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Rhinitis and Hayfever

Non-Allergic Rhinitis

All that sneezes is not allergy. Often times, New York City patients present with symptoms of runny nose, congestion and sneezing. Allergy testing may not reveal an allergy to any triggers. The major difference between individuals that have allergic rhinitis and individuals with non-allergic rhinitis is that patients with non-allergic rhinitis don’t react to your typical allergic triggers like dust mites, cat dander, mold spores, or tree, grass or ragweed pollens. Rather, rhinitis patients will react to irritants such as strong smells, pollution, particulate matter in the air, smoke or other irritants. Symptoms can also flare with atmospheric pressure changes and temperature changes. Pregnancy, hypothyroidism and even some medications can also cause symptoms of non-allergic rhinitis.

Another type of non-allergic rhinitis is called NARES: Non-allergic rhinitis with eosinophilia. Eosinophils are white blood cells that are typically elevated in the blood of individuals with allergies. They are also often found in the nasal tissue of individuals diagnosed with allergic rhinitis. These individuals have recurrent bouts of sneezing and runny nose. They are usually treated with a nasal steroid such as fluticasone, triamcinolone or mometasone. Unfortunately, nasal polyps are a common complication of this condition. These growths on the nasal mucosa can cause increased congestion and a loss in the sense of smell.

A third form of non-allergic rhinitis is Rhinitis Medicamentosa. Rhinitis Medicamentosa is a condition characterized by rebound nasal congestion and a runny nose when topical decongestants such as Afrin or Neosynephrine are abused for a prolonged period of time (possibly as little as 4 days). Your nasal tissue becomes “addicted” and must be weaned off of this medication. One of our top allergists @ New York Allergy and Sinus Centers will help to taper you off this medication and search for the underlying cause of your initial congestion. Prolonged use of these topical decongestants can lead to permanent nasal damage. one common example is a perforated nasal septum.

Of course, the most common cause of non-allergic rhinitis is a respiratory tract infection. They can be caused by a virus resulting in a URI or Upper Respiratory Infection or a bacterial sinus infection necessitating antibiotics. Common antibiotics used to treat sinus infections include:

  • Amoxicillin
  • Augemtin
  • Cefdinir
  • Azithromycin
  • Levofloxacin
  • Avelox
  • Ciprofloxacin

Our trained premier allergists will evaluate you and perform any appropriate testing, including allergy testing and, if necessary, a sinus CT scan. By using one of our state-of-the-art Minicat Sinus CT Scan machines (located in our Queens and Manhattan locations) we can confirm that you have a sinus infection and can initiate the appropriate medications necessary to get you back on the road to sinus health. A sinus scan using the Minicat Sinus CT Scan may also demonstrate the presence of a structural abnormality that can lead to sinus infections or simply cause year round nasal congestion. Examples of these abnormalities include:

  • Deviated Nasal Septum
  • Concha Bullosa
  • Nasal Polyps

A deviated nasal septum can be caused by trauma such as a broken nose or can be congenital. The deviated septum may get worse over time, resulting in progressively greater symptoms. If medical management is not effective, surgical correction with one of the top NYC Ear Nose and Throat Physicians in Manhattan may be an option.

Nasal polyps are growths from the mucosal tissues in the nose that cause obstruction and can change or augment your sense of taste or smell. They can be associated with patients who also have aspirin allergy and asthma. The anatomical blockage can also lead to recurrent and chronic sinusitis. Again, if medical management with medication, allergy treatment and avoidance is not effective, you will be referred to one of the premier otolaryngology doctors in Manhattan or Queens for evaluation of possible surgery. Our ear, nose and throat referrals all operate out of premier New York City hospitals like Beth Israel, St. Luke’s Roosevelt, New York Presbyterian Hospitals, Mount Sinai and Lenox Hill. Nasal polyps that are surgically removed have a tendency to recur and underlying causes should be identified and dealt with prior to surgery, if possible.

Our NYASC Allergists can see you at one of our Manhattan or Queens locations for an allergy evaluation. Any allergist in our New York staff can determine if your condition is truly allergic or is actually one of these forms of non-allergic rhinitis. Our top allergists are specially trained in allergy testing, insuring that you will get the best care in allergy diagnosis and treatment.

Remember - It is important to identify the causes of your rhinitis rather than simply taking medication to treat the symptoms. Medicines like Sudafed, Benadryl and Afrin are available over the counter and may temporarily relieve some of the symptoms. One of our top allergy and sinus specialists can help identify the cause of your rhinitis symptoms and fix the underlying cause rather than just treat the symptoms. The New York Allergy and Sinus Centers has multiple locations located in Manhattan and Queens. Our NYC locations include Murray Hill, The Upper Westside, Chelsea, Upper Eastside and Glendale, Queens. Our Top NYC Allergists will perform testing, including allergy tests, sinus CT scans and a thorough exam to identify what is causing your nasal symptoms. Your allergists will design a treatment plan to fix your underlying pathology and help you to breathe better - naturally and without the use of chronic medications.

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