— What is rhinitis and what types of rhinitis are usually distinguished?
— Rhinitis, or simply runny nose, is an inflammation of the mucous membrane of the nasal canals and is manifested by congestion, sneezing and copious mucous discharge.
There are actually many types of rhinitis. To begin with, they can be divided into infectious and non-infectious. The latter can be divided into allergic and specific rhinitis. The first is caused by various infections (viruses, bacteria or fungi). Allergic rhinitis occurs due to the action of an allergen, such as pollen or animal dander, and can be caused by specific ones, for example, medications.
— What is drug-induced rhinitis?
“Unfortunately, today many patients buy nasal drops on their own and start using them without a doctor’s prescription. They only need to be used for 3-5 days, but people tend to control how often they use the drops.
This leads to the development of drug addiction. Long-term use of medication leads to dryness of the nasal mucosa and a constant inflammatory process.
– How do we get rid of this addiction?
– If this is the first stage, it will be enough to give up the drops. If the situation is advanced, the participation of an ENT doctor is mandatory. He will prescribe a comprehensive treatment that will include both sanitation procedures and physiotherapeutic methods.
— Could cold pills be just as addictive?
— It all depends on the duration of taking the medicine. But as a rule, a person still controls the number of pills he takes. I have never encountered addiction to tablet forms.
— What other drops are there besides vasoconstrictors?
— All drops used for runny nose are, as a rule, vasoconstrictor. They are prescribed as symptomatic treatment to reduce swelling in the nasal anastomosis, which, like a small canal, connects the nasal cavity to the sinuses. As a result, it becomes easier for the person to breathe.
Hormonal nose drops are also sold. These are serious drugs prescribed by a doctor. They are used for severe allergic rhinitis or sinusitis. They contain various glucocorticosteroids, which have a pronounced anti-inflammatory effect and normalize the tone of the vessels of the nasal mucosa.
There are also non-hormonal antiallergic drops. They also constrict blood vessels, but also contain an antiallergic component. The rules of use are the same.
Vasoconstrictor drops differ in active substance, which varies in strength.
There are drugs that are not recommended for children, for example Naphthyzin. The active ingredient here is naphazoline, which causes poisoning with subsequent hospitalization in intensive care.
— Does poisoning only occur in children?
— Yes, that’s why this medicine is not recommended for children, but it was previously prescribed to everyone. There was no such variety of drops.
-But it is still used to treat runny nose in children. Or not?
– Dosages are different, you need to be careful about this. There is a 0.05% solution – it can be used by children from 1 year old, but only 1-2 drops per day, and there is a 0.1% solution – it can no longer be used. However, I still do not recommend you take risks. There are many more safe drops today.
— Do the effects of the drops differ?
— Yes, there are three groups here. There are short-acting, longer-acting and drugs with the maximum possible duration of action. For example, the drug “Xylometazoline” acts for up to 6 hours and belongs to the first group. There is also a drug called oxymetazoline, whose effect lasts up to 12 hours.
The frequency of taking these drugs also depends on this feature. The longer the duration of action, the less it needs to be used, all information on the rules of application can be found in the instructions. However, I still would not recommend prescribing drops for yourself, as most people do.
— Pharmacies also sell preparations for rinsing the sinuses. Can they be used independently?
– Such drugs – yes. In case of any runny nose, it is necessary to rinse your nose. These “washes” can also be divided into two groups: there are isotonic, slightly saline solutions and hypertonic solutions with a high salt content.
If there is severe swelling in your nose and it needs to be removed, we need to wash your nose with hypertonic solution. Some water is withdrawn from the tissues and swelling disappears. In milder cases, slightly saline solutions may be used.
It is important to correctly follow the washing procedure, which can be found on the Internet. Of the main points, I can underline that children under 4 years of age should never wash their nose with a strong stream, they should buy a special suction device or irrigator. Also, you should never turn your head, especially for children: after all, the auditory tube in the nasopharynx in children is much shorter and wider than in adults and is located at a different angle. If the solution gets there, otitis media may develop.
— After the pandemic, many people began rinsing their noses with salt solution on their own to prevent COVID-19. Does this method really help?
– NO. This method does not guarantee protection against the virus, because during the time it takes to walk home from the subway, the virus manages to penetrate the body. You can of course rinse your nose to calm down, but this is ineffective. Even during the pandemic, everyone used oxolinic ointment on their nose, but this does not protect against viral infections.
— Some people buy menthol and peppermint extracts and use them to treat a runny nose. Geranium extract is also used. Does this method work?
— Menthol and mint are not medicinal drugs, but distraction treatments. Yes, they are added to the drops, but the active ingredient is not menthol and eucalyptus, but xylometazoline or oxymetazoline. They affect the nasal vessels.
If we are talking about cases where people drip pure essential oils, such a practice is highly undesirable. Such an effect can be very harmful to the mucous membrane not only of the nasal cavity, but also of the nasopharynx. Burning may occur and symptoms may worsen as a result. This can cause additional swelling of the tissue, causing even greater difficulty breathing through the nose, which will prolong healing time.
— Many people also buy Ayurvedic drops. Do they work?
— Drops containing some kind of plant extract do not cure a runny nose. Moreover, they may contain allergens that will worsen the condition of the patient with allergic rhinitis.
– What about non-allergic? For example, Indian drops are very popular; They contain lotus, cinnamon, licorice, goat’s milk and sesame oil.
“Perhaps some extracts of these plants have antibacterial, antiseptic and decongestant effects. But I will not use them – it is not known what else might be there. It is better to use proven methods.
— Some people drop vitamins into their nose. Allegedly, this is how they cross the blood-brain barrier of the brain, helping to normalize cerebral circulation and, in principle, the functioning of the body. Does it really work?
– No, they are not absorbed here, they penetrate into the nasopharynx, then into the oropharynx, then roll along the mucous membrane towards the stomach. It’s much easier to drink these as usual.
Of course, the nose has a developed circulatory system located close to the brain, so part of the substance can be absorbed by the mucosa. But not in sufficient amounts to have any therapeutic effect.
— People often neglect to go to the doctor and do not even treat a runny nose with drops. What can severe rhinitis cause?
— Rhinitis can turn into sinusitis. Moreover, not only viral or bacterial, but also allergic has a complication in the form of inflammation of the nasal sinuses.
One type of sinusitis is sinusitis, in which the maxillary sinus becomes inflamed – the most common. Next comes inflammation of the ethmoid labyrinth (ethmoiditis), followed by inflammation of the frontal (frontitis) and sphenoid (sphenoiditis) sinuses. Acute and chronic sinusitis are distinguished according to the current situation. Sinusitis usually presents with nasal congestion, mucous or purulent nasal discharge, and pain in the sinus area. The disease often presents with fever or headache.
— How does one disease turn into another?
– We have seven sinuses, they are connected to the nasal cavity by narrow passages. Due to swelling of the nasal mucosa, the ventilation of the sinuses is impaired, that is, they cannot be cleaned. Then serous fluid accumulates in them, creating favorable conditions for the development of inflammation. Rhinosinusitis begins.
Sometimes, if bacteria join the serous fluid, sinusitis can only be treated with antibiotics. But first you need to confirm a bacterial infection, which can manifest itself as leukocytosis in the blood or persistent purulent discharge from the nasal cavity, which cannot be treated with traditional medicines.
— What complications may occur if rhinosinusitis is left untreated?
— As a rule, the person first develops viral rhinitis and then rhinosinusitis, in which bacterial flora also participates. All this leads to the development of intracranial rhinogenic complications.
This is a group of diseases whose mechanism of development is based on the penetration of pyogenic bacteria into the meninges from the primary infectious focus. Hence blood sepsis, inflammation of the optic nerve and eye membranes, osteomyelitis, brain abscess, meningitis.
Another complication is cavernous sinus thrombosis, in which the cavernous venous sinus of the brain is blocked by thrombotic masses. By the way, the latter often occurs with sinusitis.
Therefore, it is important to diagnose and treat sinusitis early. If the runny nose does not go away, for example, within 4-5 days, you need to consult an ENT doctor.
— How do these diseases manifest themselves?
– This includes increased body temperature, severe weakness and confusion. So there is an exacerbation of intoxication syndrome. In addition, many complications are characterized by brain symptoms: headache in the frontoparietal region or pressure in the eyes, blurred vision.
Meningeal syndrome is manifested by photophobia, increased sensitivity to odors and excruciating headache. Some patients develop psychomotor agitation and delirium. In many ways, symptoms depend on the location of the pathological process; For example, damage to the temporal lobe is accompanied by tinnitus, for example.
Most often, these diseases are diagnosed by a neurologist. So, people complain of severe headaches or an unpleasant feeling of pressure in the eyes, without paying attention to the purulent runny nose that has not stopped for several weeks.
The problem is that if a neurologist cannot recognize the disease and its cause, the disease often results in death. Yet intracranial complications are the most dangerous.
— How are these diseases treated? Medicine or surgery?
— As a rule, this is an extreme treatment and doctors try to use all methods. Initially, of course, they will sanitize, that is, treat the underlying disease that caused the complication. This is done by draining the sinuses – this is an operation. Nowadays, endoscopic, or minimally invasive, methods are used.
Only then is drug treatment administered with antibacterial drugs that penetrate the blood-brain barrier and penetrate the brain.
— How is sinus drainage performed?
— It is a quick surgery, takes about half an hour and is performed under local anesthesia. Using an endoscope, the surgeon reaches the problem area through the nostrils. Then this space is thoroughly washed, and then drainage is placed in the hole. It is necessary so that the puncture site does not close prematurely and the pathological contents flow freely into the nasal passage.
However, in order not to be referred to surgery, you should not let the situation take its course and consult a specialist in time if the rhinitis does not go away within five days.