Exercise-Induced Rhinitis

Two women running.
Two women running. Holde Schneider / Getty Images

Rhinitis is a common disorder that is associated with 1 of the following:

  • Sneezing
  • Runny nose (rhinorrhea)
  • Congestion (nasal)
  • Itching (nasal)

The most common form of rhinitis is allergic rhinitis, which is associated with triggering environmental factors. 70% of people with allergic rhinitis also have accompanying conjunctivitis, or watery eyes that are usually also red and itchy. A less common form of rhinitis is nonallergic rhinitis (NAR).

Nonallergic rhinitis is more difficult to diagnose, as it is a diagnosis of exclusion rather than a disorder that you can be tested for in a doctor’s office. A diagnosis of exclusion means that the doctor test for other identifiable reasons for rhinitis before coming to the conclusion of nonallergic rhinitis.

Normal Nasal Response to Exercise

In the majority of cases, as the heart rate increases during exercise activities, blood vessels in the body constrict (vasoconstriction). This vasoconstriction is related to the release of adrenaline and leads to a decrease in the resistance of the nasal passage airways. In many instances where blood vessels are dilated, causing nasal obstruction, exercise actually helps to decrease the symptoms.

How can exercise cause my runny nose?

Exercise can cause your runny nose by 2 methods. The first method is the best understood. About 15% of athletes, whom have allergies, experience a runny nose due to increasing their exposure to allergens.

This increased exposure is due to increasing the amount of air that is exchanged while breathing deeper and faster (during periods of exercise).

However another case of exercised-induced rhinitis that is less understood is of nonallergenic cause. There are several factors that are viewed as contributors of nonallergenic runny noses in adults that are unrelated to allergies.

The main contributing factors include: irritants, emotional, or vasomotor.

Irritant-induced rhinitis like with athletes that experience exercise-induced rhinitis is related to the increased exposure to occupational or environmental exposures that irritate the nares but do not cause allergies. In this instance, the irritants themselves activate the nasal discharge or runny nose. Decreasing exposure to the irritants can help resolve the chronic rhinitis.

Emotional-induced rhinitis is not actually an exercise-induced form of rhinitis, however is sometimes confused. Intercourse is fairly well documented as causing a runny nose and sneezing. This however does not occur during the act of sex, but rather occurs with the thought of having sex or within 5 minutes after having sex. This phenomenon is also known as honeymoon rhinitis.

Vasomotor rhinitis is the catch all category of nonallergenic rhinitis and is the diagnosis used when all other forms of rhinitis have been eliminated. It is more common in the elderly than the young.

Treatment of Nonallergenic Rhinitis

The early stages of any treatment regimen of nonallergic rhinitis should include avoidance of any known contributing factors. Continued exercise, without exposure of allergens or irritants, may actually reduce the instances of a runny nose due to the body’s natural reaction to adrenaline. A physician may also seek medical treatment including medications for cases that are unable to be modified through avoidance or lifestyle changes.

Medications tend to come from three groups. Anticholinergics like ipratropium bromide are a topical medication that has a relatively low side-effect profile. Nasal steroid sprays like Flonase or Nasocort are common nasal sprays that have been shown to be effective in treating nasal congestion and rhinorrhea (runny nose). The last group of medications used to help treat rhinitis is antihistamines. Azelastine has been shown to be both effective in the treatment of allergy-related rhinitis as well as nonallergic rhinitis. If the turbinates (spongy bone inside the nose) become enlarged, a surgical procedure called a turbinate reduction can help reduce symptoms.

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Monteseirin, J., Camacho, M.J., Bonilla, I., Sanchez-Hernandez, C., Hernandez, M. & Condie, J. (2001). 56(4), 353-4.

Peden, D. (2014). An overview of rhinitis. Accessed on August 31, 2015 from http://www.uptodate.com

Wheeler, P.W. & Wheeler, S.F. (2005). Vasomotor Rhinitis. American Family Physician. Accessed on August 31, 2015 from http://www.aafp.org/afp/2005/0915/p1057.html

Wilson, K.F., Spector, M.E. & Orlandi, R.R. (2011). Types of Rhinitis. Otolaryngologic Clinics of North America. 44:3, 459-559.

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