Severe nasal reactions to medications, pollen, dander, foods, fragrances, and other environmental stimuli may occur as people age. These responses, often not a true allergic response, are termed vasomotor or nonallergic rhinitis (1), because they are not due to a typical “allergic” response.
Nonallergic rhinitis (“itis” as in inflammation) is associated with increased irritability, problems in focusing, sleep issues, and daytime sleepiness. Also individuals with rhinitis are at higher risk of getting asthma (2).
Hallmarks of nonallergic rhinitis include inflamed sinuses, drippy, congested nose, chronic sneezing or coughing. Nonallergic rhinitis is seen when inflammation occurs in the sinuses of the face, and the nasal membranes and blood vessels in the nose expand filling the lining of the nose with blood and fluids.
According to the Mayo Clinic specific triggers for nonallergic rhinitis also include (3):
Infections: Viral infections can result in nonallergic rhinitis due to postnasal drip and nasal discharge. Facial pain and sinusitis (inflammation and pressure in the sinus cavities of the face) may also be an unwelcome outcome.
Medications: Overuse of decongestant nasal sprays can cause rhinitis as can medications such as sedatives, beta blockers, antidepressants, oral contraceptives, erectile dysfunction drugs, blood pressure medications, aspirin, ibuprofen, and other nonsteroidal anti-inflammatory drugs (NSAIDs).
Environmental: Strong odors, such as perfumes or cleaning fluids, smoking, secondhand smoke, dust, can become a cause of nonallergic rhinitis.
Foods and beverages: Nonallergic rhinitis may occur when you eat, especially when eating hot or spicy foods. Drinking alcoholic beverages, such as beer and wine, also may cause the membranes inside your nose to swell, leading to nasal congestion.
Weather: Temperature or humidity changes can trigger the membranes inside your nose to swell and cause a runny or stuffy nose. Dr. Rohit Katial, Director of Adult Allergy and Immunology at National Jewish Health, Denver, CO states “Even cold air becomes more problematic as we get older” (1).
Stress and Exercise: Stress and exercise have been shown to induce inflamed sinuses.
Hormonal changes: Changes in hormones due to menstruation or pregnancy, or a autoimmune hormonal conditions.
The majority of inflammatory illnesses result from over production of pro-inflammatory (inflammation enhancing) cytokines, and other immune cellular factors. Our survival on earth depends on the ability of the body to rapidly generate appropriate inflammatory responses to “burn out” pathogens that threaten to destroy us.
The body must be able to modulate the amount of inflammation produced and decrease its intensity as the challenge is met. The key to health is immune homeostasis. We must generate enough of an inflammatory response to meet the threat, but in controlled amounts so that bystander tissues and organs are effected.