There is a large group of people, probably constituting 50% of patients with chronic nasal symptoms, who develop a watery nasal discharge and/or stuffiness when they are around certain nonallergenic nasal triggers. This nasal disorder is called nonallergic rhinitis,and the triggers that are most commonly reported include cold air, airborne irritants (e.g., perfume, paint fumes), weather changes, and spicy foods. In the case of spicy foods, it is important to note that the food is not acting as an allergen and will not provoke more severe symp-toms such as throat swelling or wheezing upon future exposure.
Perfume, like many other scented products, is a volatile organic compound (VOC), which, at room temperature, evaporates very quickly and enters the air as small parti-cles. It is important to know that this irritant effect is not due to an allergy to perfume, and there is no skin test or blood test that can demonstrate that a person has a sen-sitivity to these things. When patients with this problem can anticipate that they will be exposed to a known trig-ger, such as perfume, they can take ipratropium bromide nasal spray 0.03% (two sprays per nostril 15 to 20 minutes beforehand) to block the development of symptoms. In patients with chronic, daily symptoms of nonallergic rhinitis due to frequent exposure to known triggers, azelastine hydrochloride nasal spray, used on a regular basis, may also be very effective.
Nonallergic rhinitis
Nasal inflammatory disease that is not caused by IgE-medi-ated hypersensitivity to allergens.