You have a condition called chronic nonallergic rhinitis. This condition goes by other names as well. Some physicians call it vasomotor rhinitis. This is a condition of unknown cause. It is often confused with allergy because it produces similar symptoms. Many patients refer to the symptoms caused by chronic nonallergic rhinitis as "sinus" or "sinus trouble. "However in most instances the sinuses are really not involved. The problem is one of the tissues in the nose rather than those in the sinuses.
Patients with this problem will complain of nasal congestion and stuffiness, postnasal drainage, sneezing, runny nose, and a sensation of pressure and fullness over the nose and sinus areas. One or all of these symptoms may be present.
It is easy to understand how these symptoms can be interpreted as allergic because sometimes allergies can produce similar symptoms. Thus patients with chronic nonallergic rhinitis oftentimes seek help from allergists. Unfortunately however, since allergies are not involved, allergy therapy would be of no benefit.
Since the cause of this problem is unknown, we do not have a definite cure. However in the vast majority of instances we can help patients with chronic nonallergic rhinitis. To do so we employ various medications. You should understand that these medicines will not cure the problem and that you probably will have it lifelong. There will probably be periods of improvement followed by periods of worsening. However we are able to control the symptoms reasonably well in most cases.
Listed below are the things that we normally do for patients with chronic nonallergic rhinitis:
We know that strong odors and fumes and respiratory irritants such as perfumes, tobacco smoke, and aerosols aggravate the condition. For these reasons efforts to avoid these substances are indicated. We also know that the condition is made worse by other elements which, unfortunately, cannot be avoided. Changes in weather such as cold fronts coming in, periods of high humidity, drafts, and sometimes simply lying flat can aggravate the condition. These things however are unavoidable and the symptoms that they produce can only be helped with medication.
We have several options as far as medicines are concerned. These are:
Antihistamines-decongestants:These drugs help some patients. They are very mild and usually do not offer dramatic relief but are oftentimes of some benefit. They are usually harmless and cause no significant side effects. They are therefore the cornerstone of long-term management in many patients.
Corticosteroids:Corticosteroids are employed when the symptoms have not been adequately controlled with antihistamines and decongestants. Corticosteroids can be utilized safely if prescribed for the proper length of time in the proper fashion. They can be given by nose spray over fairly long periods of time without any significant side effects in adults. In children, prolonged use is less advisable since slowing of growth has been seen in some children with daily use for one year.
Anticholinergics:These agents are especially good for a "runny nose" since they are specifically designed to dry secretions.
Occasionally, when the problem is unresponsive to medication and is severe, surgical procedures are helpful. The indication for surgery varies in each patient. This is a "last resort" measure.
Although chronic nonallergic rhinitis can make patients quite uncomfortable, you should understand that it is not a serious problem and there are no significant complications in the vast majority of instances. Occasionally sinus infections can occur, but these can usually be adequately treated with medication. Nonetheless, this problem, in most instances, is a lifelong condition and, although not serious, often requires the administration of medication to keep the patient comfortable.
