Vasomotor rhinitis, also called non-allergic rhinitis, is a condition that's used to describe a runny nose and/or congestion that doesn't go away and is not caused by allergies or infections such as the common cold. Research indicates that between 17 and 40 million Americans suffer from vasomotor rhinitis and that Americans spend a minimum of $1.8 billion in treatment costs each year.
Symptoms
- A runny nose with drainage that's usually clear and watery
- Congestion or feeling stuffy
- The absence of other cold or allergy symptoms, like a lot of sneezing or eye irritation
Symptoms of vasomotor rhinitis may worsen when a person is around certain odors or perfumes, the temperature changes, they feel certain emotions, or are exposed to bright lights.
Possible Causes
The cause of vasomotor rhinitis cannot always be pinpointed, but below are some triggers for vasomotor rhinitis in certain individuals:
- Medications
- Hormonal changes such as pregnancy
- Certain activities such as intense exercise or sexual activity
- Cold air
- Spicy foods or even eating in general
Certain conditions could predispose you to the development of vasomotor rhinitis, including a history of nasal trauma or a history of gastroesophageal reflux disease (GERD).
Some experts believe that people who are prone to the development of vasomotor rhinitis may have an overly sensitive autonomic nervous system.
Diagnosis
Getting a correct diagnosis will probably be the most important step in adequately treating and managing your vasomotor rhinitis.
Unfortunately, there are no specific blood or other laboratory tests that can positively identify this condition. A diagnosis is made after other conditions, specifically, allergic rhinitis, have been ruled out. Your healthcare provider may use blood tests (IgE tests) or skin tests to rule out allergies, but these tests alone are not necessarily enough to diagnose vasomotor rhinitis.
It may be helpful for you and your healthcare provider if you keep a journal of sorts: write down any places, activities, odors, foods, or other conditions which seem to trigger your symptoms. This may also be helpful in your treatment because once triggers are identified, they might be avoided or minimized.
Treatment
The treatment for vasomotor rhinitis focuses on controlling symptoms. As stated above, avoiding the triggers that cause your symptoms, if identifiable, can be very helpful. But you may not know what triggers your symptoms—their cause/s often remain a mystery.
The good news is that there are several medications that can be used to control these symptoms, including nasal sprays that are available only by prescription.
Due to the risk of rebound congestion (known by some as rhinitis medicamentosa or nasal spray addiction), over-the-counter decongestant medication such as Afrin should not be used for more than three days and are generally not adequate for the treatment of vasomotor rhinitis.
Medications for controlling a runny nose:
- Atrovent (ipratropium)
- Cromoglycate
Medications for congestion:
- Nasonex
- Rhinocort
- Flonase
- Nasacort
Astelin nasal spray, a topical antihistamine, may be used for the treatment of vasomotor rhinitis but the use of oral antihistamines is not recommended.
11 Sources
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Long A, McFadden C, DeVine D, et al. Management of Allergic and Nonallergic Rhinitis: Summary. 2002 May. In: AHRQ Evidence Report Summaries. Rockville (MD): Agency for Healthcare Research and Quality (US); 54.Available from: https://www.ncbi.nlm.nih.gov/books/NBK11954/
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Banov C, Lieberman, P. Efficacy of azelastine nasal spray in the treatment of vasomotor (perennial nonallergic) rhinitis. Annals of Allergy, Asthma & Immunology. 86(1): 28-35. doi.org/10.1016/S1081-1206(10)62352-6
Wahid NWB, Shermetaro C. Rhinitis Medicamentosa. [Updated 2019 Feb 4]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; Available from: https://www.ncbi.nlm.nih.gov/books/NBK538318/
Malmberg H, Grahne B, Holopainen E, Binder E. Ipratropium (Atrovent) in the treatment of vasomotor rhinitis of elderly patients. Clin Otolaryngol Allied Sci. 8(4):273-6.
Meltzer EO. The treatment of vasomotor rhinitis with intranasal corticosteroids.World Allergy Organ J. 2(8):166–179. doi:10.1097/WOX.0b013e3181af7c93
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Additional Reading
- American Family Physician. Vasomotor Rhinitis.
By Kristin Hayes, RN
Kristin Hayes, RN, is a registered nurse specializing in ear, nose, and throat disorders for both adults and children.
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