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Nonallergic Rhinitis

When Skin Tests Are Negative

Please print this NAR Handout
to open & print the pdf from your printer
and then 
follow along in this two page handout as we review it together with the use of the video to the right side of this webpage.  
Nonallergic Rhinitis Management:  When your skin tests are negative, you may be shocked, having believed that you had allergic rhinitis (AR) for many years. 
However, per the medical literature, nonallergic rhinitis (NAR) is almost as common as AR, accounting for about 40% of rhinitis cases. 
Even those with AR may also have a degree of NAR, too.  For example, the pollen-only AR patient's hay-fever symptoms may vastly improve in the winter; but he or she still has a stuffy or drippy nose, even in winter when no pollen is present.  This is a "mixed rhinitis."
Although allergy shots will not help NAR, the good news is that the same medications that are successful in treating AR are usually very effectove for NAR as well.  The NAR Handout & Video [on this page] explain these common rhinitis medications in detail.

When medications fail to control NAR, then we may consider other HEENT conditions that could be contributing.  Examples include:
1) Chronic Sinusitis (which can be screened for by Sinus CT).
2) LPR (laryngopharyngeal reflux) -- where stomach acid gases chronically rise to, often "silently," inflame the throat & nasal lining.  A "treatment test trial" of meds for a few weeks may "prove" this condition without the need for more costly GERD/LPR tests.
3) Medication change.  Some medications can have a side-effect of worsening NAR symptoms.  Sometimes a test off one of these agents for a couple of weeks (& subsequent improvment in NAR seen) may support this possibility and the need to look for a different replacement medication  (ie: some blood pressure, prostate and other medications can cause or worsen NAR).

Nonallergic Rhinitis (NAR) Handout Video


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