RUNNY NOSE - NOT ALWAYS ALLERGY

Rhinitis is defined as inflammation of the nasal membranes and is characterised by a typical symptom complex and has both acute and chronic causes. Allergic rhinitis is but one cause of chronic rhinitis and differentiating allergic rhinitis from other causes of rhinitis can be difficult as the diagnostic criteria for the various forms of rhinitis are not always clear-cut. Non-allergic rhinitis has nine basic subclassifications, as follows: (i) infectious rhinitis, (ii) drug-induced rhinitis, (iii) vasomotor rhinitis, (iv) hormone-induced rhinitis, (v) gustatory rhinitis, (vi) atrophic rhinitis, (vii) occupational rhinitis, (viii) non-allergic rhinitis with eosinophilia syndrome (NARES) and (ix) rhinitis secondary to systemic disorders, e. g. cystic fibrosis or primary ciliary dyskinesia. Each of these requires specific therapy. The aim of this article is to remind clinicians that chronic rhinitis, labelled as allergic in nature, requires proof of allergy. In addition when chronic rhinitis does not respond to conventional 'allergy' treatments, other causes for this condition should be sought rather than endlessly adding therapies to a failing regimen.