Seasonal Health

It’s Nothing to Sneeze at

When the diagnosis is not allergies…then what?

By Virginia Olson

So what’s a sure sign spring has arrived? Many South Dakotans will say it is when they start sneezing, their nose starts to run and they feel congested. It’s a grueling trifecta of ailments that could mean a trip to a doctor’s office.

“Many patients come in to our allergy clinic thinking they are suffering from allergies and wondering why they have all these symptoms. They want relief!” says Cathy Blumenauer, an allergy nurse at Midwest ENT & ALLERGY. “To figure out what is going on, it starts with a complete medical history; detailing their symptoms, chief complaints and seasonal patterns.”

“We take a comprehensive look at symptoms. Our goal is to find the top triggers and address the problem. We may run a combination of lab and skin tests to see whether or not allergies explain the symptoms. For some, there is a diagnosis of allergic rhinitis. For others, allergy tests are negative. These patients are diagnosed with non-allergic rhinitis,” says Cathy. “Needless to say, they are frustrated because they want answers (and relief) of their symptoms.”

So, what’s next?

Cathy says patients go on for further evaluation.

“Since we are no longer looking at an allergy, but a sensitivity or intolerance, our ENT physician is consulted to look at other potential causes and treatment options.”

Though non-allergic rhinitis is not a fun diagnosis because it means more tests, the numbers bear out that it is a somewhat common condition. According to The National Institute of Health, about one third of all rhinitis is non-allergic. This accounts for about 7% of the population that suffers from non-allergic rhinitis.

"Because the causes of nonallergic rhinitis are often unknown, the condition can only be confirmed after other conditions such as allergic rhinitis, infection, or structural abnormalities are ruled out," says Dr. Daniel Todd, a physician at Midwest ENT & ALLERGY.

“Unlike allergic rhinitis, non-allergic rhinitis is not hay fever and does not involve the allergy aspect of our immune system. It also doesn’t have the symptoms of itchy, watery eyes or a sore throat,” says Dr. Todd.

Dr. Todd says there are a number of conditions like reflux or mold toxicity that can also cause nonallergic rhinitis.

“A structural abnormality of the nose such as a deviated septum or nasal polyps can also be responsible for the allergy-like symptoms,” says Dr. Todd. “To properly treat these conditions, both require a physical exam, CT scan of the sinuses, and possibly surgery.”

An ENT physician can get to the core of the problem with a comprehensive history, complete physical exam, and in-depth testing.

“We want patients to feel confident that though those seasonal allergy symptoms may not be allergies, we will work to figure out exactly what is going on.” n

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