Other problems with symptoms similar to allergic rhinitis

Other medical problems and other types of rhinitis may cause symptoms like those of allergic rhinitis. Your doctor will usually be able to tell the difference between allergic rhinitis and these other problems by examining you and asking questions about your symptoms.

Medical problems include:

• Upper respiratory infections. Upper respiratory tract infections (URIs), especially those caused by viruses such as the common cold, often cause sneezing, a runny nose, and nasal congestion. Upper respiratory infections differ from an allergy in that they last 7 to 14 days, and you may have a fever. However, if you often have these infections, it can be difficult to know whether you have an upper respiratory infection or an allergy. You may need a skin test or a test that checks your nasal drainage for a type of white blood cell (nasal cytology).
• Nasal defects. If the wall (septum) between the nostrils is not normal (deviated septum), it may partially block one nostril and create a stuffy nose.
• Large adenoids . These can block airways and make it difficult to breathe through the nose.
• Enlarged nose bones, which also can block airways and make it difficult to breathe through the nose.
• Nasal polyps , which are noncancerous growths in the nasal passages. They can block airways, making it difficult to breath through the nose.
• Injury or foreign body. Occasionally, injury to the nose can cause the bone at the top of the nasal cavity to break. Fluid can leak out from the area, causing a runny nose. Small children sometimes put objects, such as nuts, candies, or small pieces of toys, into their noses. Injury or objects in the nose can cause a runny nose.
• Tumor. In rare cases, tumors develop in the nose and can cause symptoms such as nasal congestion. Long exposure to certain substances, such as formaldehyde, nickel, or leather dust, can make a tumor in the nose more likely.

Nonallergic rhinitis

Like allergic rhinitis, nonallergic rhinitis also causes inflammation of the nasal passages and the same symptoms. However, allergens do not cause nonallergic rhinitis, and your immune system does not react. Immune tests generally are negative. As with allergic rhinitis, nonallergic rhinitis can occur at certain times of the year or year-round.

Forms of nonallergic rhinitis may include:

• Nonallergic rhinitis with eosinophilia syndrome (NARES). People with NARES have symptoms like those of allergic rhinitis, such as sneezing, nasal itching, and a runny nose. Nasal tests show a type of cell (eosinophils) that is also seen in allergic rhinitis. However, skin testing is negative for these people. The cause of NARES is unknown.
• Infectious rhinitis. A virus may cause this form of rhinitis.
• Vasomotor rhinitis. Vasomotor rhinitis, which is also called idiopathic rhinitis, has symptoms of nasal congestion or a runny nose. A change in humidity or temperature can trigger symptoms. So can breathing in strong odors, cigarette smoke, air pollution, perfumes, the aroma of hot and spicy foods, or insecticides.
• Hormonal rhinitis. Pregnancy or hypothyroidism may cause hormonal rhinitis. More hormones in the blood, such as occurs during pregnancy, can lead to nasal congestion or a runny nose.
• Drug-induced rhinitis. Medicines such as ACE inhibitors, beta-blockers, other nonsteroidal anti-inflammatory drugs (NSAIDs), or birth control pills can cause drug-induced rhinitis. In older adults, the medicines reserpine, phentolamine, methyldopa, prazosin, and chlorpromazine may cause it. Illegal drug use, such as "snorting" cocaine through the nose, can also cause symptoms like those found in allergic rhinitis.
• Atrophic rhinitis. Atrophic rhinitis occurs mainly in older adults and causes nasal congestion and a constant bad smell in the nose. Atrophic rhinitis is seen more in developing countries, leading some researchers to believe that bacteria might cause the disease. People with atrophic rhinitis develop dry crusts within the nasal cavity.
• Rhinitis medicamentosa. Use of over-the-counter nasal decongestant sprays for more than 5 to 7 days can lead to rhinitis medicamentosa, or "rebound congestion." In rebound congestion, the decongestant first makes your symptoms better, but then your nasal congestion gets worse. Using cocaine can also cause rhinitis medicamentosa.
• Rhinitis caused by systemic disease. Occasionally, whole-body, or systemic, diseases can cause symptoms. These diseases include hypothyroidism, severe kidney disease, diabetes, and several diseases of the immune system, such as Wegener's granulomatosis and sarcoidosis. These diseases can cause a runny nose or nasal congestion.
• Food-related rhinitis. Drinking alcohol or eating hot and spicy foods may cause this form of rhinitis.