Rhinitis is an inflammation of the mucous membrane of the nasal cavity that manifests as congestion or edema. Patients often have symptoms such as nasal congestion, runny nose, nasal itching, throat discomfort and cough.
The thin, liquid-like substance secreted from the nose is called nasal mucus or nasal secretion, and its function is to help remove dust and bacteria to keep the lungs healthy. Usually, the nasal secretion, which is a mixture of bacteria and dust, is aspirated down the throat and eventually into the stomach, and is usually unnoticeable because of its small volume.
When inflammation occurs in the nose, the nasal cavity can produce a large amount of nasal mucus, which can turn yellow due to infection, and can cause coughing when it flows through the throat, and can also flow out through the anterior nostril when the amount of nasal mucus is very large.
Allergic rhinitis is a kind of rhinitis, which also includes chronic rhinitis and acute rhinitis, the latter usually refers to colds. Chronic rhinitis includes simple rhinitis, which has mild symptoms, and hypertrophic rhinitis, where nasal congestion can be very pronounced.
Rhinitis caused by an allergy to a substance is called Allergic Rhinitis, and can cause a range of allergic symptoms. Allergic rhinitis is also known as allergic rhinitis.
As mentioned earlier, the various factors that cause allergic rhinitis are called allergen or allergens, and the common allergens include.
(i) Inhalant allergens.
Such as indoor and outdoor dust, dust mites, fungi, animal fur, feathers, cotton wool, etc., cause perennial attacks; plant pollen causes more seasonal attacks.
(ii) Food allergens.
Such as fish and shrimp, eggs, milk, flour, peanuts, soybeans, etc. In particular, certain drugs, such as sulfonamides, quinine, antibiotics, etc. can cause the disease.
(iii) Exposure to substances such as cosmetics, gasoline, paint, alcohol, etc.
Others may be certain bacteria and their toxins, physical factors (such as hot and cold changes, temperature imbalance), endocrine disorders or imbalance of acid-base balance of body fluids and other etiological factors can cause the disease. It can also be due to the simultaneous or sequential presence of multiple factors.
Now for the methods of hospital examination for rhinitis.
Subnasal microscopy: Patients with allergic rhinitis can be examined after consultation and see pale, pale, gray or lavender nasal mucosa, turbinate edema, clear or mucous snot visible in the common nasal passage and nasal floor. In case of co-infection, the mucosa is congested, the inferior turbinates are dark red bilaterally, and the discharge is mucopurulent or purulent. In patients with a long history and recurrent symptoms, polypoid changes in the middle nose or enlargement of the inferior turbinates can be seen. About 30% of patients have combined allergic asthma, some patients can find nasal polyps, and patients with hay fever can have conjunctival congestion during the attack.
Smear examination of nasal secretions: During an allergic attack, eosinophilic leukocytes are seen in the nasal secretions, and more eosinophilic leukocytes or mast cells can be detected.
Allergic excitation test: Generally, skin tests (scratch, intradermal and contact methods, etc.) are used. The principle is that there are a variety of hypothetical allergic substances that make contact with the organism, and depending on the presence or absence of reactions, can assist in the diagnosis.
Diagnosis of allergic rhinitis.
The diagnosis of allergic rhinitis can be made on the basis of the above typical typical symptoms and examination findings, which generally need to be distinguished from the following diseases.
1. vasomotor rhinitis
Patients sometimes have lightning attacks caused by the slightest touch of the nose, which are sudden and disappear quickly. The symptoms are similar to those of allergic rhinitis, but there is no itching in the nose and the symptoms can be relieved with oral cold medication. The disease can be triggered by changes in heat or cold, changes in body position (getting up), and emotional excitement.
2.Eosinophilic rhinorrhea
The symptoms are similar to those of perennial allergic rhinitis, and although the cause is not known, it is not related to allergy. Patients often have intermittent nasal congestion with sneezing and a large amount of plasma mucus nasal discharge, often with dizziness and tinnitus, fatigue, cough and other systemic symptoms.
3.Cold
Patients with allergic rhinitis often think they have a cold, the difference between the two is that the latter can be accompanied by fever and other general discomfort, and the nasal mucosa can be found very red and swollen.
Medication for allergic rhinitis
Allergic rhinitis is usually not completely curable (cured) and is best treated by prevention.
The aim of treatment is to prevent and relieve symptoms as well as to reduce the duration of allergic rhinitis.
I. Medication
The mechanism of treatment may vary from one medication to another, and there are both topical and systemic medications. The following is a list of medications that are commonly used in clinical practice.
Antihistamines
Paracetamol, Neominol, etc. counteract histamine, which is released by the body under the stimulation of allergens, thus causing a series of allergic symptoms.
Prevention and treatment
Paracetamol can cause drowsiness and is prohibited for drivers and pilots. The new generation of antihistamines has no drowsiness effect.
Mast cell stabilizers, sodium cromoglycate ophthalmic solution and oral medication, trinostat, block the release of histamine from body tissues in the presence of allergens.
Prevention
Can cause drowsiness.
Decongestants: ephedrine, Pitocin, epinephrine, furosemide combination to reduce nasal obstruction.
Short-term treatment: use for no more than 3 days and up to a week. Long-term use can cause drug-induced rhinitis.
Bromides: reduce symptoms of excessive snot caused by histamine.
Treatment
Not commonly used clinically.
Hormonal drugs: dexamethasone ophthalmic solution, Burkitt’s sodium, Renocort to reduce the reaction to allergens and suppress the inflammatory response.
Treatment
Long-term use may lead to systemic side effects of hormones, but side effects are generally mild, especially with drugs that have been used clinically recently.
Nasal wetting agents: help reduce thick nasal secretions and crusts.
II. Other treatments for allergic rhinitis
General medication can be a good treatment for allergic rhinitis, but for severe allergic rhinitis, other related treatments can be used.
Significant nasal congestion can be treated satisfactorily with laser, microwave or plasma radiofrequency therapy, and can be beneficial for sneezing and runny nose by reducing the sensitivity of nerves in the nasal cavity. The low temperature plasma system recently used in clinical practice has been reported to have significant effect on allergic rhinitis, especially severe allergic rhinitis, and its clinical significance has begun to be valued by some doctors because of its small damage to the mucosa and no obvious side effects. The ear, nose and throat departments of Shanghai Sixth People’s Hospital, Nanjing Bayi Hospital, Beijing 304 Hospital, and Dalian Medical College Hospital are some of the most famous hospitals in China for the treatment of allergic rhinitis (including other types of rhinitis). In addition, many doctors and patients in the China Otolaryngology Forum have commented on low-temperature plasma treatment for rhinitis, and you can also enter the China Otolaryngology Forum to check.
Desensitization therapy, using the identified allergens as desensitizers, starts with a small dose for subcutaneous injection and gradually increases the dose to the maximum tolerated amount to a maintenance amount until the symptoms disappear. Patients treated by this method can produce a large number of specific IgG closed antibodies, which can block the combination of antigens and IgE antibodies and reduce the sensitivity of media cells, thus playing a therapeutic role, but the effect is often limited by the fact that there may be many allergens. For more information, see Immunotherapy of allergic rhinitis within this topic
Patients with nasal polyps should undergo endoscopic surgery for nasal polyps; to reduce the excitability of the parasympathetic nerves in the nasal cavity, pterygoid canal neurectomy or superficial nerve dissection of the rock duct can be performed, which is reported to have some therapeutic effect, but we do not advocate this procedure because of the pain and risk.