Vasomotor Rhinitis Symptoms and Treatment

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.

Man blowing his nose with woman holding his head
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Symptoms

  • A runny nose with drainage that's usually clear and watery
  • Congestion or feeling stuffy
  • Nasal obstruction
  • 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 certain conditions that have caused vasomotor rhinitis in some individuals:

  • Medications
  • Hormonal changes such as pregnancy
  • Certain activities such as intense exercise or sexual activity
  • Eosinophilia syndrome (a condition in which immune system cells called eosinophils flock in large numbers to certain areas or organs of the body in which they are not normally present)

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 doctor 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 doctor 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. Most doctors will initially prescribe newer medications that are supposedly less likely to cause rebound congestion ​and resort to other steroid medications only if these are not effective.

Medications for controlling a runny nose:

  • Atrovent (ipratropium)
  • Cromoglycate

Medications which treat congestion/nasal obstruction:

Astelin nasal spray, a topical antihistamine, may be used for the treatment of vasomotor rhinitis but the use of oral antihistamines is not recommended. Other measures which may be helpful in controlling congestion include remaining hydrated and using a cool-mist humidifier.

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