What is the difference between sinusitis and allergic rhinitis?

Doctor's Answer

This is a very common question asked by many of my patients. In fact, most of my patients with frequent blocked nose, runny nose and sneezing often complain to me that they have "sinus".

These symptoms are more likely due to Rhinitis (click to find out more) which means inflammation of the nasal cavity. Rhinitis (or the layman term is Sensitive nose) can be Allergic (often known as Hayfever) or Non-Allergic.

Allergic Rhinitis occurs due to exposure to a protein known as allergen. The most common allergens are common house dust mites, grass or tree pollens, mold and animal dander. Non-allergic Rhinitis can be triggered by a change of weather, cigarette smoke, strong perfumes or hormonal changes. To differentiate between Allergic and Non-Allergic Rhinitis, a combination of clinical history and Allergy tests (either a skin prick test or blood test) can be performed.

Treatment of Rhinitis is mainly allergy or trigger avoidance, nasal steroid sprays and antihistamines/decongestants. For patients with Allergic Rhinitis, desensitization to the known allergen through a treatment known as Immunotherapy can be considered.

This usually involves applying the known allergen in the form of a spray or tablet under the tongue daily for 3-5years. It is the only potential cure for patients with Allergic Rhinitis.

Sinusitis refers to inflammation or infection of the sinuses. Everybody has sinuses. They are air-filled hollow cavities surrounding the nasal cavities. They produce mucous that drains into the nose. Our nose and sinuses produce between 1-1.5 litres of mucous a day. Most of the time the mucous flows seamlessly down the throat without us noticing it.

However, when the sinuses are not draining and becomes blocked, the mucous becomes inflamed/infected. This causes coloured mucous (yellow, brown, green or even blood-stained), blocked nose, facial pain or congestion, postnasal drip, and loss of sense of smell.

To treat sinusitis, you need to take a course of oral antibiotics, nasal douche (saline wash of the nose) and nasal steroid sprays.

Based on the symptoms you have provided, it is more likely that you have Rhinitis. You should see an ENT Specialist who will take a thorough clinical history and perform a relatively painless scope through the nose (called nasoendoscopy).

Hope this helps and all the best!

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