Rhinitis is a heterogeneous group of disorders that can significantly impact the quality of life of the affected individual^[1] A heightened awareness of the condition and its potential debilitating comorbidities/complications is essential for a timely intervention.^[1][2]

Rhinitis is a very common disease, and it is sometimes erroneously viewed as a trivial disease.^[3][1] Allergic rhinitis rarely occurs in isolation, it is a product of a genetic predisposition, epigenetic events, and environmental exposures, and it is frequently associated with other forms of atopy such as eczema, asthma, and allergic eye disease(allergic rhinoconjunctivitis).^[4][5][6] The vast majority of individuals with asthma have rhinitis, and allergic eye disease has been reported to affect almost all patients with allergic rhinitis.^[4][7] Nonallergic rhinitis is also associated with asthma.^[8][7] Frequent extension of rhinitis into the sinuses also occur, resulting in rhinosinusitis.^[9][1] Children with nonallergic rhinitis have a higher likelihood of undergoing remission, compared with those with allergic rhinitis, who tend to have a more persistent disease.^[8] Remission occurs in up to 73% of four year old children with nonallergic rhinitis by the age of eight years.^[8] Rhinitis is a significant cause of lost school and work days, and it constitutes a huge financial burden to the society.^[10][3] Untreated/poorly treated chronic rhinitis is associated with a diminished quality of life, disordered sleep, impaired work performance, and several other co-morbidities.^[1][5]

The complications of rhinitis include the following:^[7][3][11]

• Conjunctivitis
• Rhinosinusitis
• Chronic cough– One of the commonest causes of chronic cough is posterior rhinorrhoea(postnasal drip)
• Fatigue
• Mouth breathing
• Aggravation of adenoidal hypertrophy^[12]
• Headache
• Poor sleep
• Obstructive sleep apnea
• Snoring
• Cognitive impairment
• Hyperactivity
• Eustachian tube dysfunction
• Acute otitis media^[12]
• Otitis media with effusion
• Aggravation of asthma
• Laryngitis^[13]
• Hyposmia (usually mild)

Allergic comorbidities associated with Allergic rhinitis include:^[7]

• Allergic eye diseases^[4]

1. Seasonal allergic conjunctivitis
2. Perennial allergic conjunctivitis
3. Vernal keratoconjunctivitis
4. Atopic keratoconjunctivitis

• Asthma: Allergic rhinitis is strongly associated with the risk of developing asthma, and the coexistence of rhinitis with asthma is often associated with an increase in asthma severity.^[14]
• Atopic dermatitis
• Oral allergy syndrome^[15]
• Eosinophilic gastroenteritis^[16]

Resolution of allergic rhinitis occurs in only 10-20% of children within 10 years.^[17] A higher likelihood of remission has been documented in children with nonallergic rhinitis compared to the allergic type, with remission occurring within four years in about 73% of four year old children suffering from nonallergic rhinitis.^[8] Poorly treated rhinitis is strongly associated with a decreased quality of life and several other co-morbidities.^[1]