the main » Runny nose » Year-round vasomotor allergic rhinitis causes. Causes and methods of treatment of vasomotor rhinitis.

Year-round vasomotor allergic rhinitis causes. Causes and methods of treatment of vasomotor rhinitis.

In otorhinolaryngology there are many varieties of the disease, which in everyday life is determined by the general concept of "runny nose". Acute infectious, chronic catarrhal, hay, atrophic, hypertrophic, ozena - each species has its own mechanism of occurrence, clinical presentation and treatment regimen. Chronic vasomotor rhinitis in this series stands out due to a very specific etiology.

Unfortunately, avoidance is difficult and only partially possible, especially in cases of seasonal allergies to trees, grass, pollen and mold. Avoiding allergens from the industrial and domestic environment includes environmental changes to reduce exposure to dust, animal dander and mold.

Pharmacotherapy The knowledge of the pathophysiology of allergic rhinosinusitis makes it possible to apply various treatment methods at different stages of the disease. Exists wide range drugs, such as drug treatment groups. Treatment can be adapted to specific clinical symptoms.

What is vasomotor rhinitis?

The word "vasomotor" means the connection with the nerves, which are responsible for vascular tone, expanding and narrowing them. Consequently, vasomotor rhinitis is a non-inflammatory disease caused by a violation of this regulation. This starts the following mechanism:

In response to any stimulus, the vascular lumen expands.
The mucous membrane swells.
All functions of the nose are impaired.

This disorder occurs much more often than recorded by medical statistics. For example, its manifestations include nasal congestion and flow from the nose in the cold, passing in heat, or a runny nose in babies during teething.

Treatment may include an introduction. medicinal product or combinations depending on the severity of the disease. Depending on the duration of the disease, they can be classified as intermittent and persistent, and the symptoms - moderate, moderate and severe. Periodic rhinosinusitis is determined when symptoms are present more than 4 days a week or less than 4 weeks.

The target year for allergic rhinosinusitis is determined when symptoms persist more than 4 days a week and are present for more than 4 weeks. Slightly expressed symptoms do not affect sleep, daily work or study and do not interfere with daily activities. The patient does not bother them.

The seeming innocence of episodes of such a reaction allows for a long time to ignore the symptoms. The process is progressing in the meantime, and vasomotor rhinitis becomes chronic: the mucous membrane thickens, the epithelium is damaged, the activity of the glands is disturbed. A person with such a diagnosis becomes more vulnerable to hypothermia and infections, the immunity weakens, and the recurrence of rhinitis becomes more frequent.

Forms of chronic vasomotor rhinitis type:

Mild and severe symptoms are those that violate these actions. Treatment of allergic rhinosinusitis includes antihistamines, decongestants, corticosteroids, mast cell stabilizers, anticholinergics, leukotriene antagonists, and immunotherapy.

Antihistamines Antihistamines are the basis for the treatment of mild intermittent allergic rhinosinusitis. As competitive histamine inhibitors, antihistamines reduce the effect of histamine even in the presence of ongoing histaminolibration. This is the first and second generation.

This classification has a rather didactic character. Many researchers have noted the important role of primary allergy in the occurrence of neurovegetative form. vasomotor rhinitis. In some cases, the opposite process is observed - the transition of a neurovegetative subspecies into an allergic one.

The most commonly used agents include chlorpheniramine, brompheniramine, hydroxyzine, and diphenhydramine. Due to the lack of selectivity, first-generation antihistamines cause anticholinergic effects, such as dry mouth, headache and urine retention. Recent studies have shown that first-generation antihistamines can significantly affect coordination, attention, memory functions, and the psychomotor. efficiency.

Thus, patients need special recommendations on the use of these drugs. Second-generation antihistamines include fexofenadine, desloratadine, loratadine, levocetirizine, and cetirizine. All of these drugs are very effective in alleviating most of the symptoms of allergic rhinosinusitis.

Among the triggers of the disease most often called:

Many of our readers for the treatment of rhinitis, sinusitis (sinusitis), actively use the monastery collection of Father George. It consists of 16 medicinal plants that are extremely effective in the treatment of chronic Cough, bronchitis and cough provoked by smoking.

Antihistamines significantly reduce the symptoms of itching, conjunctivitis, rhinorrhea, and sneezing. They have a minimal effect on nasal congestion. In several controlled studies, individual representatives of the second generation of antihistamines were directly compared, and there is no evidence of the superiority of a drug for the treatment of allergic rhinosinusitis. However, patients often experience a significant improvement in the symptoms of some antihistamines, but not others. Therefore, if one antihistamine is ineffective, you can enter another monotonous generation.

The latter factor explains the high incidence of chronic vasomotor rhinitis in adolescent girls and women. If the process is associated with pregnancy, then, as a rule, it is temporary and ends with the end of gestation.

Azelastine is a second generation antihistamine. It is used to treat seasonal allergic rhinosinusitis and vasomotor rhinitis and has been shown to improve symptoms. The improvement in symptoms was found to be similar to the second generation of oral antihistamines. Most common side effects are bitter taste and sedative effect.

Decongestants. Decongestants or vasoconstrictor agents exist in oral and intranasal forms. Oral decongestants affect the nasal obstruction with vasoconstrictor activity on β-adrenergic receptors, but do not affect other symptoms. Oral decongestants are primarily catecholamines, pseudoephedrine, and phenylephedrine. There are also combination drugs containing decongestants and antihistamine. Side effects of oral decongestants: nervousness, insomnia, irritability, headache, high blood pressure, palpitations and tachycardia.

Clinical picture

Manifestations of vasomotor rhinitis look like common cold at respiratory infection. The difference is in the absence of heat, inflammation and hyperemia of the mucous. That is why academician Voyachek in his textbook "Fundamentals of Otorhinolaryngology" calls vasomotor rhinitis "false."

They are contraindicated in patients with severe hypertension or ischemic heart disease. Long-term use of oral decongestants is undesirable because of the side effects profile. Nasal decongestants include catecholamines and imidazolines. They provide a faster and more powerful detoxification effect on the nasal mucosa. Systemic side effects of local anti-edema drugs are rarely reported, much less frequently than oral forms. However, no more than 4 days. Their prolonged use leads to damage to the normal nasal cycle, vasodilation, leading to nasal obstruction and hypertrophy of the nasal scar.

Symptoms	Causes
Nasal congestion	Edema causes a narrowing of the nasal passages, and the volume of inhaled air decreases. Vasoconstrictor drops either act briefly or do not act at all. At night, congestion may be constant due to the increased work of the parasympathetic nervous system in the night phase.
Mucous or watery discharge	As a result of edema, hyperfunction of the glands occurs, and they begin to produce more mucus. The volume of discharge can be different in different patients.
Sneezing	The pathological process paralyzes the activity of the ciliated epithelium, an excess of mucus irritates the nerve endings. The body reflexively tries to clear the airways.
Hyperemia of the eyes and nose wings	The skin of the nostrils and the front areas of the mucous membrane are mechanically irritated by handkerchiefs and napkins. High blood filling of the vessels extends to adjacent areas and causes hyperemia of the eyes. When tears can be observed.
Disturbance of smell and taste	Edema overlaps the olfactory department of the nose. Smell analyzers are closely related to taste analyzers, and as a result, the work of both groups of receptors is impaired.
The decline in vitality, fatigue, sleep problems, headaches	Appear with a long course of the disease. Difficulties with nasal breathing provoke hypoxia. The brain suffers from oxygen starvation.

In its development, chronic vasomotor rhinitis goes through several stages. In the first, attacks occur periodically and quickly change into more or less long periods of remission.

At the next stage, “explosions of a vasomotor reaction” (as defined by V.I. Voyachek) are of a longer duration. Act vasoconstrictor agents quickly leveled by degenerative processes in the vessels. The mucous membrane changes pathologically.

This nosological unit is known as rhinitis medicine. Nasal decongestants are contraindicated in patients with glaucoma. Nasal corticosteroids Because of their wide anti-inflammatory spectrum, they are very effective in treating allergic rhinosinusitis. They are recommended as a first-line treatment for moderate and severe intermittent allergic rhinosinusitis and persistent allergic rhinosinusitis. Nasal corticosteroids significantly improve sneezing, stagnation, rhinorrhea, itching.

Compared with antihistamines and cromolone, nasal corticosteroids have a stronger effect on sneezing and nasal congestion. Although nasal corticosteroids are highly effective, allergic rhinosinusitis requires additional funds to combat this disease.

The third stage is characterized by the development of polyps that close the nasal passages completely. During this period, there is an ineffectiveness of vasoconstrictor drops.

At the final stage of the disease, the walls of the vessels and the mucosa are affected by fibrosis, and the work of the nose is completely paralyzed.

Since different drugs affect different inflammatory mechanisms, the combination is acceptable and effective. Often patients are treated with antihistamines and nasal corticosteroids, but the data show the superiority of corticosteroids as monotherapy compared with the combination. Once symptoms are controlled, the amount of medication can be reduced to one. Nasal corticosteroids have a delayed onset of action. Efficacy may occur 7 hours after administration, but full effectiveness may take up to 2 weeks.

Diagnostic methods

The duty to diagnose vasomotor rhinitis lies with the otorhinolaryngologist. When interviewing a patient, he may suspect the presence of this disease under the following conditions:

Further diagnosis is carried out by the following methods.

These agents are most effective with daily or prophylactic use than intermittently. A nasal corticosteroid used before the beginning of the year can prevent the appearance of nasal symptoms or reduce its severity. Nasal corticosteroids are considered safe. The most common undesirable effect is nose bleedwhich occurs in 10% of patients. It is important that the patient is well informed about the correct use of the nasal spray. Using salt solutions gel form can significantly reduce these effects.

Method	The essence and content of the method
General inspection	The general condition of the patient is analyzed: the nature of breathing and discharge from the nose, the presence of hyperemia, sneezing, etc.
Rhinoscopy	Examination of the nose with a nasal mirror. The shape of the nasal septum and the condition of the mucosa are analyzed. Rhinoscopy is the front, middle and rear. The choice of instrument depends on which part of the nose is being examined. When conducting a secondary and posterior rhinoscopy, the nasopharynx is pretreated with anesthetic preparations.
Videoinoscopy	Inspection of all parts of the nose with an endoscope with a camera displayed on the monitor. The procedure is gentle, does not require anesthesia.
Laboratory methods	general blood analysis; allergy tests; planting flora discharge; immunogram;
Additional researches and consultations of profile specialists	Studies of the hormonal profile, blood pressure, cardiogram, consultation of an immunologist, neurologist, and endocrinologist may be required.

After collecting all the data, the diagnosis is finalized, and the ENT doctor prescribes treatment.

Other side effects include nasal burning, burning and dryness. Numerous studies have shown their safety with long-term use. Potential systemic effects include transitional growth in children, increased intraocular pressure and cataract subcapsules. However, studies have shown that nasal corticosteroids used in tolerable doses do not limit skeletal growth in children. In general, there are no clinically significant differences in side effects between different nasal corticosteroid preparations.

These include budesonide, fluticasone propionate and mometasone furoate. Systemic corticosteroids are not recommended for chronic treatment allergic rhinosinusitis due to side effects profile. Sometimes patients with severe symptoms that cannot be controlled with other drugs can be treated with systemic corticosteroids for a short time. These agents can be administered in depot injections or orally. For oral dosing, at least 20 mg of prednisone should be used to be effective.

Drug therapy

The treatment regimen is developed by the doctor individually, based on the form and severity of the disease. This takes into account the general condition of the patient and comorbidities, which also require correction.

The goal of therapy is to reduce edema, reduce the blood supply to the nasal vessels and bring their tone to normal, eliminate the hyperreaction of the mucous membrane.
Anticholinergics Anticholinergics are effective in treating rhinorchia because the glandular nose is under cholinergic control. However, they have little effect on nasal obstruction, itching and sneezing. Because of their side effects, they are only injected intranasally. To be effective, the drug should be used 3-4 times a day.

The main side effects are nasal irritation, cross-shaped and slight bleeding from the nose. Mast Cell Stabilizers They inhibit the degranulation of sensitized mast cells. Although these effects help control the symptoms of allergic rhinosinusitis, their effects are mild. Cromolin is more effective if it is administered before the allergenic effect, that is, before the season. With severe symptoms, cromol treatment is ineffective. Cromolin requires dosing four times a day, which complicates patient collaboration.

To achieve this goal, an integrated approach is applied:

For successful treatment, the patient will need to reconsider the conditions of his life and work: monitor the humidity of the air and its purity, avoid allergens and perfumes, be careful with household chemicals. It is important to get rid of bad habits and eliminate nidi from the nasopharynx. Under these conditions, it will be possible, if not to cure chronic vasomotor rhinitis, then to achieve stable remission.

The safety profile is excellent and without significant adverse reactions. Leukotriene antagonists. These drugs are used initially in the treatment of bronchial asthma, but also, as has been shown, affect the treatment of allergic rhinosinusitis. Their effectiveness is similar or slightly lower than that of antihistamines and significantly less than that of nasal corticosteroids. They are mainly manifested in patients who cannot use nasal corticosteroids or antihistamines or as additional treatment in patients in whom allergic rhinosinusitis is not controlled by nasal corticosteroids.

Non-drug treatments

These include physiotherapy and surgical procedures. Physiotherapy methods work especially well in combination with drug therapy. Calcium chloride electrophoresis is often used in the neck and collar area or endonasally. This procedure quickly eliminates swelling and alleviates the condition of the patient.

Immunotherapy Allergen immunotherapy has proven to be extremely effective in combating the symptoms of allergic rhinosinusitis due to the effects of various aeroallergens, including dust, cats, trees, grass, and weeds. Efficacy for fungal allergen has been shown. Allergic immunotherapy should be considered in patients who, despite symptomatic treatment, do not respond adequately and need systemic corticosteroids or have accompanying illnessessuch as bronchial asthma.

Immunotherapy is the only therapy that changes the course of the disease. Creates remission for 3-5 years. Recent studies have shown that children with allergic rhinosinusitis who were treated with immunotherapy have lower levels of asthma than those who do not receive immunotherapy. In addition, it was shown that children sensitized to house dust and immunotherapy cause less allergy to other allergens than those who do not have immunotherapy for house dust. The mechanism by which this anomalous reactivity to other allergens is reduced is not yet known.

Beautiful therapeutic effect gives phonophoresis of hydrocortisone endonasal using the device Beam-2. Hydrocortisone reduces irritability nerve endings, inhibits the release of histamine from mast cells, stabilizes cell membranes and relieves swelling.

If vasomotor rhinitis is associated with asthenic syndrome, it is advisable to prescribe a course of acupuncture. This method simultaneously relieves the symptoms of the disease and normalizes the functions of the nervous system. In addition, laserpuncture, inhalation, magnetic therapy and ultraviolet irradiation are often used.

In advanced complicated cases, conservative methods are ineffective, and then they resort to surgical intervention.

The goal of almost all types of operations is to destroy the vessels located under the mucous membrane. If you need to correct the curved nasal septum, remove growths (adenoids or polyps), apply septoplasty.

A particularly promising method of non-invasive surgery is considered exposure to high-intensity ultrasound - HIFU-therapy. For the treatment of chronic vasomotor rhinitis use special equipment - the system "CZB". After local anesthesia, a short-term local effect is performed on the areas of the lower shells and the mucous membrane of the septum, as a result of which the patient almost immediately begins to breathe freely through the nose.

How to cure vasomotor rhinitis at home?

Chronic vasomotor rhinitis is a complex functional disorder. It is impossible to treat it yourself without consulting a specialist. Many traditional medicines can be dangerous in the allergic form of this disease.

Strictly with the permission of the otorhinolaryngologist and in the absence of individual intolerance, you can try to apply water extract of calendula flowers. Consider the following recipes:

At home, it is possible and necessary to carry out the prevention of exacerbations of vasomotor rhinitis. To do this:

tempering (douche, rubdown, douche);
observe the day regimen (get enough sleep);
eat right (limit cholesterol, include fish and seafood in the diet);
monitor body weight.

All these measures will help to maintain normal vascular tone and achieve long-term remission of the disease.

Important to remember! A person diagnosed with chronic vasomotor rhinitis should undergo annual medical examinations.

Vasomotor rhinitis (still popularly called this ailment “false rhinitis”) is one of the forms of rhinitis in which there is inflammatory processdeveloping in the area of the nasal mucosa. This leads to a complication of the basic functions of the nose (deterioration of nasal breathing and loss of smell).

Symptoms and causes of illness

Often people confuse vasomotor rhinitis with the symptoms of a common cold, and begin self-treatment with all sorts of sprays and drops that do not have the expected effect in the treatment of the ailment. And this is a blunder, because even the usual runny nose, with long-term treatment vasoconstrictor drugs, can provoke rhinitis and other, more complex. Primary:

For this pathology, it is characteristic that the signs of the disease may appear suddenly, and then also suddenly disappear for a while. At the moments of an attack, several symptoms may appear simultaneously, and at the end - only a feeling of congestion may remain.

Before treating vasomotor rhinitis, you first need to figure out what kind of reason could provoke the disease, consider the following:

Having an idea of what factor could trigger the appearance of the disease, you can choose proper treatment. Excellent in the treatment of vasomotor rhinitis have proven themselves folk remedies, allowing to get rid of the disease, without resorting to sophisticated medicine.

Treatment

In addition to drug therapy, to date, treatment of vasomotor rhinitis in the home has become very common folk remedies. But before taking into account the advice of traditional medicine, you must consult with your doctor to avoid complications.

Today, non-traditional methods of treatment of rhinitis can rightfully compete with modern medical therapy. Moreover, it is much easier and more convenient to treat vasomotor rhinitis at home than to be constantly monitored by doctors or in hospital. In any case, before proceeding to the choice of a particular method, you need to make sure that it is suitable and does not harm the body, and for this you should first talk with the doctor.

Now you can find a lot of proven and effective methods for the treatment of rhinitis using simple recipes taken in traditional medicine. Consider the following:

As can be seen, the treatment of vasomotor rhinitis folk remedies does not cause any particular difficulties. The main thing is to choose the appropriate treatment option at home, and just follow the instructions.

Prevention

The cunning of the disease lies in the fact that in case of late treatment, the illness can develop into a more complex form, for example, pharyngitis, bronchitis, sinusitis, etc. Well, to avoid the unpleasant consequences caused by the disease, it is enough to know how vasomotor rhinitis is treated with folk remedies and what preventive measures must be followed.

To consolidate the results, it is necessary to carry out a daily massage of the wings of the nose, to be more often in the open air, to abandon the harmful habits in the form of smoking and eating spicy foods, as well as take vitamins and include fresh vegetables in the diet. In addition, it also requires:

As you know, the disease is easier to prevent than to cure, so if there are prerequisites for rhinitis, you should take note of preventive measures.