Vasomotor rhinitis - evaluation and treatment
Nonallergic rhinitis is a syndrome of chronic symptoms of nasal congestion or rhinorrhea, unrelated to a specific allergen. Vasomotor rhinitis is the most common type. Etiology- the imbalance among mediators results in increased vascular permeability and mucus secretion from the submucosal nasal glands. Clinical presentation divides patients into 2 groups depending on predominant symptomatology: “blockers” with congestion and “runners” with rhinorrhea. Nonetheless, distinguishing vasomotor rhinitis from allergic rhinitis can be challenging. A detailed history will often help to separate allergic from nonallergic process. Treatment include limiting exposure to inciting factors such as perfumes, tobacco smoke, and cleaning supplies. Topical nasal corticosteroids are considered first-line in vasomotor rhinitis (fluticasone 200-400 mcg). Anticholinergic medications can provide relief from unrelenting rhinorrhea.