Rhinitis--inflammation of the lining of the nose--is classified as allergic or nonallergic. Vasomotor rhinitis is a form of nonallergic rhinitis that is not caused by infection and lacks elevated levels of eosinophils, a type of white blood cell. Although the causes are different, the symptoms of the two types of rhinitis overlap and include stuffy and runny nose, sneezing and postnasal drip.
Allergic Rhinitis
Allergic rhinitis is caused by reaction to an airborne allergen, such as pollen, insect droppings, grass or animal dander. It comprises one out of three cases of rhinitis, according to the Joint Task Force on Practice Parameters for Allergy and Immunology.
Vasomotor Rhinitis
The symptoms of vasomotor rhinitis consist mainly of a constant runny nose and nasal congestion but they vary, reports the Joint Task Force on Practice Parameters. Unlike allergy-related rhinitis, itchy nose and eyes and sneezing are less prominent features, reports Dr. Wheeler in "American Family Physician." People with vasomotor rhinitis are divided into two groups: "runners," who have a constant drippy nose, and "dry," who mainly experience congestion and have minimal runny nose.
Diagnosis
Whether someone has allergic or vasomotor rhinitis can be determined by a simple skin test that shows results within 20 minutes. There is no specific test for vasomotor rhinitis and the diagnosis is one of exclusion, reached after allergens have been ruled out and a careful history and physical exam have been performed.
Considerations
Examining the triggers helps to determine whether rhinitis is allergic or vasomotor. If symptoms appear after changes in temperature or barometric pressure or exposure to turbulent air, it is likely that a person has vasomotor rhinitis. This is also true if symptoms come after exposure to perfume or smoke. Strong cooking odors and spicy foods are also culprits. Another trigger for vasomotor rhinitis is blood pressure medication. Both physical and emotional stress and sexual arousal are also causes, reports the Auckland Allergy Clinic. On the other hand, allergic rhinitis is the likely diagnosis if a person sneezes and has watery itchy eyes when wheat is being cut or in the presence of a pet, reports the Mayo Clinic.
Treatment
Although there is an overlap in treatments, it is important to get a specific diagnosis early, as certain medications are useful for only one type of rhinitis, reports American Family Physician. Oral antihistamines and allergy shots only help allergic rhinitis. Nasal antihistamines such as azelastine are a good first choice for vasomotor rhinitis, especially if a patient seems to have a mix of both types, but antihistamines as a pill are not. The nasal spray ipratropium, which is available only by prescription, helps vasomotor rhinitis with constant runny nose as the main symptom. Nasal steroids are helpful for both types, and a growing body of studies suggests that they are more effective than antihistamines, even if the cause is allergy.
References
- "Vasomotor Rhinitis"; American Family Physician. Wheeler PW. 2005.
- 'Vasomotor Rhinitis (VMR) or Idiopathic Non-allergic Rhinitis"; Auckland Allergy Clinic
- "The Diagnosis and Management of Rhinitis: An Updated Practice Parameter"; Journal of Clinical Immunology. 2008
