Rhinitis

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The Rhinitis:

Rhinitis

Definition

Rhinitis also known as coryza, is irritation and inflammation of the mucous membrane inside of the nose. [1]

[A]Acute rhinitis:

Acute rhinitis may be classified in to two as follows;[2]

[a] Non-allergic

1(a) Infective i.e.:

Viral: Common cold (coryza or flu), rhinitis associated with influenza or other viral disease
Bacterial: Usually occurs as a secondary infection following unresolved viral rhinitis.

2(a) Non-infective i.e.:

Vasomotor rhinitis
Rhinitis due to chemical irritation [2].

[b] Allergic (Hay fever)

This topic will separately describe under the heading of Allergic rhinitis.

[B] Chronic rhinitis:

Chronic rhinitis may be classified in two as follows;

[a]Non-allergic:

1(a) Non-specific

Chronic catarrhal rhinitis i.e.:

Chronic catarrhal rhinitis is an early stage of hypertrophic rhinitis. There is hyperaemia also oedema of mucous membrane with hypertrophy of seromucinous glands and increase in goblet cells. Besides this, Blood sinusoids particularly those over the turbinates are distended [2][3].

Chronic hypertrophic rhinitis i.e.:

It is characterized by thickening of mucosa, submucosa, seromucinous glands, periosteum also bone. Additionally Changes are more marked on the turbinates.

Chronic atrophic rhinitis i.e.:

It is a chronic inflammation of nose characterized by atrophy of nasal mucosa and turbinate bones. The nasal cavities are roomy and full of foul-smelling crusts.

Atrophic rhinitis is of two types:

Firstly, primary
Secondly, secondary.

Rhinitis medicamentosa (drug induced) [2][3].

2(b) Specific

Scleroma
Rare types: syphilis, tuberculosis, lupus also leprosy.

[b]Allergic:

Perennial allergic rhinitis.

Causes

Rhinovirus
Droplet infection
Reaction of the body’s immune system to an environmental trigger such as dust, moulds, pollen, grasses, trees, animals.
Changes in temperature or humidity
Over use of over-the-counter (in other words; OTC)drugs and prescribes nasal decongestants:
Foreign body
Allergic rhinitis may occur with exposure to allergens such as foods (e.g., peanuts, walnuts, wheat, shellfish, soy, cow’s milk, eggs etc.)
Medication (e.g., penicillin, sulfa medications, aspirin)
Most common cause of non-allergic rhinitis is common cold

Drug induced rhinitis may occur with antihypertensive agents, such as angiotensin-converting enzyme (ACE) inhibitors and beta-blockers: “statins”, antidepressants, antianxiety medication [2].

Sign & Symptoms

invasion Stage (few hours) i.e.:

Sneezing, burning sensation in the nasopharynx, nasal obstruction, also headache, pruritis of nose.

secretion Stage (few days) i.e.:

Low grade fever, malaise, arthralgia, nasal obstruction, also profuse watery rhinorrhoea.

resolution Stage i.e.: resolution within 5-7 days

Natural course of an uncomplicated disease.
Moreover, Symptoms lasting beyond 7 days, or worsening instead of improving suggest that secondary bacterial infection is being established [2].

Differential Diagnosis

Foreign body
DNS
Adenoid hypertrophy
Nasal polyp

Investigation

Physical examination
CBC
Serum Ig. E
Allergy test
X-Ray PNS [Para nasal sinus]
Other investigation if need [2].

Treatment

Supportive treatment i.e.: bed rest, analgesic’s, nasal decongestants and occasionally steam inhalations.
Antibiotics for secondary bacterial infection.
Antihistamine and corticosteroids nasal sprays may be useful.
Surgery may be indicated in some cases [3].

Homeopathic Treatment

Homeopathic treatment has been able to provide valuable help to rhinitis for acute, chronic as well as allergic rhinitis suffers for years. Homeopathy provide a natural and mild yet effective manner to solve this problem.

Homeopathic remedy is easy and safe to use, there are many homeopathic remedies which have an effective therapeutic value, some of the indications of homeopathic remedy commonly used in treating a case of rhinitis as follows;

Homeopathic treatment is based on individualization in which a doctor selects a medicine according to your/ patients constitution rather than matching only symptoms similarity, so before taking any homoeopathic medicine you have to firstly consult a homoeopathic physician for your concern problem’s, there are so many remedies are useful for this condition but some few therapeutic indications of homeopathic remedies in the cases of rhinitis are as below.

Ambrosia artemisia folia. [Ambr]

This is the common ragweed and is useful in some cases of hay fever. Mill Spaugh reports the cure of several cases. The writer has used the remedy as a prophylactic with success in those cases appearing at the time of the blooming of the ragweed and has prescribed it with marked benefit in cases unquestionably due to the ragweed irritation. It would probably be inefficacious in cases arising from the pollen of the golden rod and daisy. There are no special indications, proving’s have developed the characteristic symptoms of hay fever. Dickie claims results little short of miraculous with this remedy [5].

Arsenicum [Ars]

It is especially useful in winter colds where there is a thin, watery discharge from the nostrils which excoriates the upper lip, yet in spite of this fluent discharge the nose feels stopped up. There is a dull, throbbing frontal headache and sneezing, photophobia, and contrary to what one would expect, the sneezing does not relieve in the slightest and the irritation continues as before and is worse on going into sir. It corresponds well to patients who are rarely without a cold. These symptoms of watery discharge and sneezing place Arsenic in the front rank in the treatment of hay fever. Catarrh based upon a malarial miasm in poorly nourished subjects calls for the remedy.

Arsenic iodide may be found indicated when burning in nose and throat is marked. Allium cepa has this excoriating nasal discharge also, but, if and anything, there is more lachrymation, which, by the way, is bland. Sinapis nigra resembles Arsenicum in the heat in the nose, but with Sinapis there is dryness and no discharge. The discharge of Mercurius, though excoriating and acrid, is thicker. The cold of Arsenic always settles in the nose, that of Phosphorus in the chest. The Arsenic patient is chilly and wants to be near the fire all the time; the nose burns both externally and internally.

Allium cepa [All-c]:

One of our best remedies for cold in the head, indeed, is said by come to be the best, and probably it is when indicated. The discharge is profuse, thin and acrid, with great smarting in the nose and eyes, and the distinguishing feature between this remedy and Euphrasia is the profuse lachrymation which here is bland, and under Euphrasia is excoriating, while the opposite condition obtains in the nose.

Under Allium the edges of the eyelids burn and the eyes are red and sensitive to light. The nasal discharge is thin and flows constantly, excoriates the upper lip, and there is prolonged sneezing. A peculiarity of Allium is that the discharge ceases when the patient goes into the open air, but returns when entering a warm room again.

It is a drug Which should be given early, and if there be a splitting laryngeal cough, causing the patient to wince and crouch with pain, it is all the more indicated. Farrington, however, claims that Allium is apt to drive the trouble to the chest, and adds that when it reaches the chest Phosphorus is the remedy. Arsenic, too, is similar, but Arsenic has sneezing in the cool air after leaving a worm room, and it lacks the laryngeal symptoms so common in Allium. The Mercurius discharge is acrid, and not as thin as that of Allium.

Sabadilla. [Sabd]

Of great use in hay fever with watery discharge, profuse coryza and frontal pains. There is spasmodic and continual sneezing with only slight catarrhal discharge. It will often cut short an attack, but it will not always cure permanently as it is not deep action enough. It should be used to this end in the higher potencies. Aralia racemosa has been recommended but on somewhat insufficient testimony, likewise Benzoic acid. Kali iodatum. Sneezing, " crying colds "; the sneezing is incessant, the lachrymation is profuse and the coryza is acrid. Ipecac. Sometimes useful in the sneezing stage, but the more frequently in the asthmatic stage where the chest symptoms will indicate.

Naphthalin. [Naph]

Lippincott claims this remedy to be applicable to more cases of hay fever, and that better results are obtained from it than from any other drug, and he claims also prophylactic power from its use in the 3x or 2x trituration’s. A large number of observers bear out this idea. Dr. Laird, of Utica, N.Y., says: " It almost never fails." Its indications seem to be excoriating lachrymation and coryza, swelling of eyelids and nose; it is more pronounced in its action on the left sideas well as especially it is useful in those experiencing asthmatic symptoms. Dr. Perry Dickie obtained brilliant results with this remedy. Sanguinaria has frequent sneezing and is worse on the right side; it suits periodic coryzas. Sanguinaria nitrate is also valuable and by some is considere first on the list. Natrum muriaticum. Hay fever from suppressed intermittent; craving for salt may be an indicating symptom [5].

Ranunculus bulbosus. [Ran-b]

Among the less frequently used remedies is Ranunculus, it has smarting in the eyes, pressure at the root, with tingling and crawling within its cavity, hoarseness and muscular soreness. Silicea has itching and tingling in the nose and posteriorly at orifice of Eustachian tubes in addition violent sneezing and excoriating discharge, similarly Rosa Damascena. Allium cepa. Itching of the nose and eyes. Nose stuffed up, profuse acrid watery discharges. Arum triphyllum.

Hay fever with terrific pain over root of nose, nose and throat raw with frequent sneezing. Furthermore, Mercurius protoiodide is very often suitable to the conditions that predispose to hay fever. Psorinum 30, says Clarke, will cure a large number of cases where there is great sensitiveness to cold. Either Psoric or neuroarthritic soil indicates the remedy completely. Pothos foetida also Cyclamen have excessive attacks of sneezing. Lastly, Chromico-Kali Sulphuricum 3X has been used successfully in this disease by a number of our European confreres [5].

Diet and Nutrition

Foods to be taken

Warm fluids
Honey
Fish
Yogurt
Dark green leafy vegetables
Flax seeds
Eating locally produced unfiltered honey is believe by many to be a treatment for hay fever, supposedly by introducing manageable amounts of pollen to the body.

Foods to be avoided

Food allergies to peanuts, or strawberries, or anything else can cause symptoms like either hives or swelling.
Certain fruits and vegetables
In some people, drinking alcohol especially beer or wine can trigger nasal congestion [4].