Checklist: Non-Allergic Rhinitis, Allergic Rhinitis and Chronic Rhinosinusitis with Nasal Polyps
This document has been developed by ASCIA, the peak professional body of clinical immunology/allergy specialists in Australia and New Zealand. ASCIA information is based on published literature and expert review, is not influenced by commercial organisations and is not intended to replace medical advice.
For patient or carer support contact Allergy & Anaphylaxis Australia or Allergy New Zealand.
ASCIA HP Non-Allergic Rhinitis, Allergic Rhinitis and Chronic Rhinosinusitis 2025136.06 KB
The aim of checklist is to provide a summary of typical differences between non-allergic rhinitis (NAR), allergic rhinitis (AR) and chronic rhinosinusitis with nasal polyps (CRSwNP), to help guide management of these conditions. It is important to note that some people have more than one of these conditions, and careful clinical assessment can help to determine the best approach or combination of treatments.
|
Symptoms |
Non-Allergic Rhinitis |
Allergic Rhinitis |
Chronic Rhinosinusitis with Nasal Polyps |
|
Nasal blockage or congestion, runny nose (rhinorrhoea), itchy nose, ears or throat, sneezing. |
Yes |
Yes |
Yes: symptoms can be severe and persistent (lasting for > 12 weeks) |
|
Loss of sense of smell (anosmia) |
No |
Variable |
Yes |
|
Itchy, watery, red eyes (allergic conjunctivitis) |
No |
Yes |
No |
|
Severe symptoms that affect day to day function, leading to sleep disturbance, daytime tiredness, poor concentration. |
No |
Yes: |
Yes: |
|
Recurrent sinus infections |
No |
Not usually |
Yes |
|
Triggers |
Non-Allergic Rhinitis |
Allergic Rhinitis |
Chronic Rhinosinusitis with Nasal Polyps |
|
Inhaled allergens, such as pollen, dust mite, moulds, animal dander. |
No |
Yes |
Maybe |
|
Irritants such as strong odours, perfumes, cleaning products, air-conditioning, smoke, fumes |
Yes |
Maybe |
Maybe |
|
Physical factors, hormonal factors, medications, overuse of nasal decongestants, older age and chronic health issues. |
Yes |
No |
Maybe |
|
Exercise provoked symptoms |
Yes: vasomotor rhinitis |
No |
No |
|
Tests |
Non-Allergic Rhinitis |
Allergic Rhinitis |
Chronic Rhinosinusitis with Nasal Polyps |
|
Allergy test results to inhaled allergens (skin tests or blood tests for allergen specific IgE) |
Consider: negative results can rule out AR |
Yes: |
May be positive: |
|
Other tests required for diagnosis |
No |
No |
Consider: |
|
Treatments and Referrals |
Non-Allergic Rhinitis |
Allergic Rhinitis |
Chronic Rhinosinusitis with Nasal Polyps |
|
Trigger avoidance or minimisation |
Yes |
Yes |
Yes |
|
Saline (salt) nasal sprays or rinses |
Yes |
Yes |
Yes |
|
Antihistamine tablets or syrups |
No |
Yes |
Yes |
|
Antihistamine nasal sprays |
Yes |
Yes |
Yes |
|
Decongestant tablets or nasal sprays |
Short term use only: |
Short term use only: |
Short term use only: |
|
Corticosteroid nasal sprays used regularly and correctly |
Yes |
Yes |
Yes |
|
Combined corticosteroid and antihistamine nasal sprays used regularly and correctly |
Yes |
Yes |
Yes |
|
Allergen Immunotherapy – this requires specific allergens to be confirmed (skin tests or blood tests for allergen specific IgE) |
No |
Yes: |
Consider |
|
Antibiotics |
No |
No |
Occasionally |
|
Oral corticosteroids (short course) |
No |
No |
Occasionally: |
|
Biologics |
No |
No |
Yes: |
|
Surgery |
No |
No |
Consider: |
|
Referral to clinical immunology/allergy specialist recommended |
Consider: |
Yes: |
Yes: |
© ASCIA 2025
Content developed March 2025
For more information go to www.allergy.org.au/hp/allergic-rhinitis (health professionals) or www.allergy.org.au/patients/allergic-rhinitis-hay-fever-and-sinusitis (patients/carers)
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Other adverse reactions to foods include eosinophilic oesophagitis (EoE), food protein-induced enterocolitis syndrome (FPIES), food protein induced allergic proctocolitis (FPIAP), food protein enterocolitis (FPE), oral allergy (food pollen) syndrome and food intolerances.
