Rhinitis is a collection of disorder which is characterized by inflammation and irritation of the mucous membranes of the nose. These conditions can have a significant impact on the quality of life and affects sinus, ear, sleeping patterns and learning disorder. Rhinitis often is correlated with respiratory tract infection and disorders. Rhinitis may be of different types which may be acute or chronic, allergic or non allergic. Allergic Rhinitis is further known as seasonal or perennial Rhinitis and is commonly associated with exposure to airborne particles like dust, smoke, dander, or pollen of plants in people who are allergic to such substances. Seasonal rhinitis occurs during pollen seasons whereas perennial Rhinitis occurs throughout the year.
Rhinitis may be caused by various factors including change in weather, temperature or humidity, odours, infection or seriously underlying systemic diseases. Use of over the counter (OTC) and prescribed nasal decongestants and the presence of foreign body which irritates the muscosal lining.Allergic Rhinitis may occur with exposure to allergens for example foods ( peanuts, walnuts, wheat, sea foods, dairy products and eggs)Some of them may show allergic reaction to the medications like penicillin, and other medicines like aspirin.Most common cause of all is the common cold.
Viral Rhinitis also known as common cold is the most frequent viral infection in the general population. The term cold refers to an infectious, acite inflammation of the mucous membrane of the nasal cavity characterised by nasal congestion, rhinorrhea, sneezing, sore throat and general malaise. The term is also used when the causative agent is influenza (the flu). Colds are highly contagious because virus is shed for about 2days before the symptoms appear and during the first part of the symptomatic phase. The colds are frequent during the late fall and during winter seasons. Seasonal changes in the relative humidity may affect the prevalence of colds. The most common cold-causing viruses survive when humidity is low, in the colder months.
Rhino viruses are the most likely causative organisms. Other viruses implicated in the common cold include coronavirus, adenovirus, respiratory syncytial virus, influenza virus and parainfluenza virus. Immunity after the recovery is variable and depends on many factors including individuals natural host resistance and the specific virus that caused the cold. Despite the popular belief, cold temperature and exposure to cold rainy weather do not increase the incidence or severity of the common cold.
Causes of Rhinitis
- Abuse of nasal decongestants
- Psychological and emotional stimulation (anger, sexual arousal, emotional distress)
- Irritants (smoke, air pollution, exhaust fumes, cocaine)
- Tumor, deviated septum, crusting, foreign body
- Cerebrospinal fluid leakage
- Nasal polyps (in cystic fibrosis)
- Acute viral infection
- Acute or chronic rhinosinusitis
- Rare nasal infection like syphilis, tuberculosis.
Signs and symptoms
The signs and symptoms of Rhinitis include
- Rhinorrhea (excessive nasal drainage, runny nose)
- Nasal congestion and nasal discharge (purulent with bacterial Rhinitis)
- Sneezing and pruritus of the nose, roof of the mouth, throat, eyes and ears.
- Headache and muscle aches
- Sore throat with low grade fever
- Tearing watery eyes.
- General malaise
- As the illness progresses, cough appears.
- The symptoms of viral Rhinitis may last from 1 to 2weeks.
- If severe systematic respiratory symptoms occur,it is no longer considered viral Rhinitis. Allergic conditions ccan affect the nose, mimicking thr symptoms of the cold.
- As per the visit to the hospital, the doctor might take your physical examination and ask you various questions regarding the symptoms and its frequency.
- X-ray to rule out any problems in lungs or possible pneumonia or tuberculosis.
- Sputum test to identify the causative agent.
- Blood test may be required for futher diagnosis.
The management of Rhinitis depends on the cause, which may be identified through the history and physical examination. The physician or a nurse asks the person about he recent symptoms as well as possible exposure to the allergens in the home, workplace, environment or may ask you about any known allergies. If viral Rhinitis is the cause, medications may be prescribed to relieve the symptoms. In allergic Rhinitis, allergy test may be done to identify possible allergens. Depending on the severity of the allergy, desensitising immunizations and corticosteroids may be required. If the symptoms suggest bacterial infection, an antimicrobial agent is used.
Medication therapy for allergic and non allergic Rhinitis focuses on symptom relief. Antihistamines and corticosteroids nasal sprays may be useful. Antihistamines remains the most common treatment and are administered for sneezing, pruritis and rhinorrhea. Oral decongestants agebts may be used for nasal obstruction. Use of saline nasal spray can act as mild decongestant and can liquify mucus to prevent crusting. Cough expectorant is also prescribed to promote the removal of secretions. Several antiviral medications are available by prescription which can reduce the severity of the symptoms and may reduce the duration of the common cold. Antibiotics should not be given because they do not affect the virus or reduce the incidence of bacterial complications. In fact, their inappropriate use has been implicated in the development of organisms resistance to therapy.
The symptomatic therapy that includes
- An adequate fluid intake such as warm water, ginger tea, green tea or soup.
- Prevention of chilling
- And use of expectorant as needed.
- Warm salt water gargles soothe the sore throat
- Use of nonsteroidal anti inflammatory drugs NSAIDs such as aspirin or ibuprofen which are helpful in relieving aches and pains.
- In addition, herbal medicines for instance echinacea, zinc lozenges, zinc spray are frequently used to treat the common cold.
- The inhalation of steam or heated, humidified air has been a mainstay of home remedies for common cold sufferers.
- Mostly viruses ccan be transmitted via air, direct contact with infected secretions, inhalation from others coughing or sneezing should be avoided.
- Handwashing remains the most effective preventive measure to the transmission of organisms.
- The nurse teaches the patient how to break the chain of infection with appropriate hand hygiene or hand washing techniques and use of tissues during coughing and sneezing and use of masks to avoid the spread of virus.