Vasomotor rhinitis, more commonly known as “idiopathic rhinitis”, is a pathology characterized by nasal obstruction and clear discharge that has been present for several weeks or even months.
What is vasomotor rhinitis?
Vasomotor rhinitis is a chronic idiopathic rhinitis characterized by nasal congestion associated with clear discharge and/or sneezing. It must be differentiated from other causes of chronic rhinitis such as chronic allergic rhinitis, chronic rhinitis of drug origin (hypertensive treatment, aspirin, etc.), chronic hormonal rhinitis (during pregnancy or lactation). “To diagnose idiopathic rhinitis, all causes linked to chronic rhinitis or anatomical variations must be eliminated such as a deviation of the nasal septum or linked to an infectious pathology“, specifies Dr Léa Fath, ENT at Strasbourg University Hospital.
What are the symptoms ?
The main symptoms of idiopathic rhinitis areObstruction of both nasal passages, clear discharge and sneezing. These have been present for several weeks or several months. “This is a perennial problem. There are very few contributing factors. These symptoms are observed throughout the year.
What is the cause ? The stress ?
“The cause of idiopathic rhinitis is not yet defined. There are different mechanisms mentioned to answer this question“. The first track is that of a chronic inflammatory disorder, localized to the nose. The other hypotheses would be of neurological origin, linked to a disorder of the parasympathetic system “which would cause these nasal secretions and discharge in profusion“or the central nervous system:”the latter would be hypersensitive to all the external stimuli faced by the nose“. So, these irritants from the environment : professional conditions, habitat, pollution, stress, would cause this hypersensitivity and the nose would react by wanting to protect itself by secreting much more nasal discharge than necessary.
“The idea is to ultimately improve the tolerance of the nasal mucosa to irritants”
Who is more at risk of getting them?
Anyone can be affected by idiopathic rhinitis. Those most at risk would be women over 50.. “And this frequency is not explained“, emphasizes Dr. Fath.
The management of vasomotor or idiopathic rhinitis is carried out according to the patient’s response to the proposed treatment. As first intention, when nasal obstruction is at the forefront, rhinocorticoids are often prescribed and depending on the response, an antihistamine spray is associated. When the patient’s complaint is related to clear discharge, an ipratopium bromide or capsaicin-based spray will be offered. “The latter would, due to its chili-based composition, tend to reduce this nasal hypersensitivity due to external stimuli. The idea is to ultimately improve the tolerance of the nasal mucosa to irritants.“, she notes. Nasal sprays composed of vasoconstrictors should be prescribed for chronic rhinitis. “The latter must be prescribed for very short periods of time and would tend to aggravate the feeling of a blocked nose in these chronic rhinitis cases.“, alerts Dr. Fath. Surgical treatment may be considered in the event of failure of medical treatment. and should be the subject of a consultation with an ENT surgeon.
Thanks to Dr Léa Fath, Oto-Rhino-Laryngologist (ENT) department, Hautepierre hospital, Strasbourg University Hospital.