Exercise Induced Rhinitis – can we prevent it?

Often when exercising, some people get a runny nose. In many cases, this is nothing to worry about, just a small wipe or blow of the nose and you are good to continue. Exercise induced rhinitis, on the other hand, is an entirely different matter. We are going to look at its symptoms, possible causes and some treatments / preventions that you can use if you are affected by this condition.

What is exercise induced rhinitis?

EIR, as it is commonly referred to, is a severe form of the ‘runny nose’ that can come with exercise. Rhinitis is a form of infection that affects the nasal mucosa (mucous membranes) that line the nasal cavity. Rhinitis can be generally divided into two different forms: allergic and non-allergic rhinitis. While the common symptom for rhinitis is a runny nose, EIR is a bit more severe in that it can be accompanied by other symptoms including:

  • Congestion
  • Watery eyes
  • Sneezing
  • Itchy nose and/or eyes
  • Postnasal drip

For an athlete, these symptoms can be more than just annoying, they can actually impede their performance and in the most extreme of cases, put their lives at risk.

What are the potential causes of EIR?

EIR as a separate field is relatively unexplored. For that reason, most of its common causes have been attributed to other types of rhinitis. One of the most valid associations has
been attributed to vasomotor rhinitis. This is commonly caused by:

  • Temperature changes
  • Alcohol intake
  • Non specific odors
  • Humidity
  • Cigarette smoke
  • Air pollution

In some cases, the causes have been thought to be allergic while in other cases, the causes have been linked to increased activity in the areas of the brain that have to do with blood flow towards the nasal mucosa. The explanation here is that the increased blood flow towards an athlete’s nasal cavity could result in a runny nose because of passive decongestion or it could increase nasal sensitivity towards general irritants such as nonspecific odors and thus result in itchy nose/eyes, congestion and watery eyes.

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Possible treatment of exercise induced rhinitis

While other types of rhinitis can sometimes be improved with exercise, the same cannot be said for EIR. However, the best kind of treatments for EIR tend to work in both allergic and non-allergic forms of the condition. These forms of treatment include:

  1. Antihistamines
  2. Immunotherapy
  3. Different types of intramuscular, oral and intravenous drugs

Although, if you are a professional athlete, you are strongly advised to pay close attention to any EIR related drugs that you might be taking, because some might be in contravention to the anti-doping regulations that govern your sport.

Prevention

When it comes to dealing with exercise induced rhinitis, there are certain steps that you can take towards reducing the severity of the symptoms. Many of these steps are simple enough and do not need the intervention of a doctor. You can try the following:

  • Humidify cold air by pulling a buff over your nose when exercising in cold weather.
  • Use an antihistamine if it has been determined that your EIR is brought about by an allergic reaction to something within your exercise environment (this is more often than not the first line of defense).
  • You can also try steroid nasal spray for exercise induced rhinitis. Something like Beconase or Flonase can be easily purchased over the counter and happens to be quite effective.
  • You could also try different types of decongestants such as ephedrine or pseudoephedrine. These come in the form of drops but can only be used up to seven days. Any more than that and you could risk addiction and/or withdrawal or rebound congestion. You could try pseudoephedrine in the form of tablets, but it has been banned by WADA so this might not be of any use to professional athletes.

Lastly

EIR, unfortunately, does not seem to reduce with increased fitness or more exercise. The best you can do is have a professional diagnosis on the possible causes of your particular form of exercise induced rhinitis. The above mentioned prevention methods also help a lot for both allergic and non-allergic forms of the condition.

Should the symptoms persist, however, or the effects become more severe, your best cause of action would be to see a professional doctor and to refrain from heavy exercising until you are cleared to do so by your physician.