From the Guidelines
When evaluating a patient with rhinitis, you should ask about the nature and timing of their nasal symptoms, including congestion, rhinorrhea, sneezing, and itching, as well as associated symptoms and environmental exposures, to guide treatment decisions and distinguish between allergic and non-allergic rhinitis. To evaluate a patient with rhinitis, consider the following key elements:
- Inquire about symptom duration (acute vs. chronic), seasonality, and triggers such as allergens, irritants, or specific environments 1
- Ask about associated symptoms like postnasal drip, headache, facial pressure, loss of smell, eye symptoms, and sleep disturbances
- Obtain a thorough medical history including previous nasal conditions, allergies, asthma, and other medical problems
- Document current and past treatments including antihistamines, decongestants, nasal steroids, and their effectiveness
- Family history of allergies or nasal conditions is important, as it can strengthen the diagnosis of allergic rhinitis 1
- Ask about environmental exposures at home and work, including pets, mold, dust, chemicals, and smoke, to identify potential allergens or irritants
- Consider the patient's medications, such as antihypertensive drugs, psychotropic agents, and topical decongestants, that may cause nasal symptoms 1 These questions help distinguish between allergic and non-allergic rhinitis, which guides treatment decisions, and understanding the specific pattern and triggers of symptoms allows for more targeted therapy and better symptom control 1.
From the FDA Drug Label
If you also have itchy, watery eyes, you should tell your doctor. To determine the best course of treatment for a patient with rhinitis, you should ask:
- About their symptoms: stuffiness, runniness, itching, and sneezing
- About potential allergies: to pollen, animals, molds, or other materials
- If they are pregnant or breastfeeding: to ensure safe use of medication
- If they are taking other medications: such as ritonavir, to avoid interactions
- If they have itchy, watery eyes: to consider additional treatment 2
- About their medical history: to identify any nonallergic causes of rhinitis
- About their current medications: to avoid potential interactions with fluticasone propionate nasal spray, USP 2
From the Research
Questions to Ask a Patient with Rhinitis
To properly diagnose and treat a patient with rhinitis, it is essential to ask the right questions. The following are some examples of questions to ask:
- What are your symptoms, and how long have you been experiencing them? 3, 4, 5
- Do you have any allergies, and if so, what are you allergic to? 3, 5, 6
- Have you noticed any triggers that make your symptoms worse, such as certain foods, environmental factors, or time of year? 3, 4, 6
- Do you have a family history of allergies or asthma? 3, 5, 6
- Have you tried any treatments or medications for your symptoms, and if so, what were they? 3, 4, 7
- Do you experience any other symptoms, such as sneezing, itching, or congestion, and if so, how often? 3, 4, 5
- Have you noticed any impact on your daily life, such as difficulty sleeping or performing daily activities? 5, 6
Additional Questions for Allergic Rhinitis
For patients with allergic rhinitis, additional questions may include:
- What time of year do your symptoms typically occur, and are they worse at certain times of the day? 3, 4
- Have you noticed any improvement in symptoms when avoiding certain allergens or environments? 3, 6
- Have you tried any allergen avoidance measures, such as using HEPA filters or avoiding certain foods? 3, 6
Additional Questions for Nonallergic Rhinitis
For patients with nonallergic rhinitis, additional questions may include: