Rhinitis is inflammation of the inner lining of the nose. Allergic rhinitis is characterized by an itchy/runny nose, sneezing, and nasal congestion. Other allergic symptoms include itchy ears and throat, Eustachian tube problems, red/watery eyes, cough, fatigue/loss of concentration/lack of energy from loss of sleep, and headaches or facial tenderness. Rhinitis can be either acute or chronic. Seasonal allergic rhinitis (also called hay fever) is usually caused by pollen in the air, and sensitive patients have symptoms during peak times during the year. Perennial allergic rhinitis, a type of chronic rhinitis is a year-around problem, and is often caused by indoor allergens, such as dust and animal dander. Symptoms tend to occur regardless of the time of the year. Non-allergic rhinitis (also called vasomotor rhinitis) occurs in those patients in whom an allergic cause cannot be identified. Vasomotor rhinitis is thought to occur because of abnormal regulation of nasal blood flow. Post-nasal drip is a mucous accumulation in the back of the nose and throat leading to or giving the sensation of mucus dripping downward from the back of the nose. Chronic rhinitis is characterized by persistent irritation and inflammation of the lining tissues of the nose. One of the most common characteristics of chronic rhinitis is post- nasal drip. Post-nasal drip may lead to chronic sore throat. Post-nasal drip can be caused by excessive or thick secretions or an impairment in the normal clearance of mucus from the nose or throat.

Allergy Medications & Treatments: Histamines are naturally occurring chemicals released in response to an exposure to an allergen, and they are responsible for the congestion, sneezing, and runny nose typical of an allergic reaction. Antihistamines are drugs that block the histamine reaction. These medications work best when given prior to exposure. Antihistamines can be divided into two groups: 1) Sedating (Benadryl, ChlorTrimetron, Tavist), 2) Non- Sedating (Claritin, Hismanal). Sedating antihistamines should be avoided in those patients who need to drive or use dangerous equipment. Non-sedating antihistamines can have serious drug interactions. Decongestants: These drugs temporarily reduce swelling of sinus and nasal tissues leading to an improvement of breathing and a decrease in obstruction. Combinations: These drugs are made up of one or more anti-allergy medications. They are usually a combination of an antihistamine and a decongestant. Other common combinations include mucus thinning agents, anti-cough agents, aspirin, Advil, or tylenol. They help to simplify dosing and often will work either together for even more benefit or have side-effects that cancel each other out. Allergy Shots (Immunotherapy): Allergy shots interfere with the allergic response. After identification of an allergen, small amounts of it is given back to the sensitive patient. Overtime the patient will develop blocking antibodies to the allergen, and they become less sensitive. Steroids: These drugs (prednisone, medrol, hydrocortisone) are highly effective in allergic patients, however there is a potential for serious side effects when used over time. They are best used for the short term management of allergic problems, and must always be monitored by a physician. Steroid nasal sprays: (Vancenase, Beconase, Flonase, Nasacort, Rhinocort) They reduce allergic or inflammatory inflammation, but do not have the side-effects of oral (systemic) steroids. Nasalcrom: This spray helps to stabilize allergy cells (mast cells) by preventing release of allergy mediators, like histamine. Decongestant sprays: (Afrin, Neosynpherine) They quickly reduce swelling of nasal tissues by shrinking the blood vessels. They will improve breathing and drainage over the short term, unfortunately if they are used for more than a few days they can become highly addictive (rhinitis metamentosa). Long term use can lead to serious damage. Antihistamine sprays: It works like oral antihistamines but applied topically to the nasal membranes (Astelin). Atrovent: It helps to control nasal drainage mediated by neural pathways. It will not treat an allergy, but it does decrease nasal drainage. Reflux Medications: Antacids (Maalox, Mylanta) help to neutralize acid contents, whereas other medications (Tagamet, Pepcid, Prilosec) decrease stomach acid production. Non-pharmacological treatments include avoiding late evening meals and snacks and the elimination of alcohol and caffeine. Elevating the head of the bed may help to decrease reflux during sleep.