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Medical Author:

Siamak T. Nabili, MD, MPH

Siamak T. Nabili, MD, MPH

Dr. Nabili received his undergraduate degree from the University of California, San Diego (UCSD), majoring in chemistry and biochemistry. He then completed his graduate degree at the University of California, Los Angeles (UCLA). His graduate training included a specialized fellowship in public health where his research focused on environmental health and health-care delivery and management.

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Medical Editor:

William C. Shiel Jr., MD, FACP, FACR

William C. Shiel Jr., MD, FACP, FACR

Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

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Medical Editor:

Melissa Conrad Stöppler, MD

Melissa Conrad Stöppler, MD

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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In this Article

• What is the purpose of the nose?
• What are rhinitis and post-nasal drip?
• What causes rhinitis?
• Is rhinitis always related to allergies?
• What conditions cause an abnormal production of nasal secretions?
• What conditions cause an impaired clearance of nasal secretions?
• How can chronic rhinitis and post-nasal drip be treated?
• What medications can be used to treat rhinitis and post-nasal drip?
• What can be used to treat non-allergic rhinitis?
• Does salt water have any role in the treatment of rhinitis and post-nasal drip?
• What are other options for the treatment of rhinitis and post-nasal drip?
• Terminology
• Chronic Rhinitis & Post-Nasal Drip At A Glance
• Patient Comments: Rhinitis - Causes
• Patient Comments: Chronic Rhinitis and Post-Nasal Drip - Causes
• Patient Comments: Chronic Rhinitis and Post-Nasal Drip - Treatments
• Patient Comments: Chronic Rhinitis and Post-Nasal Drip - Describe Your Experience
• Find a local Ear, Nose, & Throat Doctor in your town
• Chronic Rhinitis Index

Treatment of non-allergic rhinitis is similar to the treatment of allergic rhinitis.

Steroid nasal sprays and nasal antihistamines [azelastine (Astelin)] as described in more detail in the previous section, are the main stray of therapy for non-allergic rhinitis. Combination therapy using steroid nasal spray and nasal antihistamine together has been shown to be more beneficial.

The other therapies, such as ipratropium (Atrovent) and decongestants, may also be used in patients who continue to have symptoms despite proper therapy with nasal steroids and nasal antihistamines.

Irrigating the nose with salt water is very useful therapy for non-allergic rhinitis and especially beneficial for treating post-nasal drip.

Nasal irrigation utilizing a buffered hypertonic saline solution (salt water) helps to reduce swollen and congested nasal and sinus tissues. In addition, it washes out thickened nasal secretions, irritants (smog, pollens, etc.), bacteria, and crusts from the nose and sinuses. Non-prescription nasal sprays (Ocean spray, Ayr, Nasal) can be used frequently, and are very convenient to use.

• Nasal irrigation can be done several times per day.
  
  
• Nasal irrigation is frequently performed with a syringe or a Water Pik device (the attachment is purchased separately).
  
  
• The irrigating solution can be made by adding two to three heaping teaspoons of non-iodized (does not sting) salt to one pint of room temperature water. It is best to use Morton Coarse Kosher Salt or Springfield plain salt because table salt may have unwanted additives. To this solution, add one teaspoon of baking soda.
  
  
• Store at room temperature, and always mix the solution before each use.
  
  
• If the solution stings, use less salt.
  
  
• In the beginning, or for children, it is best to start with a weaker salt mixture. It is not unusual to initially have a mild burning sensation the first few times you irrigate.
  
  
• While irrigating the nose, it is best to stand over the sink and irrigate each side of your nose separately. Aim the stream toward the back of your head, not at the top of your head.
  
  
• For young children, the salt water can be put into a small spray container, which can be squirted many times into each side of the nose.