Rhinitis is a very common disorder, caused by inflammation or irritation of the nasal mucosa. Patients are most often describing it as a stuffy nose, although some would rather describe it as runny nose or excessive sneezing. Besides nasal stuffiness, hypersecretion and sneezing, patients may complain of nasal itch and ocular symptoms. Most common causes of nasal inflammation are viral infections and allergic response to airborne allergens. Response to irritants may cause similar symptoms, although signs of inflammation may not always be present.
Allergic rhinitis occurs in patients whose immune system is producing a specific antibody, immunoglobulin E (IgE), due to sensitization to certain airborne allergen, like pollens, dust, molds, animal dander, etc. The disease often occurs in families with an allergic background, which is helpful in making diagnosis in patients who have rhinitis in a certain period of the year, or aggravation of nasal symptoms occurs in the environment typical of certain allergen.
Allergic rhinitis is categorized according to sensitivity to allergens that occur seasonally, like pollens, or to allergens that are all year round, like house dust mite, molds and animal dander, into seasonal and perennial allergic rhinitis. Allergy to pollens (hay fever, pollinosis) causes the same mechanism of inflammation in response to allergens, which is the result of binding of allergen to specific IgE antibody, but patients with pollen allergy usually complain more of sneezing and runny nose, while patients with allergy to perennial allergens more often complain of obstruction, while episodes of sneezing and runny nose occur only when exposed to higher concentrations of allergens (cleaning the house, around pets).
Viral rhinitis is lasting up to 10 days, and it is a part of the common cold syndrome. In a short-lived rhinitis, lasting for 7 to 10 days, sometimes it is not easy to differentiate between potential causes of the disorder, if general symptoms of infection, like fever and malaise, are not present.
In a long-living rhinitis, it is important to differentiate between infectious, allergic, non-allergic non-infectious rhinitis, and chronic rhinosinusitis. Non-allergic non-infectious rhinitis is characterised by nasal symptoms that may be induced by exposure to irritants, tobacco smoke, temperature and humidity changes, hormonal disorders, pregnancy, use or abuse of certain drugs, most commonly nasal decongestants, and emotional stress. Itch and ocular symptoms are more common in allergic rhinitis, while other symptoms, like nasal stuffiness, runny nose and sneezing may affect patients with allergic and non-allergic rhinitis. Patients with allergic rhinitis often have symptoms after exposure to irritants, temperature and humidity changes, like patients with non-allergic rhinitis, and such exposures may sometimes cause more severe symptoms than exposure to allergens.
Eye symptoms such as itching, irritation, redness or tearing, are often present in patients with allergic rhinitis. This is called allergic conjunctivitis.