Allergic rhinitis? Nonallergic rhinitis? It's all chronic rhinitis, and the drugs you recommend could differ (but not always) depending on the cause.
Clinical Assistant Professor, Department of Medicine, Perelman School of Medicine at University of Pennsylvania ; Internist, Department of Medicine, Hospital Medicine Section, Pennsylvania Hospital, Philadelphia, Pennsylvania Associate Professor of Clinical Medicine, Department of General Internal Medicine, Lewis Katz School of Medicine; Staff Physician, Department of General Internal Medicine, Temple Internal Medicine Associates, Philadelphia, Pennsylvania The CurbsidersI'm Dr Matthew Frank...
Dr Fadugba said that one clue that it might be nonallergic rhinitis is the age of onset. If the symptoms are later in onset , then 30%-40% of rhinitis is nonallergic. If the patient has never had allergies and now all of a sudden they have new chronic sinus symptoms, it's probably nonallergic rhinitis. It's a diagnosis of exclusion.If you want to make a definitive diagnosis, you need to rule it out. I suspect that you might be able to get away with some empirical treatment.
I will say that this is one of the medications — like nicotine patches and other things — where we as doctors don't really counsel patients on how to use it appropriately. So with our expert, we revisited the idea of the patient pointing the nasal spray laterally, toward their ear basically, and not spraying towards their brain. There should not be a slurping sound afterward, because"if you taste it, you waste it," as the allergists and immunologists say.
You can try nasal ipratropium for people that have really prominent rhinorrhea. Dr Fadugba said that can work well, and it's usually taken three or four times a day. I've had good success prescribing it for my patients. Another one that I have never prescribed, but that Dr Fadugba said is available over the counter, is intranasal cromolyn — a mast cell stabilizer. She said it can be beneficial.
Otolaryngology ENT Specialty Head And Neck Surgery ENT Speciality Rhinitis Vasomotor Rhinitis Nonallergic Rhinitis Chronic Rhinitis Pennsylvania Fellowship Fellows Residency Residents Antihistamine Allergy Asthma Asthmatic Steroids Allergens Rhinorrhea Runny Nose Benign Prostatic Hyperplasia BPH Benign Prostatic Hypertrophy BPH - Benign Prostatic Hyperplasia
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