Dallas Allergy

Non-allergic rhinitis is a common problem among people with nasal or “sinus” complaints. The cause of NAR is still a mystery. Even though we don’t know the cause, the problem can be treated.

Features of NAR:
·Most people with NAR have problems primarily with stuffiness and post-nasal drip. Many people also have runny nose. In contrast to people with allergic rhinitis, NAR doesn’t usually cause much sneezing, itch or runny nose.
·Allergy tests are negative or the patient has problems out of their “allergy season”
·Some people have both allergic rhinitis and NAR which accounts for some of the annual variation in their symptoms.
·NAR is associated with “sinus headache” and an increased risk of sinus infection.
·People with NAR are often triggered by exposure to ozone, cold air, perfumes, strong smells and dust. It may even appear to be seasonal.

Treatment of NAR:
·NAR is a long term problem that, for many people, gets better and worse on its own.
·Nasal irrigations (nose rinses) are the cornerstone of NAR treatment. There are many different ways to do nasal irrigation; everyone has their preferred method. This treatment may be used in small children if they are willing to tolerate it. The more fluid that is used, the better. The more times a day you irrigate, the better.
·Nasal sprays are more effective when used after nasal irrigations.
·Steroid nasal sprays (e.g., Flonase, Nasonex, and others) must be used every day but are an important component of NAR treatment.
·Astelin or Patanase nasal spray may be used twice a day or intermittently; it is very helpful for many people.
·Antihistamines are not much help.
·Oral decongestants (Sudafed and others) may be used daily or intermittently.
·Nasal decongestants (Afrin and others) may be used occasionally for no more than five days. When used for longer periods, nasal decongestants may worsen nasal congestion.

Your NAR treatment plan:
·The best plan is very individual. You will have to experiment to determine what works best for you.
·Because the benefit from steroid nasal spray takes several days to show up, it should be used every day. It is not a good on-and-off medication.
·When you are having NAR symptoms, do everything (i.e., add nasal irrigations Astelin or Patanase, and oral decongestants). If the stuffiness is a lot worse than usual, add Afrin for no more than five days.
·As the NAR symptoms improve, slowly try to cut back to the least amount of medication/irrigation that keeps you feeling well.