Stuffy And Runny Nose? It May Not Be Your Allergies


Your nose is congested, you're sneezing constantly. It's your allergies again.

Or is it?

They have similar symptoms, but there are distinct differences between allergic rhinitis (allergies) and what's called vasomotor (non-allergic) rhinitis.

Patients with allergic rhinitis-occurring when the immune system overreacts to allergens in the air-can experience sneezing; itchy, red or watery eyes; fatigue (from poor sleep quality caused by nasal obstruction); and/or post-nasal drip (discharge from the nose is usually clear). These symptoms can be triggered by allergic reactions to pollen from trees, grass and weeds, as well as molds, pet hair or dander, strong odors and dust mites. Allergic rhinitis may be seasonal (commonly known as "hay fever"), perennial (year-round) or occupational.

Sneezing, congestion and runny nose are also symptoms of non-allergic rhinitis, but this condition differs from allergic rhinitis in that it doesn't affect the immune system, isn't associated with a particular allergy, and can occur without a known cause. In addition, non-allergic rhinitis, which can persist year-round, typically doesn't cause itchy nose, eyes or throat. Although the cause of non-allergic rhinitis isn't always known, it's most commonly diagnosed as a complication of the rapid onset of infection, also known as acute viral infection, says Dr. Abhishek Ramadhin of the Sinai Hospital Division of Otolaryngology.

Triggers of non-allergic rhinitis symptoms may include:

  • Certain foods and beverages
  • Airborne pollutants or odors
  • Certain medications
  • Changes in weather or barometric pressure
  • Underlying chronic health problems
  • Rhinitis medicamentosa (rebound nasal congestion brought on by overuse of decongestants)

Distinguishing non-allergic rhinitis from allergic reactions can be complicated, and treating it "is very different" from treating allergic rhinitis, as allergy skin tests and shots are not effective for non-allergic rhinitis, Ramadhin says. The most effective treatments, he says, particularly in cases where the cause isn't known, include normal saline nasal irrigation, nasal antihistamines, nasal glucocorticoids (steroids), or some combination of these medications. Patients are also advised to avoid irritant triggers. Topical nasal ipratropium (spray) is the best treatment for a complication of non-allergic rhinitis in which watery nasal secretion is caused by certain foods and beverages, Ramadhin says.

Ramadhin cautions that over-the-counter decongestant nasal sprays "should not be used for more than two to three days at a time" to treat non-allergic rhinitis as extended use could lead to rhinitis medicamentosa. In some cases, Ramadhin says, procedures such as an adenoidectomy (removal of adenoid glands behind the nasal passages that are obstructing breathing or causing infection) or surgery to correct a deviated septum can help with treating non-allergic rhinitis.

Read this blog for more information specifically about allergic rhinitis.

Schedule an appointment with a LifeBridge Health physician

Physicians at the Sinai Department of Otolaryngology and Northwest Hospital Division of Otolaryngology are experts in treating diseases of the ear, nose and throat. Carroll Hospital also has board-certified otolaryngologists who can with abnormalities affecting those areas.

To schedule an appointment with one of our highly trained physicians and find out why LifeBridge Health is Baltimore's premier health care organization, fill out our online appointment request form, or call 410-601-WELL. You can also inquire about an appointment with a Carroll Hospital physician by calling 410-871-7000, or search its online physician directory