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That Runny Nose May Not Mean Allergy

Nonallergic rhinitis affects millions, study says

TUESDAY, May 29, 2001 (HealthDayNews) -- Feeling stuffy? Eyes watery? Nose running so fast you can't keep up?

Guess what: It may not be an allergy.

Millions of Americans with allergy-like symptoms actually suffer from nonallergic rhinitis, and they may get little relief if they reach for antihistamines, a new study says.

"The average consumer assumes all chronic nasal symptoms are allergies, when in truth a large percentage don't have allergies as a cause," says the study's lead author, Dr. Russell Settipane, an assistant clinical professor of medicine at Brown University Medical School.

Nonallergic rhinitis affects 19 million Americans each year, Settipane says, but the chronic nasal condition is often misdiagnosed, or self-diagnosed wrongly, as an allergy.

Nonallergic rhinitis can be caused by such conditions as a deviated septum, nasal polyps or environmental factors that include cold air, high humidity, strong odors and inhaled irritants.

"One quarter of the patients who visit allergists with chronic nasal symptoms turn out to have no allergies whatsoever," Settipane says. And many others have a mixture of both allergic and nonallergic rhinitis, with year-round stuffiness that combines with seasonal allergies linked to irritants like tree pollen.

"When you combine the number of people with nonallergic rhinitis and those with mixed allergies, that's 45 million people," he adds.

There is no test for nonallergic rhinitis. Rather, it is diagnosed by eliminating all the things to which a person could be allergic. But, it's hard to convince someone with all the symptoms of allergies that they don't have them, Settipane says.

"It's important for both patient and doctor to know whether it's an allergy or not, and then treat it with medications that work for both allergic and non-allergic rhinitis. Not all medications work on both," he says.

Dr. Hugh Windom, an allergist and past president of the Florida Allergy, Asthma and Immunology Society, agrees the problem is a tricky one. But many patients do get relief from antihistamines. "If they've tried them and like them, I won't tell them to stop. But it wouldn't be my first course of treatment," he says.

Nasal steroid sprays and prescription spray decongestants may help, too, Windom says. "You have to work with people. They think just because they have all the symptoms, it has to be allergies and nothing else. We try to re-educate that symptoms can be produced by other means."

The results of the study are in this month's Annals of Allergy, Asthma and Immunology.

What To Do

If you're bothered by chronic nasal problems, Settipane suggests you head to the allergist first. The doctor should take a skin test to determine whether the symptoms are being caused by allergens or something else -- like nonallergic rhinitis.

Learn the difference between allergic and nonallergic rhinitis and what you can do about the conditions at the National Jewish Medical and Research Center.

Get more information about allergies at the American Academy of Allergy, Asthma and Immunology.

For more HealthDay stories on nasal problems, click here.

SOURCES: Interviews with Russell Settipane, M.D., assistant clinical professor of medicine, Brown University Medical School, Providence, R.I.; Hugh Windom, M.D., allergist, past president, Florida Allergy, Asthma and Immunology Society
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