Causes of allergies and sinusitis: rhinitis, sinusitis, mechanisms of respiratory allergy

Rhinitis

Rhinitis is inflammation or irritation of the nose.

Allergic rhinitis  is commonly referred to as "allergies."  The disease is caused by airborne allergens: mainly pollen, mold, animal hair, animal skin scales and in rodents, urine protein.  Usual symptoms include nasal stuffiness, runny nose, sneezing, itching in the nose and throat,  itchy, watery red eyes, fatigue and headache.

Seasonal allergic rhinitis or hay fever is a condition caused by allergy to airborne pollen from plants that flower seasonally (usually spring or fall).   

Symptoms of perennial allergic rhinitis occur persistently when there is allergy to perennially present allergens (e.g., cats, house dust mites).  In climates as in the south and southwest, airborne pollen is nearly perennial and can cause perennial allergic rhinitis in muliply sensitized individuals.

Allergic rhinitis affects about one third of the population and often needs treatment to improve quality of life and reduce risk of complications including

• sinusitis
• allergic asthma
• eye inflammation
• fluid in the middle ears causing pain and reduced hearing
• excessive mucus drainage in the throat and hoarseness from laryngitis
• snoring at night from nasal obstruction
• chronic fatigue

Allergic rhinitis is often associated with allergic conjunctivitis, a condition caused by pollen and other allergens causing allergic reactions in the outer membrane of the eye.  Symptoms include eye itching,  redness, tearing and swelling of the eyelids.

Non-allergic rhinitis, a common condition, is nasal inflammation or irritation that is not caused by identifiable allergens.  There are several forms of non-allergic rhinitis, including

• Vasomotor rhinitis - nonspecific nasal irritability, with nasal congestion and /or discharge
• Infectious rhinosinusitis - nasal congestion associated with sinus infection, sometimes with nasal polyps (tags of overgrowth of the lining of the nasal or sinus cavities)
• Nonallergic rhinitis with eosinophilia syndrome (NARES) - nasal inflammation with cells in the nose typical of allergy (eosinophils) and negative tests for allergy
• Rhinitis medicamentosa or drug rebound rhinitis is nasal congestion caused by over-use of nasal sprays that constrict blood vessels in the nose. Drugs that do this are the long acting nasal decongestant sprays available over-the-counter, and inhaled cocaine.
  

Further Reading:
AAAAI:   Rhinitis
AAAAI:  Eye allergies 

Additional links

Disclaimer:   This site is for educational purposes only.  Any information that you have found in this web site is not intended to replace medical care or advice given to you by your own physicians. You should consider consulting your local medical library and other web sites for additional information. 

Comments and suggestions welcome!   Email: schumach@u.arizona.edu
Content Owner:  Michael J. Schumacher, MB, FRACP, The University of Arizona

Updated 3/2012