About Nonallergic Rhinitis in Children

If your child seems to constantly have a stuffy nose, but doesn't have allergies, she may be suffering from a nasal disorder called nonallergic rhinitis (NAR). According to Dr. William E. Berger, a professor in the Department of Pediatrics at the University of California, Irvine, approximately 1 in 5 people suffering from rhinitis (nasal lining inflammation) have nonallergic rhinitis. Since NAR is relatively uncommon in children, eliminating other causes of symptoms is your doctor's best way of determining a positive diagnosis.

The Facts

• When your child has nonallergic rhinitis, the blood vessels in his nose expand. This expansion fills your little one's nasal lining with extra fluid and blood, leading to swelling in the nose that causes the symptoms of NAR. Many parents of children suffering from NAR assume their little ones are allergic, but NAR does not occur as a result of an allergic reaction. Even though many cases of nonallergic rhinitis in children are not severe, untreated NAR symptoms can leave your child feeling miserable and can affect his day-to-day life.

Symptoms

• If your child has nonallergic rhinitis, she will typically show symptoms off and on throughout the year. The most common symptoms of NAR in children are a stuffy or runny nose and postnasal drip (mucus in the throat). Often, these symptoms last for hours or days at a time, depending upon the severity of your child's disorder. Less frequently, your child may also exhibit nasal itching and sneezing. If your little one's NAR symptoms are severe or do not respond to over-the-counter medications for nasal congestion, you should consider taking her to the doctor for diagnosis and treatment.

Causes

• Even though nonallergic rhinitis does not involve an allergic reaction in children, certain triggers can contribute to--or even cause--your child's nasal swelling, including temperature or humidity changes and strong odors. Often, sudden changes in the temperature or humidity cause the membranes lining your child's nose to swell; similarly, strong odors and other airborne irritants, such as second-hand smoke and severe air pollution, can lead to NAR in your child. Other possible causes include some medications, spicy foods and hormone changes during puberty.

Diagnosis

• Since the symptoms of nonallergic rhinitis are so similar to those of allergic rhinitis and sinus problems, your child's pediatrician will typically need to first rule out allergies and sinus problems as possible causes. Possible allergy tests that your doctor may conduct include a skin test (small amounts of different allergens are injected under your child's skin to test for a reaction) and a blood test (a lab checks your child's blood for the levels of certain antibodies that indicate the presence of different allergies). Your little one's doctor may also use specialized equipment to check your child's nose for nasal abnormalities (such as nasal polyps) that may indicate sinus problems. Usually, diagnosis can't be finalized until the doctor eliminates these two common causes of rhinitis symptoms.

Treatment

• Treatment for NAR in children varies depending upon the severity of your child's symptoms. You may be able to control mild symptoms by using a bulb syringe to rinse your child's nasal passages daily; in fact, according to the Mayo Clinic, this technique (called nasal lavage) is a successful treatment for NAR. Other common home remedies include using a humidifier and ensuring your child drinks plenty of water and blows his nose regularly. If symptoms are severe, your child's doctor will most likely prescribe decongestants or antihistamines, often in a spray form. The Mayo Clinic states that over-the-counter oral antihistamines typically don't control NAR symptoms as well as they do allergic rhinitis symptoms.