It is difficult to meet an adult who has never experienced nasal congestion at least once in his life. A runny nose is a common symptom of many pathologies; it can become a manifestation of an allergic reaction, the result of the penetration of an infection of a viral or bacterial nature, a consequence of a functional disturbance in the regulation of vascular tone. This is the leading sign of inflammatory changes in the nasal mucosa, the totality of which is classified by specialists as rhinitis. What is this pathological process, why does it arise and which stages of development are characteristic for it?
Definition and classification
The nasal mucosa is the first to encounter all the factors that threaten the respiratory system and the entire body as a whole. It is able to retain small dust particles, pathogenic microorganisms; the air entering the nasal cavity during breathing is warmed, cleaned and moistened. However, constant contact with harmful factors can lead to a weakening of the protective properties and local damage - in this case, the mucous membrane can become inflamed, and a runny nose occurs. What it is?
The definition of "runny nose" is understood as the discharge of serous, mucous or mucopurulent contents from the nasal cavity. It is believed that the concept of "runny nose" is a well-known repetition of the term "rhinitis", which is used by experts to designate an inflammatory process within the anatomical boundaries of the nasal mucosa. However, if rhinitis is a runny nose, then a runny nose is not always just rhinitis. It may indicate the development of sinusitis, inflammation in the paranasal sinuses.
The medical synonym for rhinorrhea is rhinorrhea, that is, the presence of mucus from the nose.
If not a separate symptom is described, but a specific disease, rhinitis is considered a syndrome, that is, a complex of symptoms, among which there is also a runny nose.
Inflammation of the nasal mucosa is different. For most people, it is enough to catch a slight cold - and snot in the nose immediately appears. A runny nose is a typical manifestation of hypothermia and can occur even before the absence of other symptoms as a harbinger of the disease. However, rhinitis in adults is not only a cold, according to the etiological factor it is classified as:
- infectious;
- allergic;
- traumatic.
Rhinitis is also divided as acute and chronic according to the type of inflammatory process. Chronic inflammation of the nasal mucosa can be:
- catarrhal;
- hypertrophic;
- atrophic;
- allergic;
- vasomotor.
The diagnosis is established on the basis of anamnesis (information about the duration of the disease, events that preceded the onset of symptoms), patient complaints, objective signs in favor of any variant of rhinitis. A runny nose in adults requires clarification of the diagnosis before starting treatment, since even one episode of inflammation of the nasal mucosa can provoke a variety of complications.
Infectious rhinitis
A runny nose in an adult patient is very often caused by infectious agents, among which respiratory viruses (rhinoviruses, adenoviruses, respiratory syncytial virus) and bacteria (pneumococcus, Haemophilus influenzae) prevail. Acute rhinitis of an infectious etiology is rarely observed as an independent disease - in the overwhelming majority of cases it is considered as part of the manifestations of ARVI (acute respiratory viral infection).
There are three stages of a rhinitis of an infectious nature in an acute form, a description of which can be presented in the table:
| Stage | Duration | The nature of the discharge | The severity of congestion | Rhinoscopic picture (examination of the nasal cavity) |
|---|---|---|---|---|
| Initial (dry irritation) | From 24 to 48 hours, the first 2 days of the disease. | Since a full-fledged runny nose has not yet developed, snot is not released. | The congestion grows gradually, at the same time the timbre of the voice changes - the nasal nasal characteristic of edema of the nasal mucosa appears. The patient is worried about burning, irritation, scratching. | The mucous membrane of the nose is inflamed, looks dry, swells; there is a noticeable redness (hyperemia), the nasal passages are narrowed. |
| Exudative (serous discharge) | Comes after the stage of dry irritation, lasts up to 4–5 days of the disease. | Abundant serous-mucous secretion - mucus literally flows from the nose. It contains ammonia, salts and other substances that can irritate the skin in the area of the nasolabial triangle. | It is difficult for the patient to breathe through the nose, sometimes there is a complete overlap of nasal breathing due to edema. Tickling in the nose, frequent sneezing, lacrimation, headache are noted. | With rhinoscopy, hyperemia is visible, as well as pronounced edema of the turbinates; the lumen of the common nasal passage is partially or completely blocked. |
| Mucopurulent discharge | Lasts 3-5 days, replaces the exudative stage. | The mucus in the nose first becomes cloudy, then acquires a yellowish and greenish tint - this is due to the presence of leukocytes, epithelial cells, mucin. | The nose is still stuffy, the pathological secret is removed with difficulty due to the viscous consistency; crusts may form, creating an additional obstacle to adequate nasal breathing along with edema. | There is an accumulation of purulent discharge in the nasal passages, cyanosis of the mucous membrane. |
A runny nose with infectious rhinitis is caused by damage and exfoliation of the epithelium of the nasal mucosa as a result of the multiplication of pathogenic agents.
Chronic rhinitis develops in violation of the function of the ciliated epithelium, immunodeficiency. Although the reasons for the development of chronic inflammation in the nasal cavity are not fully understood, viruses play an important role in the formation of the pathological process - their preservation or persistence in cells in a functionally active state creates the prerequisites for the activation of the bacterial flora. In this case, colonization of the mucous membrane by various microorganisms is observed, microbial associations arise. Staphylococci, streptococci, and pathogenic fungi (Candida albicans) predominate. The stages of the course of a chronic disease are represented by remission (subsidence of manifestations) and relapse (exacerbation of symptoms).
Allergic rhinitis
What is a runny nose of an allergic nature? Allergic rhinitis is an allergic inflammation caused by an IgE-dependent reaction and develops upon contact with a variety of allergens:
- pollen of plants;
- household dust;
- mold fungi;
- food products, etc.
Knowing how to get sick, you can prevent inflammation of the nasal mucosa by eliminating contact with allergens. There are several classifications that characterize the disease. Rhinitis of allergic etiology is divided as:
- Seasonal and year-round.
- Intermittent (less than 4 days a week, less than 4 weeks a year).
- Persistent (more than 4 days a week, more than 4 weeks a year).
- Flowing in a mild, moderate or severe form.
The stages of the course of an allergic rhinitis include exacerbation and remission. In the acute period, two main phases are distinguished: early, or prodromal (itching, sneezing, release of an abundant amount of watery secretion) and late (persistent violation of nasal breathing).
Signs characterizing the early phase of allergic rhinitis appear already 5-30 minutes after contact with the allergen-provocateur.
They persist from 8 hours to a day, after which the late phase begins.Allergic rhinitis can be combined with allergic conjunctivitis, pharyngitis, tracheitis, bronchial asthma.
Vasomotor rhinitis
This is a chronic non-allergic rhinitis, the development of which is associated with dysfunction of the autonomic nervous system, a change in the blood supply of the vessels of the nasal concha; ARVI is often considered as a triggering factor. Triggers, that is, provocateurs of symptoms, are:
- tobacco smoke;
- cold air;
- drops in air temperature;
- pungent odors;
- alcohol, etc.
With vasomotor rhinitis, patients complain that they have a runny nose - while the secret can be released from one nostril - right or left alternately. Runny nose and nasal congestion are the main symptoms that appear paroxysmal, caused by a sharp increase in the volume of the lower turbinates. Before starting treatment, it is important to get all the information regarding the history, complaints and objective symptoms.
Complications
What is the danger of a runny nose? Inflammation of the nasal mucosa, regardless of the etiology and form of the course, can cause the development of additional pathologies - complications of rhinitis include:
- Sinusitis.
- Otitis media (inflammation of the middle ear).
- Hypertrophy of the nasal mucosa, the formation of polyps.
At the same time, a runny nose in an adult patient intensifies, the general condition worsens, and sleep is disturbed. The middle ear can become inflamed as a result of allergies, in which case otitis media is serous - however, infectious otitis media are more common. Sinusitis is divided as infectious and allergic - this type of pathology is associated with impaired drainage of the sinuses, persistent swelling of the nasal mucosa. Since there is a runny nose among the manifestations, rhinitis is included in the definition of the diagnosis "rhinosinusitis".
If the nose is stuffy, there is discharge, you need to choose the right therapy. Which specialist can help you find out why you have a runny nose? Rhinitis in an adult patient is treated by a therapist, otolaryngologist (ENT doctor), allergist.
Before contacting a doctor, it is undesirable to use self-medication methods (except for symptomatic remedies), since this can complicate the establishment of the correct diagnosis.
