A Simple Guide to Vasomotor rhinitis

A Simple Guide to Vasomotor rhinitis
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What is Vasomotor Rhinitis?
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Vasomotor Rhinitis is a condition which consists of a group of symptoms that include a runny nose, itchiness and sneezing, that are caused by irritation and congestion in the nose. It is brought about by changes in vascular tone and permeability.

What are the symptoms of Vasomotor rhinitis?
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The symptoms of Vasomotor rhinitis include:
Recurring nasal inflammation
Sneezing
Runny nose
Profuse watery nasal discharge
Nasal membrane swelling

What causes Vasomotor rhinitis?
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Vasomotor rhinitis occurs as a result of a response of the nasal membrane to
1.irritants such as smoke,
2.temperature changes and
3.stress.

Other causes of chronic rhinitis are blockage in the nose e.g. nasal polyps, enlarged adenoids and a deviated septum that impede mucus drainage and restrict air flow. Medications can cause rhinitis or worsen it in people with allergies, vasomotor rhinitis or a deviated septum.
Prolonged use of nasal decongestants can worsen rhinitis.
Some blood pressure medications such as beta blockers and vasodilators can cause rhinitis.

What is the difference between Allergic rhinitis and Vasomotor Rhinitis?
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Allergic rhinitis could be seasonal or perennial (year round).
Seasonal rhinitis is due to pollen or mould spores.
Perennial rhinitis are due to allergens such as house dust mites, animal dander or moulds found on carpets or furniture upholstery and even some foods.

Non-allergic rhinitis can also be triggered by cigarette smoke and many other air pollutants, strong odours, exposure to cold and alcohol. Smoking and air pollution may also cause symptoms by damaging the cilia (hair cells) which moves mucus through the air passages.

Hormonal changes in pregnancy cause "Rhinitis in Pregnancy". The expecting mother will recover once the baby is delivered.

What treatments are available for Vasomotor rhinitis?
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Treatments for Vasomotor rhinitis include:
Non-medical:
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Avoid dry air
Keeping air moist
Vapourisers
Nasal Decongestant sprays are not recommended for treatment of vasomotor rhinitis

Complete avoidance of environmental allergens may be impossible but it can be minimised for example removing carpets and pets.
Use a pollen mask when mowing the grass or cleaning the house
Install an air purifier
Change the air filters monthly in heating and air conditioning systems
use cotton or synthetic materials such as Dacron in pillows and bedding
enclose mattress in plastic
keep windows closed during high pollen times
eliminate house plants
bathe pets frequently or even give away dander–producing pets.

Avoid Nasal irritants which can cause typical immune response seen with classical allergies. Examples include cigarette smoke, perfume, aerosol sprays, smoke, and smog and car exhaust

Nasal irrigation utilizing a buffered hyper tonic saline solution helps to reduce swollen and congested nasal and sinus tissues.
It also washes out thickened nasal secretions, irritants (smog, pollens, etc.), bacteria, and crusts from the nose and sinuses.
While irrigating the nose, it is best to stand over the sink and irrigate each side of your nose.
Aim the stream toward the back of your head, not at the top of your head.
For young children, the salt water can be put into a small spray container which can be squirted many times into each side of the nose.

Medical:
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Anti-histamines provide good relief for mild to moderate symptoms.
Newer antihistamines that are long-acting and less likely to cause drowsiness have been found to be useful.

Decongestants such as pseudoephedrine can help to shrink the swollen tissues caused by irritants and other causes. However decongestant nasal sprays are not advised because they cause a a rebound effect on nasal tissues(initially the nasal tissue shrinks but later they become more swollen)

Corticosteroids in the form of nasal spray reduce the immune response and may be prescribed to reduce severe symptoms.
These drugs are highly effective in allergic patients; but there is a potential for serious side effects when used over time. They are best used for the short term management of allergic problems, and their use must always be monitored by a physician.

Nasalcrom (cromolyn sodium): This spray helps to stabilize allergy cells (mast cells) by preventing release of allergy mediators, like histamine.

Immunotherapy:Allergy shots interfere with the allergic response. After identification of an allergen, small amounts of it are given back to the sensitive patient. Over time the patient will develop blocking antibodies to the allergen, and they become less sensitive and less reactive to the substance causing allergic symptoms. This is the best treatment provided the allergen is correctly identified.

Surgery:Nasal polyps, enlarged adenoids and deviated septums can be corrected with surgery. Obviously this should be done only after more conservative measures have been tried. Surgery is not a replacement for good allergy control and treatment.

A Simple Guide to Sinusitis

A Simple Guide to Sinusitis
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What is sinusitis?
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Sinusitis is a condition in which the lining of your sinuses becomes inflamed.

The sinuses are the air chambers in the bone behind your cheeks, eyebrows and jaw.
They produce mucus, a fluid that cleans bacteria and other particles out of the air you breathe. Tiny hairs called cilia sweep mucus out of your sinuses so it can drain out through your nose.
The paranasal sinuses are in direct communication with the nose.
The sinuses are normally sterile.

If the sinus openings may become blocked, the mucus becomes congested in the sinuses, resulting in stagnation of secretion and finally bacterial growth.

What causes sinusitis?
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Anything that causes swelling in your sinuses or keeps the cilia from moving mucus can cause sinusitis.
This can occur because of changes in temperature or air pressure,
Using decongestant nasal sprays too much,
Smoking, and
Swimming or diving.
Some people have growths called polyps that block their sinus passages.
When sinusitis is caused by a bacterial or viral infection, you get a sinus infection.

Sinus infections sometimes occur after you've had a cold.
The cold virus attacks the lining of your sinuses, causing them to swell and become narrow.
Your body responds to the virus by producing more mucus, but it gets blocked in your swollen sinuses.
This built-up mucus makes a good place for bacteria to grow.
The bacteria can cause a sinus infection.

Acute sinusitis is usually bacterial in origin.
Haemophilus influenzae and Streptococcus pneumoniae are the organisms most commonly found in adults.
In children, similar organisms are seen, with the addition of Moraxella catarrhalis.
In older children and young adults, Staphylococcus aureus is an occasional finding.
In systemically impaired hosts, Candida, Aspergillus, and Phycomycetes may be the cause.

Risk factors include the following: diabetes mellitus, cancer, hepatic disease, renal failure, burns, extreme malnutrition, and immunosuppressive diseases.

What are the signs of acute sinusitis?
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Presentation of sinusitis is often nonspecific.

Patients may present with a persistent cold.
A cold that starts to get better and then gets worse may be a sign of acute sinusitis.

Pain or pressure in some areas of the face (forehead, cheeks or between the eyes) is often a sign of blocked sinus drainage and can be a sign of acute sinusitis.

Pain in your forehead that starts when you lean forward can also be a sign.

Other symptoms may include a stuffy nose.

Some patients complain of dental pain or alteration in smell.

Fever is seen in fewer than 2% of individuals with sinusitis.

Facial tenderness to palpation is present.

Complete opacification of sinus on transillumination is present.

An X-ray of the paranasal sinuses usually confirms the presence of sinusitis as opacity in the sinuses.

How is acute sinusitis treated?
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Your doctor may prescribe an antibiotic.
You may take an antibiotic for 10 to 14 days, but you will usually start feeling better a couple of days after you start taking it. It is important to take this medicine exactly as your doctor tells you and to continue taking it until it is gone, even after you're feeling better.

If you have sinus pain or pressure, your doctor may prescribe or recommend a decongestant to help your sinuses drain.

Painkillers may be prescribed if there is severe pain.

How to take care of sinusitis?
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1.Get plenty of rest.

2.Lying down can make your sinuses feel more congested, so try lying on the side that lets you breathe the best.

3.Drink plenty of fluids.

4.Apply moist heat by holding a warm, wet towel against your face or breathing in steam through a cloth or towel.

5.Rinse your sinus passages with a saline solution.

How is chronic sinusitis treated?
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In cases where the acute sinus infection does not cleared or become chronic, a sinus washout may be necessary to remove the mucus stucked in the sinuses.

This involves syringing of antiseptic solution through a hole in the septum separating the maxillary sinuses from the nose.
Sometimes syringing of frontal sinuses can be done through a tube inserted into the sinuses.

In severe case of chronic sinusitis, endoscopy surgery may be done to strip the lining of the maxillary sinuses and clean the cavity of the sinuses.

A new therapy is the use of phage therapy where bacterial viruses are used to cause bacterila lysis in the sinuses.