Rhinitis

Burden of Rhinitis

Estimated to affect more than 200 million worldwide, rhinitis has a very high prevalence in Europe,The most common form of rhinitis is allergic rhinitis, with a prevalence of approximately 10% to 40%, depending on the geographic location. The highest incidence occurs in children. 

Rhinitis can result in significant disturbances in quality of life, sleep, exercise tolerance, productivity and social functioning.

Triggered by allergies and environmental irritants

Rhinitis is a very common condition caused by irritation and inflammation of the nasal mucosa. It can be triggered by allergic reactions (allergic rhinitis) and occur seasonal or perennial. Non-allergic rhinitis may be caused by environmental irritants, such as polluted air, certain medications and food, as well as changes in the weather. 

Recent data suggest that mixed rhinitis, where patients have both non-allergic rhinitis and allergic rhinitis, has a particularly high prevalence.

Common symptoms of rhinitis are a congested or runny nose, sneezing and post-nasal drip. Rhinitis makes breathing difficult and often leads to a reduced quality of life (QoL) and loss of productivity due to fatigue, resulting from loss of sleep and a continuous feeling of being blocked.

Allergic rhinitis is characterised by three cardinal symptoms: Sneezing, nasal obstruction and mucus discharge. It can result in significant physical sequelae and recurrent or persistent morbidities. 

Non-Allergic rhinitis, if left untreated, can have a significant impact on people’s quality of life and can be associated to other health conditions such as chronic ear infection, asthma and obstructive sleep apnea.  

Rhinitis is often accompanied by other upper/lower airways disease. Quite frequently, there is an overlap as well as a combination of causes leading to the condition, such as allergies and asthma.

Challenging to be diagnosed

Differentiating allergic and non-allergic rhinitis, and asthma might be challenging since symptoms are often indistinguishable for patients and healthcare professionals. 

A doctor may diagnose rhinitis based on a person’s history of symptoms, but diagnosis of allergic rhinitis is confirmed by proving sensitivity to certain allergens. Diagnosis of non-allergic-non-infectious rhinitis is made by exclusion of allergies and other causes. 

Treatments

Treatment of rhinitis includes antihistamines, nasal or in tablets, decongestant and corticosteroids. Especially in the case of allergic rhinitis, allergy avoidance and environmental controls are frequently discussed as part of the treatment strategy. 

Surgical procedures are also common, however, most techniques have associated side-effects such as nasal dryness and pain, and in the long term they do not guarantee that the symptoms will not return.