Rhinitis Unmasked: The Silent Culprit Behind Your Sniffles! 

Image credit: Allergic Rhiniti

What is Rhinitis? 

Rhinitis is a popular medical condition that affects millions of people throughout the world. It is estimated that between 25 and 40% of children and adults, respectively worldwide are affected by allergic rhinitis [1]. Rhinitis is identified by nasal mucous membrane inflammation and irritation.

The condition can be caused by a variety of sources, including allergies, viruses, germs, irritants, and even changes in weather. In addition, rhinitis can have a substantial influence on a person's quality of life, including discomfort, sleep difficulties, and decreased productivity.

Allergic and non-allergic rhinitis

Rhinitis can be further divided into allergic and non-allergic rhinitis. Both of these conditions involve inflammation of the nasal passages, but they have different causes and triggers. Allergic rhinitis happens when a person is allergic to certain things, and the body reacts to them.

Non-allergic rhinitis, on the other hand, is caused by various factors other than allergies and does not involve the body's defence system. The presence of itching in allergic rhinitis, as well as its seasonal character, can help distinguish it from non-allergic rhinitis [2]. Let’s explore the differences and similarities between these two types of rhinitis:

Table 1: Differences and similarities between allergic rhinitis and non-allergic rhinitis 

Triggers of rhinitis 

Some of the common triggers of rhinitis include:

• Pollen
• Dust
• Smoke
• Strong Odour
• Flakes of skin from certain animals
• Hormonal changes
• Changes in the enviroment [5].

Image credit : Allergic Rhinitis

How to diagnose rhinitis? 

The diagnosis of rhinitis involves a full and comprehensive evaluation of a patient's medical history, symptoms, and physical examination to determine the underlying cause of nasal inflammation and congestion. Determining the precise type of rhinitis is critical since it determines the patient's treatment regimen.

Common symptoms of rhinitis are presence of nasal congestion, sneezing, and itching. Physicians mostly focus on symptoms; their duration, the nature and pattern of reactions, triggers, and environmental factors. However, a complete history is required to identify specific triggers.

To search for presence of inflammation, nasal polyps, or other abnormalities, a comprehensive physical examination of the nasal passages, throat, and eyes must be conducted. The easiest way to differentiate between allergic and nonallergic rhinitis is by the presence of itching in the nose, eyes, or throat and by the presence of watery eyes. The presence of such symptoms may indicate allergic rhinitis, as itching is not involved if the patient has non-allergic rhinitis [6,7].

Allergy testing may be advised in cases of suspected allergic rhinitis. Skin prick tests or blood testing (particularly IgE antibody tests) can be used to detect allergens that are causing overreaction of the body's defence system. Skin prick testing offers the advantages of being quick, informative for patients, and reasonably inexpensive. Except for patients with sensitive skin or long-lasting rashes, skin prick testing should be done regularly in all patients to identify potential allergens [7,8]. 

When skin prick testing is not safe for certain patients, serum-specific IgE testing must be performed. Serum-specific IgE test is a blood test that detects the presence of different IgE antibodies in a person's blood. IgE antibodies are normally present in small amounts in the blood. However, higher levels may indicate that the body overreacts to allergens, resulting in an allergic reaction such as allergic rhinitis [9]. Performing such tests aids in identifying and avoiding specific allergens and may guide allergen immunotherapy (allergy shots) [10].

Image Credit: IgE Level -Test
 

Is it possible to diagnose rhinitis digitally?

Diagnosing rhinitis digitally can be difficult because it often involves a thorough medical history, a physical examination, and, in some cases, specialised tests. However, there are some methods and tools that can help with digital rhinitis diagnosis.

• Online Symptom Checkers: Symptom checkers are available on many healthcare websites and applications, allowing users to enter their symptoms and receive a potential diagnosis. While these tools can provide general direction, they should not be used to make a definitive diagnosis.

• Telemedicine Consultations: Telemedicine allows patients to consult with healthcare providers virtually. Patients can discuss their symptoms, medical history, and any other relevant details during these video or audio appointments, allowing the healthcare professional to do an initial assessment and provide advice or recommendations.

It is critical to note that digital diagnostic tools are not intended to replace expert medical advice and examination. While they can provide early information and assistance, a skilled healthcare provider should make a definite diagnosis of rhinitis through in-person or telemedicine consultations, a physical examination, and possibly additional tests, such as allergy testing or imaging studies. 

Want to know more about rhinitis from DOC2US? Stay tuned for our next articles where we debunk myths related to rhinitis and dive deeper into its management!

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Reference

1. Nur Husna SM, Tan HTT, Md Shukri N, Mohd Ashari NS, Wong KK. Allergic Rhinitis: A Clinical and Pathophysiological Overview. Front Med (Lausanne). 2022 Apr 7;9:874114. 

2. Fried MP. Rhinitis - ear, nose, and throat disorders [Internet]. MSD Manuals; 2023 [cited 2023 July 20]. Available from: https://www.msdmanuals.com/home/ear,-nose,-and-throat-disorders/nose-and-sinus-disorders/rhinitis  

3. Quillen DM, Feller DB.Diagnosing Rhinitis: Allergic vs. Nonallergic. Am Fam Physician [Internet]. 2006 May 1 [cited 2023 July 20];73(9):1583–90. Available from: https://www.aafp.org/pubs/afp/issues/2006/0501/p1583.html 

4. Tran NP, Vickery J, Blaiss MS. Management of Rhinitis: Allergic and Non-Allergic. Allergy Asthma Immunol Res [Internet]. 2011 Jul [cited 2023 July 20];3(3):148. Available from: /pmc/articles/PMC3121056/    

5. Rhinitis | Johns Hopkins Medicine [Internet]. [cited 2023 July 20]. Available from: https://www.hopkinsmedicine.org/health/conditions-and-diseases/rhinitis

6. Quillen DM, Feller DB.Diagnosing Rhinitis: Allergic vs. Nonallergic. Am Fam Physician [Internet]. 2006 May 1 [cited 2023 July 20];73(9):1583–90. Available from: https://www.aafp.org/pubs/afp/issues/2006/0501/p1583.html  

7. Scadding GK, Scadding GW. Diagnosing Allergic Rhinitis. Immunology and Allergy Clinics of NA [Internet]. 2016 [cited 2023 July 20];36:249–60. Available from: http://dx.doi.org/10.1016/j.iac.2015.12.003 

8. Ibekwe PU, Ibekwe TS. Skin Prick Test Analysis in Allergic Rhinitis Patients: A Preliminary Study in Abuja, Nigeria. J Allergy (Cairo) [Internet]. 2016 [cited 2023 July 21];2016. Available from: https://pubmed.ncbi.nlm.nih.gov/27247577/ 

9. Blood Test: Immunoglobulin E (IgE) (for Parents) - Nemours KidsHealth [Internet]. [cited 2023 July 21]. Available from: https://kidshealth.org/en/parents/test-immunoglobulin-e.html

10. Blood Testing for Allergies | Specific IgE Testing | Allergy Insider [Internet]. [cited 2023 July 21]. Available from: https://www.thermofisher.com/allergy/wo/en/blood-testing-allergies.html#benefits

     

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Written by

Tasnim Jaman Raisa (Bpharm) DOC2US