Vasomotor and other non-allergic rhinitis

Vasomotor rhinitis is due to an imbalance of autonomic function resulting in over stimulation of the parasympathetic system.  This causes vasodilation and oedema of the vessels in the nose- where the patient complains of nasal congestion, rhinorrhea and sneezing.  It may be brought on spontaneously or can be triggered by cold air, strong smells, inhaled irritants or even stress.  It is more common in women than men.

Other causes of rhinitis include

  • infective causes (usually URTI, more rarely sinusitis)
  • ‘hormonal’ rhinitis
  • Drug induced rhinitis (ACEIs/beta blockers/chlorpromazine/gabapentin etc. Remember to consider illegal snorted drugs e.g. cocaine)

Management

Management is only warranted if causing intolerable symptoms.  Nasal ipratropium and/or beclamethasone may help.  Antihistamines are RARELY used.

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