rhinitis

introduction

viral rhinitis (eg. Common Cold virus) and allergic rhinitis are very common causes of rhinitis
autonomic stimuli have a greater effect on patients with nonallergic rhinitis than on those with allergic rhinitis
autonomic imbalance favoring the parasympathetic system increases nasal blood flow, edema, and secretions, creating an overall presentation of rhinorrhea and nasal obstruction

~20% of people suffer from hay fever
sufferers appear to have a different fungal milieu in their upper airway microbiome but more studies are needed to understand if this is a cause or effect ¹⁾
apparently, highest rates of hay fever in Australia in descending order are:
- Canberra, Tasmania, WA, SA, Vic (especially Melbourne with its plane trees), NSW, Qld and lowest is NT
over 95% of cases of thunderstorm asthma are in people who have hay fever and may not have had a history of asthma
- if you have hay fever, especially if you have asthma as well, strongly consider starting inhaled steroids for asthma prevention in September (in southern parts of Australia - as thunderstorm asthma most likely in Nov and you need 6-8 weeks for inhaled steroids to kick in)
see also:
- allergens
- allergy and hypersensitivity reactions
- antihistamines (H1)
  - azelastine nasal spray
    - seems regular use may also substantially reduce Covid-19 and rhinovirus infections ²⁾
- corticosteroids
Dymista is a new topical nasal spray containing corticosteroid and an antihistamine (azelastine)
- https://www.nps.org.au/medical-info/medicine-finder/dymista-125-50-nasal-spray
- requires prescription in Australia and is expensive at around $50
possible natural preventives:
- daily pineapple in diet - contains bromelain
- apples and onions - contain quercetin, an anti-oxidant
- vitamin C containing foods

non-allergic rhinitis with eosinophilia syndrome (NARES)
“perennial intrinsic rhinitis”
some researchers believe that this condition may be a precursor to the aspirin triad of intrinsic asthma, nasal polyposis, and aspirin intolerance
a distinguishing feature of NARES is the presence of eosinophils, usually 10-20% on nasal smears

eg. the common cold (rhinovirus), coronavirus, adenovirus, parainfluenza virus, respiratory syncytial virus, or enterovirus
viral infections are generally self-limited and resolve within 7-10 days

symptoms are usually due to an inhaled irritant (eg, metal salts, animal dander, latex, wood dusts, chemicals).

the most common hormonal causes of rhinitis are pregnancy, menstruation, puberty, use of exogenous estrogen, and known or occult hypothyroidism.

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