Allergies that are not due to allergies
At first glance the title does not seem to make much sense. To illustrate this point, a patient came to me because of problems with constant nasal congestion and post-nasal drip that she felt may be due to her cat or mold inside her home. Skin testing was performed which was completely negative to all trees, grasses, weeds, pets, dust mites, and molds. She was relieved that her cat was not the cause of her nasal symptoms but she asked me, “How can I have allergies without any allergies?”
Often when people say that they have “allergies,” they are actually referring to their bothersome nose symptoms such as nasal congestion, runny nose and sneezing. The medical term for these nose symptoms is called rhinitis. Rhinitis can be due to allergic causes, but it can also be from nonallergic causes. Allergic rhinitis refers to nasal symptoms that are often caused by inhaled substances including pollen, cat dander and molds. However, there are many causes that can mimic allergy resulting in allergy-like symptoms yet not be true allergy. Nonallergic rhinitis symptoms can be just as problematic as true allergic rhinitis symptoms, and it is therefore imperative that the distinction between the two be made for successful treatment.
Nonallergic rhinitis is more often associated with symptoms such as nasal congestion, post-nasal drip, and sneezing, and less often associated with itching of the nose and eyes. Symptoms are usually year-round but can be worsened by weather changes. In addition, irritants such as smoke, cleaning agents, perfumes, scented candles and air fresheners are common triggers. To make things even more confusing, it is estimated that up to 50% of people with non-allergic rhinitis may also have allergic rhinitis.
So for the patient who was wondering how she could have such bothersome nasal symptoms and negative skin tests, I explained to her that her symptoms may be due to a disorder called nonallergic rhinitis. After providing education on what could be triggering her symptoms and starting specific nasal spray medications that typically work better for non-allergic rhinitis, she returned to the office for her follow-up visit stating that she could breathe better, sleep better and was overall feeling much better.
If you feel that you are having persistent and bothersome nasal symptoms then we welcome you to give us a call here at Atlanta ENT, Sinus & Allergy Associates. We have Allergy and ENT specialists available who will provide you with top quality care to help you breathe better, sleep better, and feel better.
Dr. Rodney Johnson