Vasomotor rhinitis (VMR) is a condition in which the blood vessels lining the nose swell leading to nasal congestion, and in which the mucus glands in the nose become overactive leading to excessive drainage. VMR can occur at any age, although it tends to be more common as individuals get older.
Common triggers of vasomotor rhinitis include changes in temperature, barometric pressure, or humidity. Strong odors such as perfumes, colognes, smoke and dust can also be triggers for vasomotor rhinitis. Some patients will find that eating causes significant nasal drainage or congestion. Others will experience more difficulties in breathing during the Spring and Fall due to the changes in temperature and humidity that occur during these times of the year.
It is important to understand that VMR is a nonspecific response to virtually any change or impurity in the air, as opposed to allergic rhinitis (or hay fever), which involves a response to a specific protein in pollen, dust, mold, or animal dander.
Symptoms of VMR are similar to those of allergies, with frequent congestion, runny nose and/or postnasal drip. Patients with VMR, however, often have less sneezing and itching than patients with rhinitis caused by allergies alone. Some patients have both conditions, and when they occur together, the two may aggravate one another.
We usually diagnose VMR by taking a careful history and performing a thorough exam of the nose and throat. In addition, we often perform allergy testing to make sure there is no allergic basis for any of the symptoms, since this would affect our treatment approach.
Unfortunately, there is no cure for VMR, however several medications are available to help alleviate symptoms. Immediate cessation of smoking and avoidance of second hand smoke is imperative as non-specific irritation from smoke will drive nasal drainage. One of the most effective treatments for VMR is the use of over-the-counter nasal saline spray or mist, which can be used as often as needed to soothe the nose and loosen any thick mucus. Nasal steroid sprays (Ex. Flonase, Veramyst, Nasonex), nasal antihistamine sprays (Ex. Astepro, Patanase) and nasal anticholinergic agents (Atrovent) can greatly decrease the amount of drainage produced from mucus glands within the nose. An oral decongestant can also be used to dry up watery drainage or to relieve nasal congestion, but these are generally used sparingly since they may cause insomnia or aggravate hypertension, particularly in elderly patients.
How We Can Help
Vasomotor rhinitis often overlaps with environmental allergies so it is important to be tested for environmental allergies as the presence of allergies may influence medical treatment. Through a focused medical history and targeted allergy testing, your Allergy Partners physician will be able to determine whether or not your symptoms of nasal congestion are being caused by allergies, vasomotor rhinitis or other conditions altogether.