QUESTION: Doctor, I have suffered of chronic rhinitis for a number of years. I have seen many doctors. In a dry weather it is not so bad, but in Vallarta it is unbearable, humidity makes it worse.
The allergist has told me I am allergic to everything. I don’t think that’s possible!
Can you help me?
– Paloma Reyes, Guadalajar. –
By all the evidence, the rhinitis you have is not only allergic, it is a general inflammation of the zone, thus allergy is but one of the causes.
It is called vasomotor rhinitis because essentially the cause is the local nerves around the nose as well as the nerves of the sympathetic system.
Also, when there is a very old allergy these nerves get gradually altered and skin tests come out all positive due to a generalized and non-specific histamine skin release.
There exist also many psychological implications which trigger the sympathetic nervous system and block the nose.
These notions help explain why there are very few medications to alleviate these problems and not a definite treatment, except moving to a more benign climate altogether.
The most usual treatments are antihistaminic, cortisone topic drops and in very difficult cases, intramuscular cortisone injections, which are not recommended due to their side effects.
You can also use local treatments such as nose washing with salt water, spray cortisone and anti-inflammatories. The combinations of antihistamines and local corticoids are the least aggressive. Antihistamines cause different reactions in different people, you have to try a lot to obtain the best effect.
I hope I was of help.
Dr. F. Escarras (Pediatrician).