This is an updated guideline for the diagnosis and management of allergic and non-
allergic rhinitis, first published in 2007. It was produced by the Standards of Care Committee of the British Society of
Allergy and Clinical Immunology, using accredited methods.
Allergic rhinitis is common and affects 10-15% of children and 26% of adults in the UK, it affects quality of life, school and work attendance, and is a risk factor for development of
asthma.
Allergic rhinitis is diagnosed by history and examination, supported by specific
allergy tests. Topical nasal
corticosteroids are the treatment of choice for moderate to severe disease. Combination
therapy with intranasal
corticosteroid plus intranasal
antihistamine is more effective than either alone and provides second line treatment for those with
rhinitis poorly controlled on monotherapy.
Immunotherapy is highly effective when the specific
allergen is the responsible driver for the symptoms. Treatment of
rhinitis is associated with benefits for
asthma. Non-
allergic rhinitis also is a risk factor for the development of
asthma and may be eosinophilic and
steroid-responsive or neurogenic and non- inflammatory. Non-
allergic rhinitis may be a presenting complaint for systemic disorders such as granulomatous or eosinophilic polyangiitis, and sarcoidoisis. Infective
rhinitis can be caused by viruses, and less commonly by bacteria, fungi and protozoa.