Badly Behaving Noses in Children: Rhinitis, Sinusitis, or Neither?

Abstract

Every pediatrician has likely experienced frustration with cases of chronic nasal symptoms that either do not seem to get better or do show improvement but then worsen again. Often, this leads to the diagnosis of allergic rhinitis or sinusitis and subsequent prescription of medication(s) that may or may not be warranted. This article discusses the various causes of rhinitis, both allergic and nonallergic. Recommendations for treatment place special focus on nasal irrigation and the role that a child's diet can have on chronic nasal symptoms, with the hope of reducing excessive and sometimes unnecessary medication use. [Pediatr Ann. 2016;45(11):e384-e387.].

Fifteen-minute consultation: Child with persistent runny nose

“…Addressing patient and family expectations8 and acknowledging the common lack of adherence to long-term treatment are important 5 13. Even doctors with AR have poor adherence to long-term medication!13…”

“…Majority of nasal symptoms in children are secondary to frequent acute viral upper respiratory tract infections or AR. However, it is important to consider the differential diagnosis to avoid missing red flags, prevent unnecessary medication use and guide appropriate management 8. Rhinitis should not be confused with normal nasal reflexes, for example, sneezing on exposure to temperature extremes and bright light, and nasal congestion when supine which improves with being upright.…”