Chronic Rhinitis: Symptoms, Diagnosis, and Treatment

Q: Chronic Rhinitis: Symptoms, Diagnosis, and Treatment

Hello： Rhinitis and sinusitis can sometimes occur simultaneously, making it difficult to differentiate between the two. <br>Generally, a diagnosis of sinusitis can be made with an X-ray, so X-rays are sufficient for evaluation; it is not always necessary to use a CT scan. <br>Whe

Chronic rhinitis

Dear Dr.
Hsu,
In addition to symptoms such as frequent sneezing, runny nose, and nasal congestion, can rhinitis also cause pain similar to that of sinusitis? I have been experiencing intermittent sharp and dull pain in the area of my upper right molars and near the back of my nose close to my cheek for the past two years.
Recently, after examinations by a periodontist and an endodontist, it was confirmed that my teeth are fine.
Today, after seeing Dr.
Hou at Shin Kong, I felt that the symptoms of allergic rhinitis were more pronounced, which has left me confused.
I always thought that chronic sinusitis was the cause of such prolonged pain.

In addition to the pain, my symptoms include occasional nasal congestion upon waking, a constant sensation of fluid in the nasopharynx (post-nasal drip?), and I do not experience sneezing.
The mucus or phlegm I expel from my nose or nasopharynx is almost always clear and thick.
Later, I had a head X-ray taken; if it were sinusitis, would it show up on the X-ray? Why was a CT scan not chosen? Is it normal to have a bitter taste in my throat after using a nasal spray? Since there is post-nasal drip, is it safe if I swallow it? Given the suspicion of allergies, why was Clindamycin prescribed for me?
I currently have these questions and would appreciate your guidance.
(I may have additional thoughts to add later.) Thank you!

Nìmíng, 30~39 year old female. Ask Date: 2012/11/21

Dr. Xu Jiazhen reply Otolaryngology

Hello: Rhinitis and sinusitis can sometimes occur simultaneously, making it difficult to differentiate between the two.
Generally, a diagnosis of sinusitis can be made with an X-ray, so X-rays are sufficient for evaluation; it is not always necessary to use a CT scan.
When there is inflammation or to prevent inflammation, antibiotic treatment or prophylactic medication may be administered, which is very important for patient care.
Your attending physician has already taken this into consideration and prescribed you Clindamycin.
Allergic rhinitis is a different issue, but unfortunately, it can also occur alongside rhinitis or sinusitis.
Therefore, it is quite common in clinical practice for patients to experience mild rhinitis or sinusitis in conjunction with allergies, and patients often present with various symptoms.
Sincerely, Hsu Chia-Chen.

Reply Date: 2012/11/21

More Info

Chronic rhinitis is a common condition that can significantly impact a person's quality of life. It is characterized by persistent inflammation of the nasal mucosa, leading to symptoms such as sneezing, nasal congestion, and runny nose. However, it can also manifest with symptoms that overlap with sinusitis, including facial pain and pressure, particularly in the areas around the nose and cheeks.
In your case, the symptoms you've described—persistent pain in the upper right molar area and near the cheek, along with a sensation of liquid in the throat—are indeed consistent with chronic rhinitis. The fact that your dental evaluations have ruled out dental issues suggests that the source of your discomfort may be related to nasal or sinus inflammation rather than dental pathology.

Chronic rhinitis can lead to complications such as sinusitis, which may explain the facial pain you are experiencing. The pain associated with rhinitis can be due to pressure changes in the sinuses or referred pain from the nasal passages. It is not uncommon for individuals with chronic rhinitis to experience a sensation of post-nasal drip, which can contribute to throat discomfort and a feeling of mucus accumulation in the throat.

Regarding your questions about diagnostic imaging, X-rays can sometimes reveal sinusitis, but they are not as sensitive or specific as a CT scan. A CT scan provides a more detailed view of the sinuses and can help identify any structural abnormalities, such as polyps or significant inflammation, that may not be visible on an X-ray. If your symptoms persist despite treatment, a CT scan may be warranted to further evaluate the condition of your sinuses.

As for the nasal spray you mentioned, it is not uncommon for patients to experience a bitter taste in the throat after using a nasal spray, especially if the spray is not administered correctly or if there is post-nasal drip. While this is generally not harmful, it can be uncomfortable. If you are experiencing significant post-nasal drip, it may be beneficial to discuss this with your healthcare provider, as they may recommend alternative treatments or adjustments to your current regimen.

The prescription of Clindamycin, an antibiotic, suggests that your physician may be concerned about a potential bacterial infection, possibly secondary to your chronic rhinitis. While chronic rhinitis is often allergic in nature, it can lead to secondary infections, particularly if there is significant mucus accumulation or blockage in the sinuses. Therefore, the use of antibiotics may be appropriate in certain cases, especially if there are signs of bacterial sinusitis.

In summary, your symptoms are consistent with chronic rhinitis, which can indeed cause pain similar to that of sinusitis. Further evaluation with a CT scan may be beneficial if your symptoms do not improve with current treatments. It is also important to communicate with your healthcare provider about any concerns regarding your treatment plan, including the use of nasal sprays and antibiotics. They can provide tailored advice and adjust your treatment as necessary to help alleviate your symptoms and improve your quality of life.

Similar Q&A

Managing Allergic Rhinitis: Long-Term Solutions and Treatment Options

Hello Doctor: I previously visited a doctor for my nasal allergies. My symptoms included inferior turbinate hypertrophy, a lot of yellow mucus in my nasal cavity while sleeping, and nasal congestion. The doctor prescribed me Montelukast and a nasal spray, which worked quite well ...

Dr. Jian Huangqi reply Otolaryngology
Nasal congestion accompanied by yellow mucus in the nasal cavity may indicate sinusitis. You can visit my specialty clinic for examination and treatment.

Distinguishing Between Sinusitis and Allergic Rhinitis Symptoms

Hello Doctor, I have been experiencing significant nasal congestion and swelling over the past week. I have previously been diagnosed with allergic rhinitis, but I have never felt such pronounced discomfort before. I researched that sinusitis can also cause nasal swelling, and I ...

Dr. Ji Zhaoyun reply Otolaryngology
Hello, common symptoms of sinusitis include nasal congestion, yellow-green nasal discharge, fever, facial pain, foul smell, and changes in smell, although not all symptoms may be present. Diagnostic methods include endoscopy and imaging studies. If acute sinusitis persists despit...

Understanding Allergic Rhinitis: Causes, Diagnosis, and Treatment Options

Hello, Dr. Hsu: I have been experiencing post-nasal drip that often makes my throat uncomfortable. An otolaryngologist diagnosed me with allergic rhinitis, and after medication treatment, I feel that my nasal condition remains the same. (1) Could this indicate an allergic constit...

Dr. Xu Jiazhen reply Otolaryngology
Hello: In response to your question, allergic rhinitis is a condition related to one's constitution; it can only be managed, not cured. Blood tests for allergens can identify what substances you are allergic to, so if possible, it is advisable to avoid those triggers. Untrea...

Effective Strategies to Alleviate Allergic Rhinitis Symptoms

Recently, I have been experiencing frequent sneezing every morning right after I wake up, along with a sensation in my nose as if I have inhaled water. My throat is also filled with phlegm, and I have a runny nose, which leads me to constantly rub my nose. These symptoms do not o...

Dr. Zheng Jueyi reply Otolaryngology
Hello, it is likely allergic rhinitis. The most effective treatment is the use of corticosteroid nasal sprays and oral antihistamines. Engaging in regular exercise can also help improve your overall condition. Wishing you safety and health. Sincerely, Dr. Cheng Jue-Yi, Director o...