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Non-Allergic Rhinitis (Vasomotor)

Non-Allergic Rhinitis (Vasomotor)

Non-allergic rhinitis is a chronic condition that can occur at any age but is more common in adults. The most common symptoms are nasal congestion, post-nasal drainage, and headache, although runny nose, sneezing and itching of the nose may occur in some non-allergic individuals. Many non-allergic patients have recurrent sinusitis and middle ear infections or middle ear fluid collection.

Initial evaluation requires that surgical conditions (growths in the nose, crooked nasal septum, etc.) and general medical conditions (thyroid disease, pregnancy, etc.) are not responsible for the chronic symptoms. We recommend that ever patient have a family practitioner, internist, or pediatrician to follow them for their general medical care. If the history and physical examination are not positive for surgical or general medical problems, the patient most likely has the most common nasal problem of non-allergic or allergic nasal disease.

Non-allergic rhinitis is a very difficult topic to fully understand. The actual defect resulting in the symptoms commonly found is not known. We do know that the difficulty arises in the inability to correctly change the size of blood vessels and the quantity of mucus produced by mucus glands in the nose. Under normal circumstances the nose warms or cools the air entering the nose to 98 degrees F., increases the humidity to at least 80%, and filters unwanted substances resulting in relatively clean air at 98 degrees F. and 80% humidity entering the lungs regardless of current environmental conditions. These changes occur almost instantly with each breath. The non-allergic individual has lost the ability to make the necessary changes either from an ineffective blood vessel and mucus gland controlling mechanism, temperature and humidity sensing mechanism, or both. The end result is inappropriate blood vessel size and/or excess mucus production which can result in nasal congestion, post-nasal drainage, and headaches.

Many individuals with non-allergic nasal disease will have a significant amount of irritation, inflammation, and hyperreactivity in the nose contributing to the persistent, chronic nature of the disease.

Nasal allergy on the other hand usually presents with runny nose, sneezing, and itching but some patients can also have nasal congestion, post-nasal drainage, and headaches. With nasal allergy we usually see definite problems at certain seasons of the year or a correlation with exposures to dust, animal dander, mold or mildew exposures and in some patients’ extreme reactions to certain foods. Allergy symptoms also involving the eyes usually are redness, itching and watering of the eyes.

It is possible for an individual to have problems with both non-allergic rhinitis and allergic rhinitis, and this makes the problems at times more difficult to clearly diagnose and treat.

Several tests can be used to differentiate non-allergic rhinitis from allergic rhinitis. Skin testing, as one might expect, displays positivity in patients with allergic rhinitis, whereas a negative skin test will be obtained in patients with non-allergic rhinitis. In addition, the blood IgE levels and eosinophils (the allergy cell) are elevated in patients with allergic rhinitis but not in non-allergic rhinitis.

Non-allergic rhinitis often is triggered by drafts, temperature changes (especially cold air), by scented cosmetics (both men’s and women’s cosmetics), by cigarette and tobacco smoke, as well as fireplace smoke, scented or perfumed soaps. Many types of aerosol sprays, even scented deodorants can cause problems. Paint fumes, insecticides, bug sprays,
varnishes, and even the odor from new clothing, carpeting or furniture can cause problems. Kerosene, lighter fluids, oil and gas fumes can cause problems. House dust may act as an irritant, and should be avoided.

Do not overuse over-the-counter decongestant sprays or nose drops because these can cause “rebound” nasal congestion. All nasal decongestant sprays should be discontinued following 3 days of continuous use. Medications will be prescribed to help with this problem. A good part of the treatment is avoiding known problems and exposures, and working by trial and error to find medications that work best in your case. Medications that may be tried include: Astelin© nasal spray, decongestants, decongestant-antihistamine combinations, intranasal steroid sprays, and possibly an atropine-derivative nasal spray (Atrovent©).

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Oklahoma Allergy & Asthma Clinic Warns High Heat May Trigger Asthma Flare-Ups

Doctors urge residents to take precautions as extreme summer temperatures hit Oklahoma

With dangerous heat and humidity gripping Oklahoma and much of the Southern United States, the Oklahoma Allergy & Asthma Clinic is urging individuals with asthma and respiratory conditions to take extra precautions. According to clinic physicians, extreme heat can significantly worsen asthma symptoms and contribute to a rise in asthma related medical emergencies during the summer months.

“Oklahomans with asthma need to take summer heat seriously,” said Dr. Dean Atkinson, a board-certified allergist at the Oklahoma Allergy & Asthma Clinic. “High temperatures and humidity can combine with high pollen and high mold levels to create a perfect storm for asthma attacks.”

Excessive heat, often accompanied by high ozone levels, humidity, and stagnant air, poses multiple threats to individuals with asthma. According to the Centers for Disease Control and Prevention (CDC) and the American Lung Association, heat increases inflammation in the airways, while humidity can trap allergens like mold spores, dust mites, and pollen—making it harder to breathe and easier to trigger flare-ups.

“We see a clear uptick in asthma flare-ups during Oklahoma’s high heat index days,” added Atkinson. “Staying cool and following an asthma action plan are critical steps for staying safe.”

In Oklahoma, where summer temperatures often reach triple digits, local air quality can deteriorate rapidly. The Oklahoma region continues to experience “HIGH ALLERGY ALERT DAYS” and “Ozone Alert Days,” with elevated pollen, mold, and pollution levels that can exacerbate asthma symptoms, especially for children, seniors, and individuals with chronic lung disease.

TIPS TO HELP YOU BREATHE EASIER WHEN THE HEAT IS ON

To help residents protect their respiratory health, physicians at the Oklahoma Allergy & Asthma Clinic recommend the following five strategies during extreme heat:

1. Stay indoors in air-conditioned spaces, especially during peak heat and ozone hours (typically mid-afternoon).

2. Stay hydrated to help maintain healthy airway function.

3. Check the Daily Pollen and Mold Report and the Air Quality Index (AQI) and avoid strenuous outdoor activity on high alert days.

4. Follow your asthma action plan and keep quick-relief inhalers accessible at all times.

5. Minimize exposure to additional triggers, such as cigarette smoke, cleaning chemicals, and other pollutants.

“Children are especially vulnerable to the effects of extreme heat and poor air quality. Their lungs are still developing, and they tend to be more active outdoors, which increases their exposure to asthma triggers during high heat index days.” says Dr. Maya Gharfeh, another board-certified allergist at the Oklahoma Allergy & Asthma Clinic

The Oklahoma Allergy & Asthma Clinic encourages all asthma patients to review their action plans and speak with their healthcare providers about how to adjust medications or activity levels during extreme weather.

For more information about asthma care, pollen counts, and summer safety tips, visit www.oklahomaallergy.com or follow the clinic on social media.

About Oklahoma Allergy & Asthma Clinic

Founded in 1925, Oklahoma Allergy & Asthma clinic has a 100-year history of patient-focused, state-of-the-art allergy and asthma care. Today, the clinic is home to 13 allergy and asthma specialists, caring for tens of thousands of patients a year with a focus on evidence-based treatment, research, and patient education. To learn more, visit OklahomaAllergy.com.

The post Oklahoma Allergy & Asthma Clinic Warns High Heat May Trigger Asthma Flare-Ups appeared first on Oklahoma Allergy and Asthma Clinic.

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