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Dr. Jackie on USA Today: Your Health: Got allergies? Maybe it’s actually non-allergic rhinitis

Your Health: Got allergies? Maybe it’s actually non-allergic rhinitis

By Kim Painter, USA TODAY

If you have a drippy or congested nose today, you’ve got lots of company.

After all, it’s late August, and in much of the country, it’s hay fever season or, more accurately, ragweed and mold allergy season. But if the symptoms get bad enough to send you to an allergist, you might get a surprise: You might not have allergies at all.

You could, of course, have a cold — and some adults get so many they are convinced they’ve developed an allergy, doctors say. One hint to their true condition, says Albany, N.Y., allergist David Shulan: They often are teachers or parents.

“They’re really just catching a lot of colds from kids,” he says.

But there’s another possibility, one many people have never heard of: It’s called “non-allergic rhinitis.”

People with non-allergic rhinitis have many of the same symptoms as people with nasal allergies — the runny noses, congestion and annoying post-nasal drip. Some sneeze, too. But “when we do allergy testing on them, we don’t find anything,” Shulan says.

These patients often have no personal or family history of allergy and are older than the usual new allergy patient, averaging about age 35, says Jonathan Bernstein, an allergy researcher at the University of Cincinnati. They are more often women than men, he says.

Patients often say they have symptoms year-round or are bothered by irritants that are not known to cause the immune system responses associated with a true allergy, says Michael Blaiss, an allergist at the University of Tennessee Health Science Center in Memphis. The possible triggers include:

  • Perfumes and other substances with strong odors.
  • Cigarette smoke and car exhaust.
  • Cold air, wind and high humidity.
  • Foods — and not just the spicy ones (this variation is called gustatory rhinitis).

Just lying down triggers symptoms in some people, Blaiss says. Although these people don’t have allergies, “this is a real condition,” he says. “Some are suffering more than the patients I see with allergies.”

Bernstein says: “It can have an impact on sleep and concentration, cause headaches and lead to sinus infections.”

The underlying causes are not well understood. In some people, the problem seems related to changes in the nose that occur with aging, says Stanley Fineman, an Atlanta allergist and vice president of the American College of Allergy, Asthma & Immunology. Older noses tend to be drier, he says, so sometimes simple saline nose sprays can help.

Doctors also often recommend certain antihistamines, decongestants, steroid nasal sprays and drying agents. But the popular non-sedating antihistamines sold in drugstores often don’t work, Blaiss says. Patients also won’t benefit from allergy shots — unless they also have some allergies, which is possible, he adds.

It should be noted that adults can, at any age, develop new allergies or redevelop allergy symptoms that faded decades earlier, says Jacqueline Eghrari-Sabet, an allergist in Gaithersburg, Md. Sensitive people who move to new areas with high pollen counts often get new symptoms after two or three years of exposure. The best way to sort it all out, she says: Go to an allergist and get a skin test.

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