Rhinitis, Non-Allergic - Health Tips

Vasomotor or non-allergic rhinitis is a common condition frequently confused with allergy. The diagnosis is suspected by history and confirmed when allergy skin tests are negative or do not correlate with the appearance of symptoms.

Rhinitis means inflammation of the nasal membranes. The nasal membranes can respond to the environment in two ways: by secreting clear mucus (runny nose), and by swelling (nasal congestion). In vasomotor rhinitis patients, these allergy-like symptoms are a reaction to physical factors, such as temperature changes, humidity changes, strong odors, air pollution and smoke. The symptoms of allergic and non-allergic rhinitis are very similar, but the triggers are quite different. One major difference is that allergic individuals have much more sneezing and itching. Often, however, non-allergic and allergic rhinitis occur together in the same patient.

A function of the nose is to warm and humidify the air that we breathe in. This air is passed over the mucous membranes covering tiny bony structures called turbinates. Normally the membranes overlying the turbinates swell and contract, alternating left to right. In both allergic and non-allergic rhinitis, the membranes swell more than the usual amount. Persistently swollen turbinates cause the sensation of congestion and may also cause excessive mucus production.

While there is no cure for vasomotor rhinitis, there are many medications available for symptom control. Oral decongestants, such as pseudoephedrine, temporarily shrink the membranes of the nose. These medications must be used with care in patients with hypertension, as they can raise the blood pressure. Over–the-counter decongestant sprays, such as Afrin and Neosynephrine, are useful for severe congestion, but should only be used for 3 to 4 days, as they can cause a rebound effect with worsened congestion. They may also be habit-forming. Antihistamine nasal sprays and topical steroid nasal sprays, which are available by prescription, also decrease nasal congestion, are safe and are not habit forming. Ipratropium bromide nasal spray is particularly useful in patients whose main complaint is rhinorrhea, or runny nose. In all patients, nasal saline irrigation can be helpful. Your physician will work closely with you to find the medication that works best for your symptoms.