Nonallergic Rhinitis

Diagnosis

Nonallergic rhinitis is diagnosed based on symptoms, medical history, and exclusion of allergic causes. A healthcare provider will ask about the pattern, duration, and triggers of nasal symptoms, such as exposure to strong odors, weather changes, medications, or irritants.

To rule out allergic rhinitis, allergy testing may be performed. Skin prick tests or blood tests can help determine whether symptoms are caused by an allergic response. A normal result supports a diagnosis of nonallergic rhinitis.

In some cases, a nasal examination is done to check for structural problems, infections, or nasal polyps. Imaging studies may be considered if symptoms are severe or persistent to exclude sinus disease.

Treatment

Treatment of nonallergic rhinitis focuses on relieving symptoms and avoiding triggers. Management often involves a combination of lifestyle adjustments and medications.

Common treatment options include:

• Saline nasal sprays or rinses to reduce irritation and clear mucus

• Intranasal antihistamines to control congestion and runny nose

• Intranasal corticosteroids to reduce inflammation in persistent cases

• Anticholinergic nasal sprays for excessive nasal drainage

• Avoidance of known triggers such as smoke, strong perfumes, and air pollution

Decongestant nasal sprays may provide short-term relief but should not be used for extended periods due to the risk of rebound congestion. Consistent treatment and trigger avoidance help improve symptom control and quality of life in individuals with nonallergic rhinitis.

Checking for allergies

Allergies often cause symptoms such as sneezing and a stuffy, runny nose. Some tests can help make sure that your symptoms aren’t caused by an allergy. You may need skin or blood tests.

• Skin test. The skin is pricked and exposed to tiny bits of common allergens found in the air. These include dust mites, mold, pollen, and cat and dog dander. If you’re allergic to any of these, you’ll likely get a raised bump where your skin was pricked. If you’re not allergic, your skin won’t have changes.
• Blood test. A lab can test a sample of your blood to find out if you have an allergy. The lab checks for higher levels of proteins called immunoglobulin E antibodies. These can release chemicals that cause allergy symptoms.

Sometimes, symptoms may be caused by both allergic and nonallergic triggers.

Checking for sinus problems

Your provider also will want to find out if your symptoms are due to a sinus problem. You might need an imaging test to check your sinuses.

• Nasal endoscopy. This test checks the sinuses with a thin tool that has a camera on the end. The tool is called an endoscope. The endoscope is passed through the nostrils to look inside the nose.
• computed tomography (CT) scan. This test uses X-rays to make images of the sinuses. The images are more detailed than those made by typical X-ray exams.