Exercise-Induced Rhinitis Causes and Treatment

Exercise can lead to a runny nose or other symptoms of rhinitis. Rhinitis is a common medical condition that may cause sneezing, a runny nose (rhinorrhea), nasal congestion, or an itchy nose.

Two common forms of rhinitis that can lead to a runny nose when exercising are allergic rhinitis and nonallergic rhinitis (NAR). Allergic rhinitis, also called hay fever, is caused by environmental irritants like pollen or dust mites, while NAR may be caused by any non-allergic irritant, like a strong perfume, tobacco smoke, or a change in the weather.

Exercise forces you to breathe in higher volumes of air, in turn increasing your exposure to rhinitis-causing irritants. This article further explains the relationship between rhinitis and exercise. It also covers the treatment options for both allergic and nonallergic rhinitis.

Normal Nasal Response to Exercise

In response to exercise, the heart rate speeds up, and blood vessels within tissues narrow (vasoconstriction).

Exercise-induced vasoconstriction is triggered by the release of adrenaline, a hormone your body produces during times of stress. Vasoconstriction increases the capacity of your nasal passages, creating more space in your airways for you to breathe harder.

In addition to opening your nasal passages, exercise has an expectorant-like effect, meaning that it thins mucus and expels it from the airways and nasal passages. Thus, even if you don't have rhinitis, exercise can still give you a runny nose.

Causes of Rhinitis With Exercise

Nasal mucus serves a few important purposes. For one, it keeps your nasal passages lubricated. But it also traps viruses, bacteria, and other irritants that can make you sick and prevents them from entering your airways by draining them from your nose.

When you are exposed to an irritant, your body produces a chemical called histamine that tells membranes in your mouth, nose, sinuses, and lungs to produce more mucus. A runny nose ensues in order to rid the irritant from your body.

Exercise causes you to breathe deeper and faster and take in larger amounts of air. With the increased airflow comes a larger exposure to allergens and irritants, any number of which can trigger rhinitis.

Also, your nose is the air filter for your body and constantly captures irritants and particulate matter before they reach your lungs. During exercise, this process is ramped up and thereby can cause more inflammation in the nasal cavities.

Allergic Rhinitis

Allergic rhinitis is a common respiratory illness that happens when your body is allergic to an airborne allergen. Depending on the allergen you are sensitive to, you may experience allergic rhinitis seasonally or throughout the year.

Triggers

Some of the most common triggers of allergic rhinitis include:

• Dust mites
• Insect bites and stings
• Animal dander
• Molds
• Pollen
• Household chemicals

If you are sensitive to an allergen, exposure to it will set off the allergic response that leads to such symptoms as runny nose, sneezing, postnasal drip, and congestion.

Treatment

Treatment for allergic rhinitis begins with identifying the allergen behind your body's allergic response. There are two tests commonly used for this purpose:

• Skin prick tests involve pricking the skin with tiny amounts of common airborne allergens, like mold, pollen, and dander. The formation of a raised bump at the site of a prick indicates an allergy to it.
• Blood tests measure levels of immunoglobulin E (IgE) antibodies in the blood that point towards specific allergen sensitivities.

Once an allergen is identified, you will need to avoid it. Your healthcare provider may also prescribe a medication for symptom relief, such as:

• Anticholinergic nasal spray, for minimizing nasal mucus production
• Antihistamine nasal spray, for reducing nasal inflammation
• Corticosteroid nasal spray, for reducing nasal inflammation
• Decongestant nasal spray, for relieving nasal congestion
  

If your symptoms persist despite medication, your healthcare provider may recommend immunotherapy. This treatment involves exposure to an allergen via injections in gradually increasing doses over time, allowing your body to build a tolerance to it.

Nonallergic Rhinitis

The exact genesis of nonallergic rhinitis, also called vasomotor rhinitis, is unknown. Unlike allergic rhinitis, NAR is not an allergic reaction and therefore does not involve the immune system.

Nonetheless, a person with NAR can experience the same symptoms as those seen in allergic rhinitis, including runny nose, congestion, postnasal drip, and sneezing.

Triggers

The main nonallergic causes of NAR are airborne substance that irritate your nasal passages although they do not trigger true allergies.

Nonallergic rhinitis can be triggered by:

• Chemical fumes
• Strong odors, like perfume
• Stress
• Weather changes
• Oral or topical medications
• Hot or spicy foods
• Chemicals and factory byproducts
• Hormone changes, like those caused by pregnancy or hypothyroidism

Symptoms of non-allergic rhinitis can be persistent or intermittent, depending on which irritant is to blame and how often you are exposed to it.

Treatment

Nonallergic rhinitis is diagnosed through a process of exclusion. After performing a physical exam, a healthcare provider may also administer a skin prick test and blood test to rule out allergic rhinitis.

If the tests do not indicate that an allergen is to blame, your provider may order additional tests to rule out other diseases, like sinusitis or a cerebrospinal brain fluid leak, which can cause similar symptoms.

If the trigger is found, you'll need to avoid it. If it isn't, and your provider did not find another underlying condition, you may still be diagnosed with NAR.

There is no cure for nonallergic rhinitis. Treatment involves managing symptoms and avoiding irritants that trigger them.

Certain medications may be prescribed to reduce nasal inflammation, mucus production, and congestion, such as:

• Anticholinergic nasal spray, for minimizing nasal mucus production
• Antihistamine nasal spray, for reducing nasal inflammation
• Corticosteroid nasal spray, for reducing nasal inflammation
• Decongestant nasal spray, for relieving nasal congestion

Your healthcare provider will instruct you when and how often to use your medication. Follow their directions carefully; left untreated, nonallergic rhinitis can lead to ear infections, nasal polyps (non-cancerous growths in the nasal passage), and sinus infections.

Summary

Exercise can cause rhinitis, a common medical condition that can make you have a runny nose, sneezing, nasal congestion, or an itchy nose.

Allergic rhinitis is triggered by allergens in the environment. Nonallergic rhinitis may be caused by substances in the workplace or around you that irritate your nasal passages but don't trigger true allergies.

Nonallergic rhinitis may also occur because of your emotions. If a doctor rules out all other forms of rhinitis, it's called vasomotor rhinitis. Rhinitis is treated with various kinds of nasal sprays.