Rhinitis is an inflammation of the nasal mucosa. Rhinitis can be divided into acute simple (infectious) rhinitis and chronic rhinitis, among which we can distinguishallergic rhinitisand non-allergic, idiopathic rhinitis (sometimes called vasomotor rhinitis).

Acute simple rhinitis

Acute simple rhinitis, commonly known as thecommon cold, is the condition most often caused by viruses. The pathogens causing infections includeadenoviruses, rhinoviruses,influenzaand parainfluenza viruses, and more rarely others. Rhinitis can also be caused by bacteria, e.g.,Streptococcus pneumoniae,Moraxella catarrhalis, andHaemophilus influenzae, although these usually constitute a superinfection of a prior viral infection.

Not very characteristic, but the most common symptom of acute rhinitis is a runny nose – initially watery, in the later stages of the disease it becomes thicker, which may make breathing through the nose difficult. An additional obstacle in the proper ventilation of the nasal cavity is theswellingof the mucosa.Coughingmay be present , from irritation from nasal discharge running down the back of the throat, or from an accompanying throat infection (also most commonly caused by viruses). Patients also complain of headaches or symptoms of viral conjunctivitis caused by viruses, such as redness, itching, excessive tearing.

Allergic rhinitis

Allergic rhinitis is characterized by the followingsymptoms: runny nose (more often watery), a feeling of blocked nose, sneezing, itchy nose and sometimes also eyes. Additionally, allergy may be manifested by rash or other skin lesions, eyelid swelling, reddening of the eyes. It is caused by the immune system’s abnormal reaction to a substance (allergen) which should not normally cause this effect. The body begins to fight the allergen (e.g. mites or grass pollen), which causes inflammation of the nasal mucosa and allergy symptoms.

In order to makea diagnosis, it is necessary to conduct a thorough interview with the patient, otolaryngological examination and allergy tests. The allergen is identified byskin testsor a laboratory blood test. Skin tests are performed by pricking the skin and applying a small amount of the allergen. A positive reaction causes a thickening, a lump, the bigger the allergy is. A blood test looks for specific antibodies that the body produces in response to contact with an allergen.

Treatmentconsists of avoiding the substances that cause the symptoms when possible and using antiallergic drugs. Various antihistamines (usually administered intranasally) and intranasal glucocorticosteroids are used. It should be remembered that intranasal glucocorticosteroids do not work immediately after administration, but only after a few days of use, therefore, decongestants of the nasal mucosa are often used in the initial period, but not longer than for 5–7 days. Treatment of allergic rhinitis is a long-term process, although in the case of seasonal allergies (e.g. hay fever) it is applied periodically.

In the case of severe symptoms, the doctor may consider immunotherapy, commonly known as desensitization. It consists in subcutaneous administration (in the form of injections) of a gradually increasing dose of the allergen at various intervals. The goal is to get the body used to the allergen and stop the symptoms of allergy.

Non-allergic rhinitis

Vasomotor rhinitis, also known as non-allergic rhinitis or idiopathic rhinitis, is a chronic non-inflammatory disease not related to allergies. Its essence is the widening of the blood vessels in the nasal cavity, the consequence of which is swelling of the mucosa and excess discharge as a runny nose. The causes of this type of rhinitis are not fully understood (hence the name idiopathic), although there are many theories about it.

The disease is more common in women than in men and is usually> 20 years old. no.

SymptomsThey are caused by factors irritating the nasal mucosa, including dry air, sudden changes in ambient temperature and atmospheric pressure, tobacco smoke, exhaust fumes, as well as certain smells, spicy food, emotional arousal and sexual arousal. Some medications can also cause similar symptoms, such as aspirin, chlorpromazine and angiotensin converting enzyme inhibitors. It is believed that the cause may also be fluctuations in the levels of various hormones, which is why such rhinitis often occurs in adolescence and also in pregnant women. A separate form of chronic non-allergic rhinitis is drug rhinitis associated with the excessive use of intranasal alpha-adrenomimetic drugs (eg xylometazoline, oxymetazoline), the duration of which should not exceed 5-7 days.

Idiopathic rhinitis occurs throughout the year, although there are periods of exacerbation – most often spring and autumn, which is associated with a change in weather conditions (humidity, temperature). Symptoms include stuffy nose, runny nose and sneezing.

Diagnosisis most often made on the basis of an interview (especially regarding the working environment and housing conditions, as well as the circumstances of the symptoms) and an otolaryngological examination, but it is usually based on the exclusion of other diseases. In the case of anterior rhinoscopy, that is, examination of the nasal cavity, significant swelling of the mucosa is visible. It may be necessary to perform allergy tests and other additional diagnostic tests, such as peripheralblood counts .

Treatmentis mainly based on avoiding triggers or situations that trigger the symptoms. Sometimes it is necessary to completely change the lifestyle, and sometimes even to change the profession. Sea salt solutions in sprays as well as antihistamines or intranasal glucocorticosteroids are used to help alleviate local symptoms.

Complications ofchronic rhinitis includeinflammation of the paranasal sinuses, caused by impaired ventilation through the natural sinus openings and excessive production of secretions, and polyposis of the lining of the nasal cavity. Patients may also report impaired smell and recurrent otitis media (its ventilation is significantly impaired by the swelling of the nasal mucosa, obstructing the Eustachian tube – the tube connecting the middle ear to the nose).

It should be remembered that chronic rhinitis, regardless of its cause, is a big problem for the patient, because it often significantly reduces everyday functioning.