Chronic rhinitis symptoms

Posted on by admin

Types of chronic rhinitis: their signs, symptoms and treatment methods

Inflammation of the mucous membrane of the nasal cavity is called rhinitis. Acute rhinitis is caused by common viral and colds. Chronic rhinitis occurs for many reasons, including atrophic processes occurring in the nasal mucosa and a deviated nasal septum.

Table of contents:

It has its own classifications. Distinguish

Among the reasons are frequently recurring acute rhinitis (especially in children), proliferation of the nasal turbinates, chronic diseases of the paranasal sinuses, constant presence of a person in dusty rooms, in enterprises with harmful fumes and sharply changing air temperatures. Chronic rhinitis can be treated with traditional medicine, physiotherapy, and folk remedies.

Features and symptoms of types of chronic rhinitis

Chronic catarrhal rhinitis

Expressed in congestive inflammation of the mucous membrane. This type of chronic rhinitis is caused by uniform swelling of the nasal turbinates and copious secretion of mucous secretion. There is a disturbance in the sense of smell and difficulty in nasal breathing. Symptoms are usually mild. Chronic catarrhal rhinitis often develops into hypertrophic rhinitis. In children, the development of this form is often associated with chronic adenoiditis or tonsillitis.

Chronic hypertrophic rhinitis

It is the final, most severe degree of catarrhal rhinitis, which can sometimes only be cured surgically. It is caused by atrophy of the epithelium, its loosening and the absence of cilia of the ciliated epithelium on certain parts of the nasal mucosa.

This disease is not always a consequence of prolonged catarrhal rhinitis and can begin on its own. It is expressed in severe difficulty breathing, dullness of smell, usually characterized by a nasal voice and frequent headaches. During a detailed outpatient examination by an otolaryngologist, reddening of the shells, their severe swelling, and sometimes the formation of polyps in the nasal cavity are observed.

Chronic atrophic rhinitis

It is caused by atrophic processes occurring in the mucous membrane of the nasal cavity (less commonly, the bone and cartilaginous parts of the shells), its significant thinning, and the replacement of ciliated epithelium with flat epithelium. Atrophic rhinitis is accompanied by the appearance of a thick crust in the nose, slight trauma to the mucous membrane, and sometimes an unpleasant odor appears in the patient’s nasal cavity, which only he can feel. The olfactory nerve is deformed, and the secretion of nasal mucus is disrupted. There is a feeling of dryness and tightness. When trying to remove the crusts, children experience bleeding.

Primary symptoms of types of chronic rhinitis

Common symptoms of rhinitis also include:

  • sneezing
  • tearing and redness of the eyes (especially with allergic rhinitis)
  • itching, burning and tingling in the nose
  • dullness of taste
  • heavy or moderate snoring.

In children, symptoms may not always occur, but when changing body position. A person suffers from a feeling of pressure in the temples, drowsiness, high fatigue, deterioration in the quality of sleep or insomnia.

The most common causes of the disease

“Chain reaction” of rhinitis

For the occurrence of chronic rhinitis, there is a chain of preceding events associated with the disease. Chronic catarrhal rhinitis is caused by repeated or prolonged acute infectious rhinitis. In children, the development of this disease is almost always associated with adenoids, tonsillitis and sinusitis. Hypertrophic rhinitis grows mainly from catarrhal rhinitis and is its severe stage. Allergic rhinitis is directly related to bronchial asthma and allergic eczema.

General disorders of the anatomical structure of the nasal cavity

A common cause of the development of chronic rhinitis is deformation and atrophic processes in the nasal cavity. A deviated septum can cause hypertrophy of the nasal concha, often unilateral. Destruction of the epithelium leads to atrophic and hypertrophic rhinitis. These causes of the development of the disease also include the acquisition of mechanical injuries, congenital and acquired defects and defects. Chronic rhinitis in children develops against the background of the appearance of adenoids in the nasopharynx.

Environmental factors and breathing air quality

Heavily polluted air, constant inhalation of vapors and gases and being in dusty rooms are the reasons that lead to the development of chronic rhinitis. Inhalation of harmful fumes and dust (flour, metal, chalk, mineral) - all this contributes to disturbances in the nasal cavity, destruction of the cilia of the ciliated epithelium, deformation of the nasal concha and disruption of the secretion of the mucous glands.

Dangerous factors are inhalation of dry and hot air (heaters, air conditioners without the use of humidifiers, including), prolonged exposure to the cold leads to changes in the tone of the nasal vessels.

Poor circulation in the nasal cavity

Circulatory disorders are caused by chronic diseases of the body - dysmenorrhea, hypertension, kidney disease, endocrine and nervous dysfunctions. This category also includes bad human habits. Alcoholism, drug addiction, and smoking inevitably lead to impaired blood circulation in the respiratory tract, which leads to the development of chronic diseases of the nasal cavity.

Taking certain medications

First of all, this applies to medications against hypertension and vasoconstrictor drops. Nasal drops with a vasoconstrictor effect are allowed to be used for no more than a week, otherwise their frequent use leads to atrophic changes and irritation of the mucous membrane and nasal turbinates. Long-term use of drops can cause the development of vasomotor rhinitis.

Treatment of chronic rhinitis

They practice medicinal, outpatient, surgical and folk remedies.

Traditional treatment of chronic rhinitis

Drug treatment involves the appointment of vasoconstrictor drops, ointments with antiseptic and anti-inflammatory effects, astringents (colargol solution). At elevated temperatures, antipyretic and antiviral drugs are prescribed. If hard crusts form, softening sprays and drops, usually oil or salt based, can be used. The doctor may prescribe antibiotics depending on the clinical picture.

Ambulatory treatment

Outpatient treatment consists of a combination of physiotherapy, warming and quartz treatments.

It helps to cure chronic catarrhal rhinitis and requires the patient to undergo a course of physiotherapy. UV heating, irradiation with a Sollux lamp, UHF, electrophoresis, magnetic therapy, microwave - these methods can cure rhinitis most quickly and effectively. Many of them also help with the atrophic form of rhinitis. Useful inhalations: honey, phytoncides, alkaline and oil. Some inhalations are carried out at home and are considered folk remedies.

Surgery

Surgical interventions are sometimes necessary for the hypertrophic form of chronic rhinitis. Severe hypertrophy may be the reason for the need for surgery - a minor partial resection of hypertrophied conchae. Surgical treatment of chronic sinusitis also includes eliminating the causes of its occurrence. This is the surgical removal of polyps and adenoids, correction of a deformed nasal septum (septoplasty).

Treatment of chronic rhinitis with folk remedies

Despite today's abundance of pharmaceutical products, treatment with folk remedies is still in demand and effective. Our ancestors treated chronic and acute rhinitis mainly with herbs; Rhinitis can still be cured with herbal medicine.

It is especially useful to drink a decoction of peppermint (a tablespoon of dry mint leaves per half liter of boiling water). You can rinse your nose with this solution, this will help relieve congestion without resorting to the use of vasoconstrictors.

Other herbal tinctures are also useful - from licorice, viburnum bark and wild rosemary. An oil tincture (100 grams of oil + 1 spoon of mashed wild rosemary leaves) is excellent for treating rhinitis. The mixture must be infused for 21 days, shaken daily and stored in a dark place. This tincture should be instilled into the nose for a week.

Regular rinsing of the nasal cavity with a saline solution with the addition of eucalyptus, menthol oil or calendula is considered effective.

For rhinitis, it is useful to bury freshly squeezed beet juice in your nose, covering the nostril with a swab. Rubbing menthol oil into the temples, wings of the nose and forehead is very useful for incipient rhinitis.

An extreme type of treatment with folk remedies is kerosene compresses. It is unlikely that in our time there will be desperate people who can lubricate their feet with kerosene at night. However, the ancestors assure that this type of treatment can, if not eliminate the problem, then significantly alleviate the condition.

It is most useful to treat rhinitis with folk remedies in combination with traditional medicine.

Chronic rhinitis in children, symptoms and treatment

The appearance of chronic rhinitis in children is an extremely dangerous phenomenon that affects all functions of the body and interferes with important aspects of its normal growth. Moreover, it can provoke disorders of children's mental and psychological development.

Chronic rhinitis in children occurs due to frequent acute rhinitis (about 12 times a year), the presence of adenoids in the nasopharynx and against the background of existing sinusitis, which at an early age passes without pronounced symptoms.

Regardless of the type and severity of rhinitis in children, you should not try to treat it yourself and you should definitely consult a pediatric ENT specialist.

At home, you can follow only a few useful recommendations:

  1. ensuring a normal microclimate (air humidification, ventilation, regular wet cleaning)
  2. baths with essential oils for children (juniper, eucalyptus, tea tree)
  3. herbal or oil inhalations
  4. moisturizing the child’s nasal mucosa with oils, salt and saline solutions.

You can treat your child with some folk remedies: tinctures, decoctions and vegetable juices.

Video on the topic

Video in which an ENT doctor talks about the treatment of chronic runny nose:

This is useful to know:

It helps us a lot to go to the salt cave. We go to the Halocenter about 15 sessions 2 times a year. After the examination, the doctor recommends frequent visits, because relief comes and the health problem goes away

During seasonal flare-ups I always use morenasal spray. It washes away all germs from the nose and moisturizes the mucous membrane. This is our domestic spray based on calcined sea salt. It is inexpensive and is no worse in efficiency than foreign analogues.

Chronic rhinitis

Symptoms of chronic rhinitis

Common to all forms of chronic rhinitis, in addition to difficulty breathing through the nose, are the following symptoms:

  • Decreased sense of smell;
  • Nasal discharge;
  • Feeling of dryness in the nose;
  • The appearance of crusts in the nose;
  • Mild nosebleeds;
  • Feeling of itching, burning;
  • Sneezing;
  • Accumulation of thick mucus in the nasopharynx;
  • Snore;
  • Headache.

Forms of chronic rhinitis

a) simple - limited, diffuse;

b) fetid runny nose or ozena.

a) allergic form;

b) neurovegetative form.

Chronic catarrhal rhinitis

This form of chronic rhinitis most often develops as a result of repeated acute runny noses, which is facilitated by constant exposure to unfavorable environmental factors - a polluted, dusty atmosphere, frequent temperature changes, dampness and drafts. The development of chronic runny nose is predisposed by long-term congestive hyperemia of the nasal mucosa caused by alcoholism, chronic disease of the cardiovascular system, kidneys, etc. In the etiology of the disease, hereditary preconditions, developmental defects, and disturbances in normal anatomical relationships that cause difficulty in nasal breathing may play a role. Chronic runny nose also develops as a secondary disease in pathology of the nasopharynx and paranasal sinuses.

Morphological changes

Morphological changes in chronic catarrhal rhinitis are less pronounced compared to other forms of rhinitis and are localized in the superficial layers of the mucous membrane. The vessels of the mucous membrane of the nasal concha are dilated, their walls may be thinned. With a long course of chronic rhinitis, sclerosis develops in the submucosal layer.

Clinic and symptoms of chronic catarrhal rhinitis

The symptoms of chronic catarrhal rhinitis generally correspond to the symptoms of acute rhinitis, but are much less intense. The patient complains of nasal discharge of a mucous or mucopurulent nature. Difficulty in nasal breathing is not permanent. It gets worse (like nasal discharge) in the cold. Alternating congestion of one half of the nose is often noted. It usually appears when lying on your back or side. In these cases, there is a rush of blood to the underlying parts of the nose. The vessels of the cavernous tissue of the turbinates, which are in a relaxed state due to loss of tone, become overfilled with blood, which causes nasal congestion. When you change your body position, the congestion moves to the other side.

Chronic catarrhal rhinitis may be accompanied by a violation of the sense of smell in the form of its weakening (hyposmia). Complete loss of smell (anosmia) is rare. The transition of catarrhal inflammation from the nasal cavity to the mucous membrane of the auditory tube with the subsequent development of tubo-otitis is possible.

Treatment of chronic catarrhal rhinitis

The success of treatment depends on the ability to eliminate unfavorable factors that cause the development of chronic rhinitis. Staying in a dry, warm climate, hydrotherapy and spa therapy are beneficial. It is necessary to treat common diseases accompanying chronic rhinitis, as well as eliminate intranasal pathology (deformation, sinusitis, adenoid vegetations).

Local treatment consists of the use of antibacterial and astringent drugs in the form of 3 - 5% solution of protargol (collargol), 0.25-0.5% solution of zinc sulfate, 2% salicylic ointment, etc. Prescribed to the nasal area UHF, endonasally UFO (tube -quartz). The prognosis is usually favorable.

Chronic hypertrophic rhinitis

The causes of hypertrophic rhinitis are the same as catarrhal ones. The development of one form or another of chronic rhinitis is apparently associated not only with the influence of external unfavorable factors, but also with the individual reactivity of a person.

Pathomorphological changes

Pathomorphological changes in hypertrophic rhinitis differ from those in catarrh by the predominance of proliferative processes. The development of fibrous tissue is observed mainly in places where cavernous formations accumulate. Hypertrophy of the mucous membrane of the nasal concha often reaches significant sizes. There are three types of shell hypertrophy: smooth, tuberous and polypous. It can be diffuse and limited. The most typical sites of hypertrophy are the anterior and posterior ends of the inferior and anterior ends of the middle turbinate. Hypertrophy can also occur in other areas of the nose - in the anterior part of the nasal septum and at its posterior edge, on the vomer.

Swelling of the mucous membrane in the area of ​​the nasal turbinates, especially the middle one, is possible, resembling nasal polyps. This swelling and polyp-like thickening, unlike polyps, has a wide base. In the future, polypous hypertrophy can gradually transform into polyps. This is facilitated by allergization of the body (auto- and exogenous). Occurring bony hypertrophy of individual turbinates is a variation of the anomaly of nasal development.

Clinic and symptoms of chronic hypertrophic rhinitis

Hypertrophic rhinitis is characterized by constant nasal congestion, which depends on excessive enlargement of the nasal turbinates, which practically do not contract under the influence of vasoconstrictors. Nasal breathing is complicated by copious mucous and mucopurulent discharge. Due to obstruction (narrowing) of the olfactory fissure, hyposmia occurs and then anosmia. In the future, as a result of atrophy of the olfactory marks, essential (irreversible) anosmia may occur. The timbre of the voice becomes nasal (rhynolaliaclausa).

As a result of compression of the lymphatic gaps by fibrous tissue, lymphatic drainage from the cranial cavity is disrupted, which causes a feeling of heaviness in the head, impaired ability to work, and sleep disturbances.

Shutting off nasal breathing leads to impaired ventilation of the paranasal sinuses, as well as disease of the underlying respiratory tract. Hypertrophy of the posterior ends of the inferior turbinates disrupts the function of the auditory tube and leads to tubo-otitis. Thickening of the anterior sections of the inferior turbinates can compress the nasolacrimal duct with subsequent development of dacryocystitis and conjunctivitis.

Treatment of chronic hypertrophic rhinitis

Endoscopic examination allows us to determine the nature of hypertrophy. Further treatment of hypertrophic rhinitis is predominantly surgical. Treatment methods for diffuse hypertrophy pursue the development in the postoperative period of a sclerosing scar process in the submucosal layer, which reduces the size of the nasal turbinates. For this purpose, various methods of intrashell cauterization of tissue are used (electricity - electrocautery, ultra-low temperatures - cryodestruction), as well as such effects as ultrasonic or mechanical disintegration. A laser beam is also used for this purpose.

Atrophic rhinitis

Simple atrophic rhinitis

This form of chronic rhinitis is based not on an inflammatory process, but on a dystrophic process, affecting mainly the mucous membrane. It may be a particular manifestation of a systemic disease, in which trophic disorders (atrophy) spread to the pharynx, larynx and other organs and systems. This is the so-called primary (genuine) atrophic rhinitis, the extreme degree of which is a fetid runny nose (ozena).

Secondary atrophic rhinitis

Secondary atrophic rhinitis is a consequence of exposure to various unfavorable environmental factors: hot, dry climate, dust and gas pollution in the atmosphere of industrial production (flour milling, woodworking, cement, silicate, chemical, etc.). Various injuries also play a role in the development of atrophic rhinitis - domestic, gunshot and surgical, causing damage to the tissues and blood supply of the nasal cavity.

Morphological changes

Morphological changes in simple atrophic rhinitis are most pronounced in the epithelial layer of the mucous membrane. The number of mucous goblet cells decreases, the ciliated epithelium loses cilia and degrades. The viscosity and pH of nasal secretions change, which leads to disruption of the functional activity of the ciliated epithelium.

Clinic and symptoms of atrophic rhinitis

Patients suffering from atrophic rhinitis are characterized by complaints of a feeling of dryness and itching in the nose, constant drying of yellowish-greenish crusts, the removal of which is accompanied by injury to the mucous membrane.

In cases where the process affects the olfactory zone, hypo- and anosmia develops. In some cases, patients note an unpleasant odor that is not detected by others (kakosmiasubjectiva).

Treatment of atrophic rhinitis

When treating atrophic rhinitis, it is necessary, as with other forms of rhinitis, to eliminate or reduce the impact of harmful environmental factors. A course of treatment with ointments and iodine-glycerin is prescribed locally. In the morning and evening, the patient should inject Vojacek's diahilum ointment into the nose on a cotton swab for 10 minutes. Twice a week, the doctor or the patient himself lubricates the nasal mucosa with a solution of iodine-glycerin. This treatment is carried out for 2 months and is repeated 3 times a year.

It is popular to insert cotton swabs into the nose with rosehip or sea buckthorn oil in olive or peach oil in a ratio of 1:3 - 1:4 or with the addition of an oil solution of vit. A (no more than 50,000 IU). Oral intake of Vit is also appropriate. And, and a complex of multivitamins with microelements (for example, Vitrum).

In the treatment of atrophic rhinitis, alkaline and oil inhalations through the nose are widely used. During spa treatment, irrigation of the nasal cavity and inhalation of mineral waters from local sources are useful. The most effective are inhalations and irrigation of the mucous membranes of the upper respiratory tract with 2 - 3% solutions of sea salt, as well as sea bathing. This is due to the fact that magnesium ions contained in sea water have a beneficial effect on the mucous membrane.

Ozena

Ozena is a chronic atrophic fetid runny nose, which differs from a simple atrophic runny nose by deep atrophy of the entire mucous membrane, bone walls of the nasal cavity and nasal turbinates. Ozena is characterized by the secretion of a thick secretion that dries into foul-smelling crusts.

Despite the fact that the disease has been known since ancient times, the etiology and pathogenesis of ozena continue to remain insufficiently understood to this day. It is now recognized that in the pathogenesis of ozena, a significant role is played by hereditary-constitutional characteristics, transmitted by inheritance as a recessive trait, as well as environmental conditions, incl. nutritional and vegetative insufficiency. As a result, a patient with ozena develops various neuroendocrine, neurovegetative and neurotrophic disorders. The central links that form these disorders probably involve the hypothalamic-pituitary department of the central nervous system.

Clinic and symptoms of ozena

The disease usually begins at a young age, women are more often affected. After the onset of menopause, many clinical manifestations of ozena decrease, which is the basis for considering this disease as being associated with dysfunction of the endocrine glands.

Patients with ozena are characterized by severe atrophy of the nasal mucosa and a decrease in the size of the nasal turbinates, especially the lower ones. Sometimes the lower shells atrophy faster than the middle ones, and therefore the latter appear unusually large against the background of the small atrophied lower ones. As a result of atrophy of the mucous membrane and nasal turbinates, the nasal cavity becomes wide. Often during ozena, the entire nasal cavity is filled with crusts. They usually have a yellowish-greenish, brownish or dirty color and are easily removed in the form of casts. At the same time, the outer surface of the crusts is dry, and the lower surface is viscous, thick, and an extremely unpleasant fetid odor emanates from it, which is a mixture of indole, skatole, phenol, hydrogen sulfide and volatile fatty acids. Actually, of all the objective signs of ozena, stench (kakosmiaobjectiva) should be placed in first place, as the constant and most significant objective symptom. However, patients suffering from anosmia do not feel this smell. It is the stench emanating from ozena patients that makes it impossible for them to communicate closely with other people, determines the tragedy of their situation and puts ozena patients in the position of outcasts of society. All this allows us to consider ozena as a disease of social significance.

Atrophic phenomena during ozena affect not only the nasal cavity, but also the paranasal sinuses and underlying respiratory tract. The crusts filling the nasal cavity spread posteriorly into the nasopharynx and pharynx, closing the mouths of the auditory tubes. Unfavorable conditions are created for ventilation of the tympanic cavity, which contributes to its involvement in the inflammatory process. This is the reason for the often observed damage to the hearing aid in patients with ozena.

Treatment of ozena

Treatment of ozena, as well as other degenerative processes of the nose, is one of the most difficult problems of rhinology. In recent years, however, pathogenetically based conservative and surgical treatment methods have appeared, combined with the use of etiotropic drugs that directly affect Klebsiella ozena. However, symptomatic treatment methods aimed at removing fetid crusts and deodorizing the nasal cavity have not lost their importance and continue to remain in the arsenal of modern rhinologists.

Based on the infectious hypothesis of the etiology of ozena, antibiotics active against Klebsiella ozena are used in treatment. However, these treatment methods do not allow obtaining lasting clinical results.

In the treatment of ozena, surgical methods are mainly used. Thus, based on the idea that dystrophic (atrophic) processes in the nasal cavity develop as a result of a violation of the trophic function of the autonomic nervous system, a synthetic implant (polyurethane, ivalon, etc.) is implanted in the area where the diffuse autonomic ganglion of the nasal septum is located. Inserting a graft into the area of ​​the autonomic ganglion aims to have a positive effect on the trophism of the nasal mucosa. The described surgical method allows for clinical recovery (i.e., cessation of drying of foul-smelling crusts and revitalization of the mucous membrane) in 75% of cases.

Also, at the discretion of the doctor, a conservative method can be used, based on the use of cholinomimetics, anticholinesterase drugs, vitamins E and D, long-acting nitrites, stimulants of tissue regeneration, in particular, metacil. This treatment is carried out for 1 month in a hospital setting.

Vasomotor rhinitis (“false rhinitis”)

A characteristic feature of vasomotor rhinitis is the manifestation of a runny nose symptom complex without pathological signs of inflammation of the mucous membrane. This is either a neurovegetative runny nose, which is a manifestation of autonomic neurosis, or an allergic one, which occurs in response to the action of allergens.

The basis of the neurovegetative form of vasomotor rhinitis is the inadequate “play” of the vessels that make up the main content of the cavernous bodies of the turbinates. These are cycles characterized by regular narrowing and expansion of the vessels of the nasal concha. Subjectively, no nasal breathing disturbances are felt. This alternating cyclical fluctuation of nasal congestion can be considered as a normal manifestation of physiological functional asymmetry. On the other hand, a more pronounced enlargement of the nasal turbinates, in which a clearly felt difficulty in nasal breathing appears, is a pathological condition, namely vasomotor rhinitis, in particular its neurovegetative form.

In healthy individuals, a change in the predominance of breathing through one or another half of the nose occurs according to a sinusoidal law with a period of 20 to 90 minutes, and the ratio of the volumes of exhaled air varies from 25% to 75%, i.e. complete congestion of one half of the nose is not observed. In patients with the neurocirculatory form of vasomotor rhinitis, there is a violation of the period and linearity of the law of change in the predominance of nasal breathing. Their exhaled air volume ratio ranges from 0% to 100%.

In the occurrence of the neurovegetative form of vasomotor rhinitis, the main role is played by functional changes in the central and autonomic nervous systems, as well as the endocrine system. The hypothalamus, the main integrating autonomic center in the regulation of nasal functions, plays an important role. The influence of dysfunction of the endocrine glands, primarily the thyroid gland, on the development of vasomotor rhinitis is also important. Vasomotor rhinitis is an endocrine-vegetative syndrome.

The development of vasomotor rhinitis is also facilitated by reflex effects, in particular: cooling, to which non-hardened people are especially susceptible; sedentary lifestyle; medications used for hypertension and coronary heart disease to dilate blood vessels, etc. Vasomotor rhinitis often occurs in people who have spines and ridges on the nasal septum.

Allergic form

The allergic form of vasomotor rhinitis occurs when exposed to various allergens, and depending on their name, seasonal and permanent (year-round) forms of allergic rhinitis are distinguished. Allergic rhinitis is one of the most common diseases. According to various studies, they occur in % of the population.

The cause of the seasonal form of allergic rhinitis (hay fever) can be pollen from various plants during their flowering period. Residents of many cities are especially concerned about the fluff and pollen of poplars, while rural residents are concerned about the cereals blooming in the fields (timothy, fescue, etc.). In recent years, ragweed, an overseas cereal that has penetrated into the southern regions of Russia from North America and has increased allergenic properties, has become relevant.

In the permanent (year-round) form of allergic rhinitis, the allergens are more diverse and can affect patients over a long period. These include: environmental allergens - book dust, relevant for library workers; house dust, bird feathers (feather pillows), hair, pet dander, daphnia (dry food for fish living in an aquarium); food products - citrus fruits, strawberries, honey, milk, fish, crayfish; medicines, perfumes, etc.

The pathogenesis of allergic rhinitis involves a specific reaction between the allergen and tissue antibodies, resulting in the release of chemically active substances (allergic reaction mediators) that contribute to the development of clinical manifestations of the disease. The possible mechanism of development of allergic rhinitis is described as follows.

An Ig E-dependent reaction occurs - activation of mast cells located in the nasal mucosa. The released mediators are contained in granules (for example, histamine and tryptase) or in the membrane of mast cells (leukotrienes and prostaglandins). Another mediator is platelet activating factor (PAF). Mediators have a vasodilating effect and increase vascular permeability, which leads to nasal congestion. Increased secretion is accompanied by the appearance of mucous discharge. Stimulation of afferent nerve fibers causes itching and sneezing. In addition, afferent stimulation (especially under the influence of histamine) can enhance the axonal reflex with local release of neuropeptides (substance P, tachykinins), which, in turn, cause further degranulation of mast cells, further enhancing the pathological response.

Neurovegetative form

In the neurovegetative form of vasomotor rhinitis, no specific changes in the mucous membrane are observed. The ciliated epithelium is thickened, the number of goblet cells is increased. The cavernous vessels are dilated. Microcirculation is disrupted. These disturbances are especially noticeable in the inferior turbinates. The movement of blood in the capillaries is uneven and often does not correspond to pulse impulses. In the allergic form of vasomotor rhinitis, stasis occurs. The epithelial cover of the mucous membrane thickens, in places metaplasizing into a multilayered flat layer. The number of goblet cells increases significantly. In the subepithelial layer, tissue infiltration with eosinophilic leukocytes takes place. They are also found in significant quantities in nasal mucus.

Clinic of the neurovegetative form of vasomotor rhinitis

As with all forms of vasomotor rhinitis, the neurovegetative form is characterized by the following symptoms: difficulty in nasal breathing, profuse serous or mucous discharge, attacks of paroxysmal sneezing, itching and burning sensation in the nasal cavity. These symptoms are often intermittent. They can occur after waking up from sleep (a change in the predominance of the parasympathetic over the sympathetic autonomic nervous system), with a change in ambient temperature, with overwork, emotions, stress, etc. Difficulty in nasal breathing is associated with the expansion of the cavernous spaces of the nasal mucosa, mainly the lower nasal shells The mucous membrane has a bluish color due to blood overflow (venous hyperemia). "Bluish or pale" spots are often visible. Lubricating the mucous membrane with vasoconstrictor drugs leads to rapid contraction of the conchae.

Clinic for seasonal allergic rhinitis (hay fever)

This form of vasomotor rhinitis is characterized by a clear seasonality of exacerbation, which occurs during the flowering period of plants to the pollen of which patients have increased sensitivity (sensitization). During this period, paroxysms of sneezing, itching and burning in the nasal cavity, eyes, and conjunctival hyperemia are noted. Almost complete nasal congestion and severe rhinorrhea occur, which leads to maceration of the skin in the vestibule of the nose. The mucous membrane in the initial period is sharply hyperemic, and there is a significant amount of clear fluid in the nose. Subsequently, the mucous membrane acquires a cyanotic appearance and then turns pale. Along with the noted rhinological symptoms, patients during this period often experience itching in the eyes, conjunctival hyperemia, a feeling of rawness in the pharynx, larynx and skin itching. In some cases, it is possible to develop Quincke's edema (enlargement of the face or part or limb) and larynx. Various discomfort manifestations are observed, incl. headache, increased fatigue, sleep disturbance, increased body temperature. The duration of the disease usually corresponds to the period of flowering of plants and ceases on its own after its end or after the patient changes the allergenic area.

An intermediate position between the neurovegetative form of vasomotor rhinitis and seasonal allergic rhinitis is occupied by the so-called. "neurosis of a reflected nature." Thus, in people suffering from hay fever, which occurs when smelling flowers, in particular roses, attacks of a runny nose are observed not only when inhaling the aroma of flowers, but also when just looking at an artificial rose, which the patient mistakes for a real one. In these cases, there is a combination of conditioned reflexes coming from the optic and olfactory nerves.

Clinic for permanent (year-round) form of allergic rhinitis

The disease is chronic from the very beginning. Severe swelling of the nasal turbinates is detected, associated with profuse sweating of transudate from the capillaries. The mucous membrane is pale; swelling affects not only the turbinates, but also the mucous membrane of the bottom of the nasal cavity and the nasal septum. The middle turbinates are also swollen, resembling polyps. Due to swelling of the mucous membrane, mucus is difficult to clear and can be discharged from the nose at random.

The allergic form of vasomotor rhinitis is characterized by the formation of mucous polyps. Gradually increasing in size and quantity, they can fill the entire nasal cavity, in some cases pushing apart the bone walls and deforming the external nose. Often there is a combination of allergic rhinitis with bronchopulmonary pathology - asthmatic bronchitis and bronchial asthma. An “asthmatic triad” may occur, including intolerance to acetylsalicylic acid, nasal polyposis and attacks of bronchial asthma.

Treatment of the neurovegetative form of vasomotor rhinitis

It consists of eliminating various causes, often of a reflex nature, that cause this disease. It is necessary to treat general diseases (neuroses, diseases of internal organs, endocrine dysfunction). If there are any local abnormalities in the nasal cavity (Conchabullosa, spines and ridges of the nasal septum), they should be eliminated. An active, mobile lifestyle and hardening procedures are recommended, in particular, effects on reflex zones - short-term dousing of cold water on the soles of the feet. Performing various gymnastic exercises.

Systematic use of vasoconstrictors is not recommended, because this gives only a short-term effect, and with prolonged use it damages the mucous membrane and is addictive. Acupuncture is also used, influencing the reflex zones of the nasal cavity (novocaine blockades in the inferior nasal turbinates, in the aggernasi, on the sphenopalatine node). Surgical interventions on the inferior turbinates (various options for intraturbinate disintegration) are more effective.

Treatment of allergic rhinitis

There are three main areas in the treatment of allergic rhinitis: elimination therapy, immunotherapy and drug therapy. The goal of elimination therapy is to eliminate allergens (pollen, dust, etc.) and control the state of the environment. Specific immunotherapy is very effective, but severe reactions are possible, especially in people suffering from bronchial asthma. It is not widespread in our country. In other countries (Great Britain, Scandinavian countries), the use of specific immunotherapy is sharply limited. To minimize the risk of immunotherapy, the question of its appropriateness should be decided by an allergist or clinical immunologist. Currently, drug therapy for allergic rhinitis has acquired the greatest importance.

Our medical center successfully treats various types of chronic rhinitis!

ENT consultations on our website

You can consult and make an appointment by calling:

People come to us for treatment from: Ramenskoye, Zhukovsky, Bronnitsy, Moscow, Lyubertsy, Voskresensk, Kolomna, Yegoryevsk, Kotelniki, Dzerzhinsky, Belozersky, Bykovo, Vereya, Gzhel, Druzhba, Oak Grove, Igumnovo, Ilyinsky, Konstantinovo, Kraskovo, Kratovo, Malakhovka , Oktyabrsky, Ostrovtsy, Village named after. Telman, Rechitsa, Springs, Tomilino, Udelnaya. As well as residents of other settlements of the districts: Ramensky district, Lyuberetsky district, Voskresensky district, Egoryevsky district, Kolomensky district.

Source: http://rammedic.ru/ramenskoe/lor/xronicheski-rinit.html

Chronic runny nose (rhinitis) in adults - how to treat correctly?

Quite often, adults develop chronic rhinitis. This is an inflammatory process that periodically occurs on the nasal mucosa under the influence of certain factors. It may be a consequence of an untreated acute form or be caused by deep penetration of bacteria. With chronic rhinitis, breathing through the nose is difficult, copious discharge of various types is observed, the sense of smell is reduced and excessive dryness of the mucous membrane appears. To avoid complications, it is imperative to treat chronic rhinitis in adults.

Chronic rhinitis - features of the disease

Rhinitis in adults is a fairly common occurrence. It occurs in people with weakened immune systems. Its chronic form develops from an untreated acute form, which develops during infectious inflammation caused by fungi, microbes and bacteria.

With chronic rhinitis, irritation of the mucous membrane periodically occurs due to the influence of a number of factors. Unlike an acute runny nose, this form of nasal congestion is characterized by:

  • increased volume of mucus and mucous glands;
  • proliferation of connective tissues of the nose;
  • thickening of vascular walls;
  • lesions of the bone and periosteum.

The effectiveness of treatment in adults of the chronic form depends on the correct identification of the root cause of the disease. Various diseases can be predisposing factors to its appearance.

Causes of chronic runny nose

The development of chronic rhinitis can be triggered by several factors. They may be previous injuries to the nose. Contact with volatile toxic components on the mucous membrane also causes irritation and the appearance of snot. The appearance of chronic runny nose is due to the following reasons:

  1. Diseases of the cardiovascular system or kidneys.
  2. Deviation of the nasal septum.
  3. Exposure to harmful substances (heavy metals, chemicals).
  4. Abuse of bad habits (smoking, alcohol, drugs).
  5. Infection (microbial, bacterial, viral).

The prolonged course of a runny nose is primarily due to the weakness of the protective functions of the immune system. Therefore, before treating a chronic runny nose, a diagnosis should be made to determine the true cause of its development.

Classification of species

Symptoms and treatment of chronic runny nose also depend on its type. The following types are distinguished:

  1. Atrophic. This form is characterized by a decrease in the thickness of the mucosa.
  2. Catarrhal. There is copious discharge of snot from the nose, and breathing is difficult.
  3. Hypertrophic. Breathing problems arise due to hypertrophy of the mucous membrane, periosteum and bone of the nose.
  4. Vasomotor. It may be caused by inflammation caused by allergens or a disruption in the functioning of the nervous mechanisms.

The development of a runny nose in an adult occurs in three stages. The early stage lasts about 1-2 days and is caused by discomfort in the nose. At the next stage, swelling of the mucous membrane occurs and breathing problems arise. The final stage is characterized by the development of a chronic form under the influence of internal and external causes.

Symptoms and manifestations of chronic rhinitis

In the chronic form of a runny nose, symptoms vary depending on its type. The scheme of the prescribed course of treatment also depends on this.

You should begin to fight the chronic form of the atrophic type of runny nose when:

  • the occurrence of itching in the nose;
  • the appearance of dryness, tightness in the nasal cavity;
  • frequent bleeding;
  • the appearance of greenish crusts with a repulsive odor.

This type of runny nose is characterized by severe atrophy of the mucous membrane and expansion of the nasal cavity. The pathology in this case may be exposure of cartilage.

Catarrhal rhinitis is characterized by:

  • frequent purulent, mucous or mixed nasal discharge;
  • simultaneous or alternating congestion of both sinuses;
  • increased swelling of the mucous membrane in a horizontal position;
  • decreased sensitivity of smell;
  • improvement of general condition in a hot room or after exercise.

When a doctor examines this type of chronic rhinitis before treatment, the condition of the epithelium (it may be keratinized) and the number of mucous glands (usually it increases) are also recorded. Another distinctive feature is the narrowing of the lumen of the nasal cavity.

With hypertrophic rhinitis in chronic form, in addition to congestion and severe nasal discharge, the following appear:

  • headache;
  • nasal voice;
  • the mucous membrane changes color to bright red or purple;
  • the inner surface of the shell becomes lumpy.

The disease develops after a long course of the catarrhal type of runny nose.

With vasomotor rhinitis the picture is somewhat different. This type is characterized by the following symptoms:

  • frequent urge to sneeze;
  • nasal congestion in the morning;
  • pale swollen mucous membrane.

The patient's mucus discharge is watery. The appearance of bluish spots is noted in the nose.

Treatment methods for chronic runny nose

Chronic runny nose in adults will be treated most effectively in a comprehensive manner. An integrated approach to treatment combines several techniques:

  1. Drug therapy.
  2. Surgical intervention.
  3. Physiotherapeutic procedures (non-drug treatment).

Separately, we can highlight traditional medicine, the recipes of which help speed up the healing process. The choice of treatment method depends on the causes of snot and the type of runny nose. It is impossible to cure the chronic form of rhinitis, the appearance of which is caused by pathologies of the structure of the nose, without medical help.

Non-drug therapy

To cure chronic rhinitis without medication means to improve the conditions and environment for the patient (clean and humidify the air, establish a work and rest schedule). This technique also involves the treatment of common diseases of internal organs and systems. It is aimed at eliminating the factors and causes of chronic runny nose. It also involves attending physiotherapeutic procedures to make you feel better and speed up the recovery process. The patient may be prescribed:

  • ultraviolet endonasal irradiation;
  • electrophoresis;
  • exposure to different frequency currents;
  • acupuncture;
  • magnetic therapy;
  • inhalation;
  • massage;
  • helium-neon laser.

Some of these procedures can be performed at home, but they are usually performed in a hospital setting.

Treating a runny nose with pharmaceutical medications

Chronic runny nose can also be cured with medication. This method is already called medicinal. Drugs are prescribed to the patient depending on the type of rhinitis, the stage of its progression, the presence of complications, the age and contraindications of the patient.

The course of treatment includes the use of nasal drops or sprays, solutions for rinsing the nasal sinuses and moisturizing the mucous membrane. For some types of rhinitis, it is permissible to use vasoconstrictor drops, ointments for the common cold, and medications containing antibiotics.

Surgery

Often, only surgery can save you from chronic rhinitis. Today's medicine offers a fairly large list of interventions:

  • ultrasonic disintegration;
  • radio wave disintegration;
  • cryodestruction;
  • laser destruction;
  • cauterization with an electrode;
  • removal of the posterior ends of the inferior nasal concha;
  • cauterization of shells with trichloroacetic acid.

In case of chronic rhinitis, the operation is aimed at reducing the size of the nasal turbinates, which should make it easier for the patient to breathe.

Treatment regimen for the atrophic form of chronic rhinitis

In the absence of complications, treatment of this form can easily be done at home. It is enough to follow the scheme:

  1. Moisturizing the nasal mucosa: saline, fish oil.
  2. Lubricating the nose: Lugol ointment.
  3. Strengthening the immune system: iron supplements, vitamin complexes.
  4. Physiotherapy: UHF, Electrophoresis, inhalations.

How to cure a chronic runny nose if the nasal mucosa has become so thin that the cartilage is exposed? In this case, how to deal with the complication that has arisen will be decided not by the ENT specialist, but by the surgeon. This requires an operation to implant an artificial cartilage implant. This is the most radical solution in the treatment regimen.

From traditional medicine, an infusion of chamomile flowers can be used to moisturize it. You can also drip freshly squeezed aloe juice into your nose. 2-3 times a day, 2 drops in each nostril.

Treatment regimen for chronic catarrhal rhinitis

How to cure catarrhal runny nose in chronic form? This type of disease is treated using drug and non-drug therapy:

  1. Instillation of astringent drops into the nose: Protargol, Silver Nitrate, Rinofluimucil.
  2. Strengthening the immune system: Isofra.
  3. Inhalations: based on iodine, based on ammonia.
  4. Physiotherapy: UHF, UV, electrophoresis.

For this type of runny nose, your doctor may also prescribe pepper nasal plasters. They warm up the nose and help get rid of congestion. An allergy test should be performed before using them. When sticking to the areas of the nose, a small amount of cream (for example, baby cream) is applied under the patch.

Treatment regimen for hypertrophic chronic rhinitis

How to cure a chronic runny nose of a hypertrophic type? Its treatment is also carried out using a combination of several techniques. It could be:

  1. Surgical intervention: cauterization with tri-chloroacetic acid under local anesthesia, electric cauterization, ultrasound or laser destruction.
  2. Introduction into the nasal cavity of drugs that enhance the production of interferons: Splenin.
  3. Physiotherapy: massage of the nasal mucosa.

If there are pronounced symptoms of chronic rhinitis, indicating the proliferation of the mucous membrane, then they are removed using a conchotomy operation (removal of the posterior ends of the lower nasal concha).

Treatment regimen for vasomotor chronic runny nose

How to treat a chronic runny nose, the appearance of which is caused by contact with the mucous membrane of an irritating allergen? In such a situation will help:

  1. Hemotherapy: administration of autoserum.
  2. Antihistamines: Suprastin, Zodak, Fenkarol.
  3. Hyposensitizing drugs: Histimet, Intal.
  4. Immunostimulants: Vilazen drops.
  5. Vasoconstrictor drops: Naphthyzin, Sanorin, Phenylephrine.
  6. Physiotherapy: magnetic therapy, exposure to low-frequency currents.

Before you get rid of chronic vasomotor runny nose on your own, you should still consult a doctor about choosing the most suitable medications for you. A neurologist should treat the disease that provoked the appearance of rhinitis.

Is it possible to cure chronic runny nose?

So is it possible to cure a chronic runny nose completely? It will not be possible to get rid of this form of rhinitis forever, but everyone can eliminate the symptoms and maintain good health with the help of preventive measures.

It is impossible to treat chronic runny nose in adults once and for all. It has already passed into a form in which, under the influence of any provoking factor (for example, weakening of the immune system), it will make itself felt again and again.

General treatment recommendations

In case of chronic rhinitis, the treatment prescribed by the otolaryngologist depends on the symptoms. It is he who selects the scheme individually for each patient. There is also a general course in the methods, which is relevant for any type of chronic runny nose:

  • acupressure;
  • rinsing the nasal passages with solutions based on sea salt (Aqualor, Aquamaris);
  • vasoconstrictor drops (Dlyanos, Sanorin, Ximelin, Nazol).

It is not recommended to use drugs for longer than the period specified in the instructions, as some of them are addictive. If some medications are not effective, your doctor should prescribe you others that are stronger and more effective.

Traditional methods of treatment

The use of traditional medicine recipes also applies to general recommendations. With their help, you can perform inhalations, warm compresses, and rinse your sinuses at home. It is recommended to rinse your nose 4-8 times a day. For this:

  1. Lean over the sink without throwing your head back.
  2. Tilt your head to the left and pour the rinsing solution into your right nostril.
  3. Open your mouth and stand in this position for 10 seconds so as not to choke if the liquid goes down your throat.
  4. Repeat the procedure for the left nostril.

If done correctly, as a result of rinsing, the mucus will come out through the second nostril. 1-2 days of such procedures are enough and you yourself will feel significant relief. A saline solution (2 teaspoons of salt per glass of water) is suitable for rinsing.

Dry inhalations help to quickly cope with severe congestion. To carry them out, components that are natural antibiotics are used:

200 gr. any of the ingredients must be grated and placed in a container. You should breathe over it the vapors released for minutes. Afterwards, the jar can be tightly closed and stored in the refrigerator. The mixture is suitable for 3 more similar inhalations.

Chronic runny nose during pregnancy - treatment features

What should pregnant women do about chronic rhinitis? It must be treated without fail so that no complications arise. The treatment regimen is selected in such a way as not to harm the normal development of the fetus and help its mother.

The signs of chronic rhinitis during pregnancy are identical to the symptoms of its manifestation in adults. The only difference is that in pregnant women, the body temperature does not increase with nasal congestion.

How to treat chronic rhinitis during pregnancy? You should be careful when choosing medications. If treatment of a runny nose began at the initial stage, then you can do without potent drugs. The use of vasoconstrictor drops is contraindicated. The safest treatment regimen:

  1. Rinse the nose with saline and a solution based on sea water (Aquamaris).
  2. Humidification and ventilation of the room.
  3. Drink plenty of fluids.
  4. Nose massage and breathing exercises.
  5. "Pinosol" nasal drops, Nasonex nasal spray."

The closer the body position is to a vertical state, the less stuffy the nose is. That's why, if you have a runny nose during pregnancy, doctors recommend that a woman sleep on a high pillow. Thanks to this positioning of the body during sleep, the likelihood of severe swelling of the nasal mucosa is reduced. If a course of treatment without vasoconstrictor drops does not give positive results, then you can use drugs for children: Naphthyzin, Naphazolin, Vibrocil, Nazol Baby. In this case, it is necessary to strictly follow the regimen and dosage according to the instructions.

Preventive measures for chronic runny nose

Prevention of chronic rhinitis consists of following certain rules and recommendations that will help avoid chronicity of the runny nose. If you do not want to constantly suffer when treating snot, you should:

  • timely treat any pathologies of the ear, nose and throat;
  • periodically rinse the sinuses;
  • quit smoking and alcohol;
  • strengthen the immune system;
  • Do not use nasal drops too often.

Having understood what chronic rhinitis is and what factors provoke its occurrence, you can independently protect yourself from this disease. People engaged in hazardous work must protect their respiratory organs with personal protective equipment. During seasonal epidemics of colds and viral infections, it is recommended to avoid public places with large crowds of people or use special protective ointments (for example, “Oxolinic”).

REPRINTING OF MATERIALS IS POSSIBLE ONLY WITH THE PERMISSION OF THE ADMINISTRATION AND INDICATING AN ACTIVE LINK TO THE ORIGINAL SOURCE.

ALL INFORMATION PROVIDED IS SUBJECT TO MANDATORY CONSULTATION WITH A TREATING DOCTOR!

Source: http://doctos.ru/np/hronicheskij-nasmork-u-vzroslyh.html