II. Symptoms: Chronic (>3 months)

  1. Characteristics
    1. Allergic symptoms are typically absent (nasal, ocular or pharyngeal/palatal Pruritus, sneezing, Nasal Polyps)
    2. Wet or Dry
      1. Dry: Nasal obstruction, airway resistance and congestion
      2. Wet: Rhinorrhea predominates
      3. Mixed (congestion and Rhinorrhea)
  2. Provocative (non-allergic triggers)
    1. Odors (e.g. perfumes, auto emissions, Tobacco smoke)
    2. Alcohol
    3. Spicy food
    4. Humidity
    5. Temperature extremes (e.g. cold)
    6. Sunlight
    7. Gustatory Rhinitis (seen in older patients)
    8. Antihypertensive use

III. Signs

  1. Normal nose exam
    1. Contrast with blue mucosa of Allergic Rhinitis, and the red mucosa of Rhinosinusitis

IV. Differential Diagnosis

V. Management

  1. See Chronic Nonallergic Rhinitis
  2. Intranasal Ipratropium (Atrovent) 0.03% two sprays 2-4 times daily
    1. First-line therapy for Rhinorrhea predominant Vasomotor Rhinitis

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