Long-term non-allergic chronic rhinitis / nothing helping

Posted by bentoboy @bentoboy, Apr 15 1:25pm

Hi there,

I developed a non-allergic chronic rhinitis some time five years ago. It appeared out of blue, and my nose has been blocked and runny ever since. I believe it significantly affects my breathing which, in its turn, affects my physical performance as well as sleep. There also must be a connection between this and the fact that I have been experiencing drowsiness, slowness of thought processes, and general brain fog.

I have tried to address this problem in many ways, including by using saline sprays, corticosteroids, antibiotics etc. No allergies whatsoever. Eventually, I was proposed to do a septoplasty, as my septum was slightly deviated. It was suggested that my breathing would significantly improve as a result, so I agreed. After the surgery, my breathing did improve for some time, but then the production of mucus re-started a few weeks/months after that.

At this point, I don't know what to do. I've tried most of the options to address this issue, but it seems there is no clear solution. My assumption is that I have a constant low-degree inflammation in my nose which restricts the airflow in the passageways. The surgery helped somewhat but didn't solve the primary issue of this inflammation.

Any suggestions as to what I could do? Personal experience?

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Profile picture for Rubyslippers @triciaot

My doctor recommended azelastine, a nasal spray, specifically targets non-allergic rhinitis. But also allergic rhinitis. Prescription is cheaper for me, $5 co-pay. You can buy OTC it is branded AstePro. Its amazing how well it works.

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@triciaot thanks for your recommendation. I will check it out, this spray sounds very promising. thanks!

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Profile picture for arbez @arbez

Make sure you have your upper back teeth checked, especially if you've ever had dental work on them. It took awhile but finally found out I had odotogenic sinusitis. It was caused from an abscessed tooth (that never hurt, had a cap and was a tiny bit sensitive). Also never showed on a sinus CT. It is very difficult to get good pics of those teeth without a CBCT scan (usually an endodontist).

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@arbez thanks for sharing. Actually, this is a very interesting comment, and I will definitely check with my dentist soon. The issue is that I have something like 6 wisdom teeth (removed two just recently). Perhaps there is a connection between my half-burrowed wisdom teeth and this chronic problem. Thanks!

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Profile picture for brittis @brittis

I had Covid for the first time in May 2025. Lost my taste and smell. Came back but not fully. I still can't smell like before. Then my nose started running. All the time. Someone suggested it could be related to acid reflux which I have. I have acid seeping into my lungs at night. I'm taking a steroid for that. I sit up and sleep. Every morning my nose is completely stuffed up and starts to run. I have not talked to my doctor yet so I could be wrong. Do you have dry eyes?

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@brittis thanks for sharing and I'm sorry to hear about your struggle. I do have dry eyes from time to time and, more importantly, my eyesight has been slowly deteriorating over the past years (I'm 30), and it's not clear whether there's a connection between this issue, chronic rhinitis and some sort of low-degree inflammation that I have been experiencing on top of all that.

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I have a form of acid reflux called LPR. One of the symptoms is chronic rhinitis but not the stuffed up kind, just clear drainage, also hoarseness. Others experience coughing. There may be info on this on Dr. Jamie Koufman’s website or elsewhere on Mayo Connect. Just mentioning to you as a long shot.

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Hi!
I also have non allergy rhinitis and subsequently developed asthma. I have had a eustacian tube dialation and sinusolasty. Been to multiple dr’s. Also a chronic migraine sufferer. Went to a new ENT and was asking for a posterior nasal nerve ablation. He said I have chronic silent reflux, chronic uncontrolled migraines and that non allergic rhinitis was just part of my problem. Starting taking prescription strength Prilosec and nurtec for migraine prevention and I am a lot better. My non allergic rhinitis started with runny nose in morning but then I started getting thick post nasal drip. Just sharing in case this helps you. 😊

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Profile picture for cezanne @cezanne

I have a form of acid reflux called LPR. One of the symptoms is chronic rhinitis but not the stuffed up kind, just clear drainage, also hoarseness. Others experience coughing. There may be info on this on Dr. Jamie Koufman’s website or elsewhere on Mayo Connect. Just mentioning to you as a long shot.

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@cezanne
Hi! What are you doing for your LPR?

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Profile picture for tulipstulips @tulipstulips

@cezanne
Hi! What are you doing for your LPR?

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@tulipstulips I read Dr Koufman’s books and experimented with suggestions to see what worked. There is a range of differences in what works. When at its worst I slept sitting up, then on my left side, followed most of Koufman’s dietary guidelines, ate smaller more frequent meals, tried to eat last meal by 4PM. Drink lots of water. The more intense symptoms began to subside. The globus ended.
A sluggish digestive system makes it worse and when that happens I eat little or much less. There are many helpful comments by others.
Best of luck.

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Profile picture for tulipstulips @tulipstulips

@cezanne
Hi! What are you doing for your LPR?

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@tulipstulips AM
4 sprays Azelastine, 4sprays Flonase.

PM
4 sprays Azelastine.

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Profile picture for cezanne @cezanne

@tulipstulips I read Dr Koufman’s books and experimented with suggestions to see what worked. There is a range of differences in what works. When at its worst I slept sitting up, then on my left side, followed most of Koufman’s dietary guidelines, ate smaller more frequent meals, tried to eat last meal by 4PM. Drink lots of water. The more intense symptoms began to subside. The globus ended.
A sluggish digestive system makes it worse and when that happens I eat little or much less. There are many helpful comments by others.
Best of luck.

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@cezanne
Hi I will look at the book. I went to a nutritionist and she put me on magnesium and mega sporebiotoc for gut health. I am currently taking Esomeprazole but the goal is to get me off of that.
I wanted to mention this to you because I think at least for me it is stress and gut related. I hope you find this helpful. 😊

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So sorry and glad you are now better! Hope that continues. I share your condition. No, it's not fatal but sure does affect one's quality of life. I've had a balloon procedure, antrostomy, do twice-daily nasal rinses with saline + budesonide + mupiricin, have taken antibiotics and various supplements -- and still have it. I'm wondering: Did your sinusitis appear concurrent with Covid? Mine worsened noticeably after the virus, and many in the Post-Covid group here suddenly had mucus and phlegm after Covid, never having had it before.

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