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Background and Aims: Nasal congestion is a prevalent symptom often alleviated with over-the-counter nasal sprays containing decongestants. Rhinitis medicamentosa (RM), caused by the overuse of decongestants leading to recurrent mucosal swelling, poses a significant challenge for specialists in managing patients. Despite advancements in understanding, research primarily consists of case series with limited data on its impact on quality of life. This qualitative study aimed to explore the effect of nasal spray overuse on quality of life and identify addiction components among individuals with RM., Methods: Twenty participants with RM were interviewed by an otorhinolaryngologist and addiction counsellor. The study employed a qualitative approach utilising directed content analysis and revealed eleven categories, classified into addiction components and distinctive features of nasal spray addiction., Results: The analysis revealed the presence of all Griffiths' addiction components in the identified themes. Additionally, sleep disorders, the feeling of suffocation, side effects, illness identity and psychological effects on nasal congestion significantly impair individuals' quality of life., Conclusion: This qualitative study identified key components of addiction in nasal spray overuse and suggested that RM might be conceptualised in the DSM-5 category of "Other (or Unknown) Substance-Related Disorders", considering the lack of psychoactive effects. Nevertheless, in view of the current findings, it also seems to be plausible to examine the phenomenon in the behavioural addiction framework. The study underscores the need for further research and intervention strategies to address the significant impact of RM on individuals' quality of life.

Background and Aims: Limited data are available on long-term disease outcomes in elderly-onset (EO) inflammatory bowel diseases (IBD) from well-defined population-based cohorts. Our aim was to analyze incidence, disease course, surgery rates, and therapeutic strategies of EO IBD in a prospective population-based cohort., Methods: Elderly-onset inflammatory bowel diseases were defined if diagnosis was established at ≥60 years of age. Patient inclusion lasted between 1977 and 2018. Study endpoints were compared between elderly- and adult-onset (AO) patients and different therapeutic eras. Data from medical records were prospectively collected and regularly reviewed, as part of the well-established Veszprem IBD cohort., Results: Data from 946 Crohn's disease (CD) and 1370 ulcerative colitis (UC) patients were analyzed. The proportion of EO CD and UC patients was 6.1% (58/946) and 13.4% (183/1370) in the total cohort. Biological therapy exposure was significantly lower in EO CD compared to AO [pLogRank = 0.003], but similar exposure was seen amongst UC patients [pLogRank = 0.770]. Early surgery rates (≤1 year from diagnosis) were significantly higher in EO CD patients compared to AO (27.6% vs 15.6%; P < .001). However, there was no statistically significant difference in overall resective surgery rates between the EO and AO cohorts in CD [pLogRank = 0.838], nor colectomy rates differed in UC [pLogRank = 0.435]. Disease phenotype progression in CD and UC were both lower in EO disease [pLogRank = 0.015; pLogRank = 0.022]., Conclusion: Elderly-onset inflammatory bowel diseases represents an increasing proportion of IBD patients, with high exposure to biologicals in EO UC. Overall surgery rates were similar in EO and AO cohorts, however, early surgeries in CD were higher in EO patients., (© The Author(s) 2025. Published by Oxford University Press on behalf of European Crohn’s and Colitis Organisation.)