Inflammation of the nasal
mucous membrane is called rhinitis. The symptoms include sneezing and
runny and/or itchy nose, caused by irritation and congestion in the
nose. There are two types: allergic rhinitis and non-allergic
rhinitis.
Allergic rhinitis: This condition occurs when the
body’s immune system over-responds to specific, non-infectious
particles such as plant pollens, molds, dust mites, animal hair,
industrial chemicals (including tobacco smoke), foods, medicines, and
insect venom. During an allergic attack, antibodies, primarily
immunoglobin E (IgE), attach to mast cells (cells that release
histamine) in the lungs, skin, and mucous membranes. Once IgE connects
with the mast cells, a number of chemicals are released. One of the
chemicals, histamine, opens the blood vessels and causes skin redness
and swollen membranes. When this occurs in the nose, sneezing and
congestion are the result.
Seasonal allergic rhinitis or hayfever occurs in late
summer or spring. Hypersensitivity to ragweed, not hay, is the
primary cause of seasonal allergic rhinitis in 75 percent of all
Americans who suffer from this seasonal disorder. People with
sensitivity to tree pollen have symptoms in late March or early
April; an allergic reaction to mold spores occurs in October and
November as a consequence of falling leaves.
Perennial allergic rhinitis occurs
year-round and can result from sensitivity to pet hair, mold on
wallpaper, houseplants, carpeting, and upholstery. Some studies
suggest that air pollution such as automobile engine emissions can
aggravate allergic rhinitis. Although bacteria is not the cause of
allergic rhinitis, one medical study found a significant number of
the bacteria Staphylococcus aureus in the nasal passages of patients
with year-round allergic rhinitis, concluding that the allergic
condition may lead to higher bacterial levels, thereby creating a
condition that worsens the allergies.
Patients who
suffer from recurring bouts of allergic rhinitis should observe their
symptoms on a continuous basis. If facial pain or a greenish-yellow
nasal discharge occurs, a qualified ear, nose, and throat specialist
can provide appropriate sinusitis treatment.
Non-allergic rhinitis: This form of rhinitis does not depend
on the presence of IgE and is not due to an allergic reaction. The
symptoms can be triggered by cigarette smoke and other pollutants as
well as strong odors, alcoholic beverages, and cold. Other causes may
include blockages in the nose, a deviated septum, infections, and
over-use of medications such as decongestants.
Rhinosinusitis: Clarifying the Relationship between the
Sinuses and Rhinitis
Recent studies by otolaryngologist–head and neck surgeons have better
defined the association between rhinitis and sinusitis. They have
concluded that sinusitis is often preceded by rhinitis and rarely
occurs without concurrent rhinitis. The symptoms, nasal
obstruction/discharge and loss of smell, occur in both disorders. Most
importantly, computed tomography (CT scan) findings have established
that the mucosal linings of the nose and sinuses are simultaneously
involved in the common cold (previously, thought to affect only the
nasal passages). Otolaryngologists, acknowledging the
inter-relationship between the nasal and sinus passages, now refer to
sinusitis as rhinosinusitis.
The catalyst relating the two disorders is thought to involve nasal
sinus overflow obstruction, followed by bacterial colonization and
infection leading to acute, recurrent, or chronic sinusitis. Likewise,
chronic inflammation due to allergies can lead to obstruction and
subsequent sinusitis.
Other medical research has supported the close relationship between
allergic rhinitis and sinusitis. In a retrospective study on sinus
abnormalities in 1,120 patients (from two to 87 years of age),
thickening of the sinus mucosa was more commonly found in sinusitis
patients during July, August, September, and December, months in which
pollen, mold, and viral epidemics are prominent. A review of patients
(four to 83 years of age) who had surgery to treat their chronic sinus
conditions revealed that those with seasonal allergy and nasal polyps
are more likely to experience a recurrence of their sinusitis.
