic rhinitis but occur without a specific allergen trigger. Pathophysiology involves inflammatory mediators such as histamine and leukotrienes, with eosinophils and IgE playing key roles in allergic rhinitis.

Diagnosis relies on clinical history and nasal examination; skin prick testing or serum-specific IgE testing can confirm sensitization when an allergic cause is suspected. Nasal endoscopy or imaging may be used to evaluate complications such as polyps or sinusitis. The condition is typically classified by duration (intermittent vs persistent) and severity (mild vs moderate-severe).

Management aims to reduce symptoms and prevent complications. Allergen avoidance and environmental control are foundational for allergic rhinitis. Pharmacologic therapy includes intranasal corticosteroids as first-line treatment for persistent symptoms, intranasal or oral antihistamines, leukotriene receptor antagonists, and saline nasal irrigation. Short courses of nasal decongestants may be used briefly to relieve congestion but are discouraged for long-term use due to rebound congestion. Immunotherapy (allergen immunotherapy) can modify disease in selected patients and may reduce symptoms over time. Non-allergic rhinitis treatment focuses on trigger avoidance and symptom-directed therapy. Complications of rhinitis include sinusitis, nasal polyps, and sleep disturbances. The prognosis varies; many patients achieve good control with appropriate therapy, though rhinitis can be a chronic condition with recurrent symptoms.