Inflammation of the nasal mucous membrane

introduction

An inflammation of the nasal mucosa occurs in most cases as part of a cold, and it does Rhinitis or colloquially called runny nose. This generally refers to an inflammation of the mucous membrane that can occur acutely or chronically and is caused by an infection with pathogens, by allergic reactions or by so-called pseudoallergic mechanisms.

The inflammation of the nasal mucosa is usually associated with a narrowing or occlusion of the upper airways. Often there is unilateral or bilateral nasal discharge, which can be slimy (serous) to bloody and purulent. A common symptom of inflammation of the nasal mucosa is sneezing, a rapid, reflex-like and involuntary expulsion of air through the nose triggered by the sneezing reflex, which removes nasal secretions, including dust and other foreign bodies, from the nose.

Anatomy of the nasal mucosa

The whole Nasal cavity including the Sinuses is equipped with the so-called nasal mucosa. This mucous membrane forms special Cilia on the surface (multi-row ciliated epithelium) from in which mucus-producing cells (Goblet cells), which ensure constant moistening of the nasal mucosa. The cilia move rhythmically in the direction of the nasopharynx, whereby dust particles, foreign bodies and pathogens are excreted.

The nasal mucous membrane can become inflamed by various causes, depending on the severity, a distinction is made between the acute inflammation of the nasal mucosa in form of Runny nose and one chronic sinus infection, the so-called Sinusitis.

Acute inflammation of the nasal mucous membrane

The colloquial as "common runny nose"called acute nasal mucosal inflammation is triggered in most cases by viruses and represents a harmless infection. There are a large number of viruses that can trigger such nasal mucosal inflammation, it is estimated that up to 200 different types of virus can cause"cold"Upper respiratory tract. Typically one goes acute rhinitis due to the swelling of the nasal mucosa with a runny nose and a congestion of the nose. As a rule, the inflammation of the nasal mucosa as part of a cold lasts about a week.

Developing a vaccine against acute rhinitis is currently impossible because there are too many different viruses that can be the cause of the disease.

Read more on the topic: Man flu

Treatment for acute sinus infection aims to relieve the symptoms and discomfort. For example, nasal sprays or drops and inhalations of salt water vapor can briefly clear the airway.

The typical symptoms of acute inflammation of the nasal mucous membrane are sneezing, itching, secretion of thick or thin nasal secretions (catarrh), burning pain caused by irritation of the nasal mucous membrane and swelling of the nasal mucous membrane and the associated obstruction of nasal breathing
Read more about the topic here: Swollen nasal lining

A foreign body can also be the reason for your nasal mucosal inflammation. - Find out more about one here Foreign matter in the nose

Nasal sprays for the treatment of acute inflammation of the nasal mucous membrane

Active ingredients like Tramazoline and Xylometazoline can be used very effectively against the symptoms of nasal mucosal inflammation. These active ingredients cause the mucous membrane to swell when applied to the nose using a spray (e.g. Nasic®) or in the form of drops and thus free the airways for a certain period of time.

The active substance Oxymetazoline also has a second mechanism of action, which certain viruses (Rhinoviruses) from entering the nasal mucosa. In this way, the active ingredient oxymetazoline can reduce the duration of an acute nasal mucosal inflammation by about a third of the time.

However, the therapy duration of seven days should not be exceeded for any of the named active ingredients in nasal spray or drop form, as this can lead to the nasal mucous membranes drying out and increased blood flow to the blood vessels in the nose. This can cause a so-called medical runny nose (Privinism), in which the nasal mucous membrane gets used to it and without the active ingredients it no longer swells to a normal level. This drug runny nose is caused by the fact that the active substances at certain receptors (alpha adrenergic receptors) cause the blood vessels in the nasal mucous membrane to constrict and thus have a decongestant effect. If the active substances are used for a long time (beyond ten days), the number of these receptors in the blood vessels decreases. At these receptors, however, the body's own messenger substance adrenaline naturally regulates the widening and narrowing of the vessels. By reducing the constricting effect, without stimulation by the drug, the vasodilating influences predominate and the nasal mucous membrane swells.

Therapy for such a privinism usually consists in simply stopping the nasal spray. This causes the chronic swelling of the nasal mucous membrane to recede after a while. In some cases, an underlying problem that caused the nasal spray to be used in the first place remains to be addressed. For example, if nasal breathing is generally poor, surgery on the nasal septum can be performed to alleviate the symptoms.

During pregnancy and breastfeeding, nasal sprays with the active ingredients mentioned are only recommended after medical advice, as they can also have a systemic effect in the body and are not limited to the nasal mucosa.

For babies and toddlers, the active ingredients are usually well tolerated in age-appropriate doses, for example Nasic® nasal spray for children, but use should be discussed with a doctor beforehand.

Read more on the topic: Nasic® nasal spray for children.

Allergic inflammation of the nasal mucous membrane

Inflammation of the lining of the nose can occur allergic be conditioned and often goes with other respiratory diseases like Inflammation of the sinuses (Sinusitis) and asthma hand in hand. The onset of allergic rhinitis usually occurs in early childhood. One distinguishes between seasonal rhinitis (e.g. hay fever), which occurs only in certain times of the year, year-round allergic nasal mucosal inflammation (e.g. House dust allergy) and work-related allergic rhinitis.

Allergic rhinitis has many different causes. The tendency to develop an allergy (allergic diathesis), is inherited. One theory suggests that the increasing number of illnesses is due to the increase in hygiene and the aggressiveness of allergens due to pollutants. This theory is supported by the fact that rural children, who have had extensive contact with animals and flowers, are less likely to suffer from allergies than urban children.

A allergy arises (in simplified terms) by the body's defense system a foreign substance (Allergen) recognizes as an alleged enemy on first contact and then tries to fight him on each new contact. Redness, itch, Sneeze and a runny nose are the typical symptoms caused by this reaction. The diagnosis of an allergic nasal mucosal inflammation can be made using a Prick tests be asked. Various allergenic solutions are dripped onto the skin of the person affected and the skin is scratched with a needle. If against one or more substances a Hypersensitivity (Awareness) is present, this is indicated by reddening of the skin with wheal formation. For small children, one can also Blood test to identify the allergen.

The therapy an allergic nasal mucosal inflammation consists in the Avoidance of the allergen (Parental leave), drug therapy (Treating symptoms) and one specific immunotherapywith which the allergic reaction is to be switched off in the long term.

For animal hair, allergen avoidance can be done with a Avoiding the animals can be achieved at a House dust mite allergy often help special covers and frequent cleaning and ventilation of the bedroom. It is recommended for people allergic to pollen after staying outdoors Change clothes and the Washing hair.

A specific immunotherapy (Desensitization) should be started as early as possible for a permanent insensitivity to achieve against the allergy trigger. This therapy is usually carried out over three years and usually consists of one monthly injection of the allergen in the back of the upper arm. With the consistent implementation over the entire therapy period, there is a significant improvement in the symptoms.

Please also read our topic on this Mite allergy

Medicines for allergic nasal mucosal inflammation

Medication with the active ingredient Cromoglicic acid are used locally in the nose, where they inhibit the release of inflammatory mediators such as histaminethat play an important role in the allergic reaction. However, the effect is delayed, so that these drugs already a week before the first pollen count must be applied.

Another group of substances are the so-called Antihistamines represent. These active ingredients (eg Levocabastine, Loratadine, ceterizine) also prevent the symptom-triggering effect of the messenger substance histamine. Antihistamines can be used locally by using Nasal sprays or systemically as tablet be applied. Older generations of this substance class seemed tiring (sedating), which is why modern antihistamines are particularly preferable for children, drivers, professionals, etc.

A very effective treatment for allergic nasal inflammation can be the use of topical glucocorticoids (Cortisone, e.g. Budenosid, Fluticason) can be achieved. Glucocorticoids suppress the allergic reactions in the nose, especially those constipation (obstruction), which is hardly influenced by antihistamines, for example. Systemically acting cortisone can be useful at the beginning of a treatment, but should only for a short time be given so no Side effects (e.g. Diabetes) may occur. In the local treatment with cortisone these side effects are not to be feared.

Nasal sprays with active ingredients that sympathomimetic work, relieve the nasal congestion, as they have a decongestant effect, but the other symptoms are not reduced. They should only be used for a short time.

Atrophic inflammation of the nasal mucosa

The Atrophic rhinitis is also under the name Ozaena or popular "Smelly nose"known. It is a disease of the nose in which the nasal mucous membrane of a Tissue shrinkage (atrophy) is affected. The name of a smelly nose results from the fact that the atrophic nasal mucous membrane is often of Germinate is populated that one unpleasant, putrid smell secrete. The mucous glands are also affected by the tissue shrinkage, which is why it becomes one dryness of the nasal cavity comes and goes black to yellow-green bark form. Consequences of this crust formation can Epistaxis, Headache or nasal pain and Suppurations be.

The smell from the nose is often not noticed by the person affected, as the olfactory nerves also atrophy and they get used to the smell. However, people with atrophic rhinitis are often shunned and suffered by others social exclusion due to the smelly nose odor. The disease is more common in women than men, is likely to be inherited, and usually begins during puberty. In some cases it comes through Tumors of the nasopharynx, through malformations of the nasal septum Abuse of nasal decongestant sprays or after surgery an atrophic inflammation of the nasal mucous membrane in the area of ​​the nasal cavity.

The atrophic rhinitis is with oily nose drops and -anoint treated to keep the nasal mucous membranes moist. The bark can be removed using a Nasal douche be removed and Vitamins A and E. can counteract tissue shrinkage in high doses. A complete cure of the disease is not to be expected, however, the symptoms can often be alleviated for a few years operative narrowing of the nasal cavity can be achieved.

Vasomotor inflammation of the mucous membranes

A Vasomotor rhinitis is an inflammation of the nasal mucous membrane caused by impaired regulation of the blood vessels in the nasal mucous membrane. The disease is also called NARE syndrome denotes what differs from the English Non-Allergic Rhinitis with Eosinophilia Syndrome derives. The cause of this inflammation of the nasal mucous membrane has not yet been clarified and in many cases leads to Sleep apnea syndromecausing respiratory arrest (Apneas) comes during sleep. Some theories suspect that extreme temperature changes, alcohol, stress, warm drinks, drug abuse or the abuse of nasal sprays lead to vasomotor nasal mucosal inflammation, as these influencing factors increase the blood flow to the nasal mucosal vessels and the mucous membrane swells.
You can find out more about the topic here: Swollen nasal lining

Sinus infection

An inflammation of the mucous membrane of the paranasal sinuses is called a so-called Sinusitis. The paranasal sinuses include Maxillary sinuses, Ethmoid cells, Frontal sinuses and the Sphenoid sinus and a distinction is made between an acute and a chronic form of sinusitis.

The acute form often arises from a common cold. As the swelling of the nasal mucous membrane prevents the discharge of secretions from the sinuses, suppuration occurs. The disease is often accompanied by symptoms such as fever, headache, tiredness and fatigue. A burning sensation in the nose is also common. Since acute sinusitis usually arises from acute rhinitis, bacteria are also responsible here in a few cases, usually a viral infection.

If a sinus infection lasts more than two to three months, it is referred to as chronic sinusitis. Often there is a chronic, mostly watery runny nose (Rhinorrhea), to long-lasting loss of smell (Anosmia), Nasal secretions flow down the throat and a dull pressure over the sinuses or in the area behind the eyes. In many cases, simultaneous growth of inflammatory polyps in the sinuses can be observed. Chronic sinusitis is carried out with the help of cortisone preparations (e.g. nasal spray or tablets). An operation is only necessary if the drug therapy does not lead to any significant improvement in symptoms. Sinus surgery is performed inside the nose and improves the condition in about 80 percent of cases.

Chronic sinus infection can spread to what is also called the lower airways Sinubronchial Syndrome referred to as. The constant flow of nasal secretions can lead to acute inflammation of the bronchi (bronchitis) come. In rare cases, it should be clarified whether a chronic sinus infection that does not heal despite therapy or keeps recurring (relapses) Cystic fibrosis present. Cystic fibrosis is an inherited metabolic disease that causes various functional disorders in different organs.