Vasomotor Rhinitis

Commonly Mistaken for Allergies

by Dr. Herbert Weinman

Detection of allergic rhinitis has been made possible by the development of blood and skin tests. If blood tests reveal no abnormal elevation of IGE (the hallmark of allergic disease), and skin tests are negative, the diagnosis is probably VMR.

Sufferers of VMR often report that their symptoms occur year-round and are made worse by small fluctuations in temperature. Another sign of VMR is nasal stuffiness that alternates from one nostril to the other, especially with changes in head position. The physician must consider all of these factors about the nature of the rhinitis before making a definitive diagnosis.

There is no cure for VMR but there are a few methods for controlling the severity of the symptoms. A physician may prescribe a nasal decongestant spray, a nasal cortisone spray or oral medications (decongestants) for use when symptoms are particularly bothersome. Allergy injections are no help for VMR patients. These injections work by creating antibodies to block the effects of IGE. Since VMR has nothing to do with IGE, allergy shots are an inappropriate treatment, not to mention a waste of valuable time and money.

It should also be noted that the chronic use of over-thecounter nasal sprays can lead to persistent swelling and stuffiness of nasal membranes. This condition, called rhinitis medicamentosa requires special treatment.

Some environmental control measures may relieve the symptoms of vasomotor rhinitis. One should avoid powders, sprays, perfumes, tobacco smoke, air conditioning and excessive household heat, in addition to those familiar plug-ins which spew chemicals into the air. Never put the thermostat over 65° during the winter. Hot dry air is very unhealthy.

Frustrations, “nerves,” and persistent stress are also contributors to VMR. Although not able to alter the environment, a healthcare provider can appreciate the frustration caused by vasomotor rhinitis and is available to answer questions and treat this disorder.