Abundant discharge from the nose and other symptoms: sneezing, cough, sore throat

Slime, which performs a protective function in relation to many cavities of our body, is simultaneously a protective, antiseptic substance and a substance that maintains a normal level of humidity. Nasal discharge refers to the category of such fluid media of the human body. Protection, moisturizing and maintaining the optimal temperature of the nasal cavity is due to the unique constituent components of mucus - enzymes, specific antibodies, protein compounds. The amount of mucous secretion produced in each person is individual, but an increase or decrease in the activity of secretions may indicate diseases, traumas, the onset of destructive changes in the mucous membrane of the nasopharynx.

[1], [2], [3], [4], [5], [6]

Epidemiology

Rhinitis, according to international statistics, is considered one of the most common conditions and diseases in the category of ENT-nosology.

It is impossible to find a person who would not suffer from a runny nose at least several times in his life. On average, about 12.5% of the world's population has been transferred earlier, or currently suffering from a form of rhinitis. The share of specific drugs that are purchased for the treatment of diverse types of nasal secretions is more than 30% of the total world market of medicines.

Statistics on certain types of rhinitis is not accurate, it is often compiled as an epidemiological overview for the description of rhinitis as an independent disease, for example, for the common cold of allergic etiology. In general, according to the latest WHO data, epidemiological indicators of rhinitis are as follows:

• The prevalence of rhinitis is from 10 to 25-40% of the population of all countries of the world.
• The information collected in 2015-2016, says that more than 600 million people in the world have consulted a doctor about the discharge from the nose.
• In a large list of species of rhinitis, AR - allergic rhinitis is the leader.
• Allergic rhinitis accounts for 22 to 35% of all diagnosed varieties of rhinitis (the figures vary depending on the territory, the country where the information came from).

Consider the statistical data of the most common type of common cold:

1. Allergy and including an allergic rhinitis suffer every fourth inhabitant of the planet.
2. Throughout the world, the dynamics of the increase in the number of diagnosed allergic rhinitis is observed every year.
3. The average age of a "typical" patient with allergic nasal secretions is 18-25 years. This indicator is "younger" every year, there is a large increase in rhinitis in adolescents, especially during the flowering season.
4. More than 25% of patients suffering from an allergic rhinitis are at risk for otitis media.
5. About 30-35% of allergic rhinitis can fall into the category of patients with asthma (bronchial asthma).
6. Early differential diagnosis of an allergic rhinitis reduces the risk of getting into the group of asthmatics by 40%.
7. Allergic rhinitis is considered the leader in the rating of all forms and forms of rhinitis non-infectious etiology.
8. Acute sinusitis is diagnosed in 25-27% of cases of pathology of the ENT system, it is the leader in the list of complications of a common cold caused by ARVI. Various types of sinusitis in the acute form are affected by about 10% of adult patients and more than 5.5% of all children who are in the field of vision of doctors.

Direct costs for the treatment of allergic muconasal secretions only in European countries exceed 1.5 billion euros per year. Statistics on the costs of treating allergic rhinitis in other countries is almost the same and tends to increase.

[7], [8], [9], [10], [11], [12], [13]

Causes of the discharge from the nose

The nasal cavity is constantly in need of protection, which is successfully performed by the mucous membrane of the nasopharynx. Discharge from the nose is a natural physiological process in which the moist environment in the cavity is maintained, heating and filtering the inhaled air from dust particles, allergens, bacteria and viruses. Abundant or altered in color, in consistency, mucus is a sign of many uncomfortable phenomena and illnesses.

Causes of discharge from the nose are divided into two large groups:

1. Coryza of infectious etiology.
2. Discharge from the nose of non-infectious etiology.

Forms - acute or protracted, chronic depends on the causes and other factors that affect the production of mucous secretions.

Reasons, list:

1. Rhinitis:
   • Acute form of rhinitis as a response to the "invasion" of an infection of a viral or bacterial etiology (influenza, scarlet fever, whooping cough, measles, tonsillitis).
   • Chronic form of rhinitis as a consequence of an unfavorable ecological atmosphere, a malfunction of the microcirculation of blood in the mucous tissue, as a result of acute, undetectable in time rhinitis.
   • The vasomotor form of rhinitis is the failure of an adequate neuro-reflex reaction to aggressive stimuli (odor, microtrauma, excessively cold inhaled air).
   • The allergic form is associated with the reaction of the nasopharyngeal mucosa to various types of allergens. Allocations can simultaneously protect the body from agents of allergic, bacterial and viral etiology.
   • Runny nose, provoked by taking medications, as a by-effect of treatment with medications that lower blood pressure (BP), drug overdoses.
   • A rare type of rhinitis is atrophic, developing against a bacterial inflammatory process (Proteus, Klebsiella).
2. Causes of discharge from the nose may be due to hypertrophic tonsils of the sky - adenoids.
3. Infectious, viral, bacterial diseases as complications of the underlying disease:
   • Otitis is an otitis.
   • Sinusitis is a sinusitis and its complication, a species - highmoritis (sinusitis)
   • Frontitis
4. The ingress of foreign bodies into the nasopharynx can cause an atypical form of discharge from the nose.
5. Nasal polyps.
6. Group of autoimmune diseases:
   1. Rheumatoid arthritis (rheumatoid arthritis)
   2. Psoriasis (psoriasis).
   3. SSD - systemic scleroderma.
   4. Granulomatosis with polyangiitis (Wegener).

In general, the causes of discharge from the nose can be combined into two categories:

• The local immunity of the nasopharyngeal mucosa has failed.
• The influence of external negative factors - allergens, cold air, microtrauma.

Elucidation and definition of a provoking cold, the diagnosis of the underlying disease helps to choose an effective course, treatment strategy, and neutralize the discomfort in the shortest possible time.

Discharge from the nose with genyantritis

Inflammation of sinus maxillaris (maxillary sinus) or maxillary sinusitis, has a variety of species. The process can take place either in acute, subacute, or in chronic form. Allocations from the nose with genyantritis carry the characteristic, clinical signs:

• Light, clear, without density (serous fluid).
• Slime greenish shade, thick.
• Yellow-green color of discharge with a characteristic odor.

Inflammation can develop immediately in both sinuses, but it also happens to be one-sided. The sinusitis that is triggered and not diagnosed in a timely manner is classified morphologically as follows:

1. The catarrhal form, when there is no discharge from the nose with sinusitis.
2. Purulent process, accompanied by a specific yellow runny nose in combination with sensations of raspiraniya, headache.
3. Sinusitis, which is provoked by polyps.
4. Atrophic form of sinus inflammation.
5. Hyperplasia of the nasal mucosa.

It should be noted that sinusitis most often develops as a consequence and complication of other individual diseases, including dental. Symptoms of sinus inflammation are quite obvious - high fever a week after the onset of the disease in combination with a runny nose and with headaches in the forehead or cheekbone. Palpation or percussive tapping in the area of the maxillary sinuses provokes an intensification of the pain symptom. Clinically significant sign is the yellow color of mucus, indicating the formation of pus. White, abundant discharge from the nose with sinusitis is characteristic of the initial stage of sinusitis. Such markers help the experienced physician in a timely manner to determine the nature of the inflammatory process and to promptly decide on effective treatment.

[14]

Discharge from the nose with a cold, rhinitis

In the practice of otolaryngologists, the discharge from the nose is called a mucous secret. In everyday life, it is customary to talk about the familiar physiological phenomenon - the common cold. In addition to these names, there are several more definitions - rhinorrhoea (rhinorrhea), mucus exudate, mukonasal secret, but the common formulation combining all the options is one - it's rhinitis.

Allocations from the nose in the rhinitis, rhinitis are different in the etiology, composition and volume of secretory fluids. Mucus is composed of specific components, among which the most interesting glycoproteins are mucus (mucins). It is the mucins that create the protection of the mucous tissue and are responsible for the gel-like consistency of secretions. In addition to glycoprotein mucins, the composition of mucus includes specific substances:

• Muramidase, an antibacterial substance - lysozyme (lysozyme).
• The antiviral component is interferon.
• The transferrin protein is lactoferrin, which is responsible for humoral immunity.

In the quantitative change in the discharge from the nose in the rhinitis, rhinitis looks like this:

1. 93-95% of water.
2. 1-3% of protein components.
3. 0.5-1% nucleic acids.
4. About 1% of enzymes.

Also in the list of constituent parts of the nasal mucus are neutrophils, which stain the nasal secret in a greenish hue, eosinophils indicating allergic causes of the common cold.

Mucous secretions perform various functions depending on the factor provoking them:

1. In rhinitis of allergic etiology, mucus envelops, binds and attempts to remove the allergen.
2. In diseases of the catarrhal character in muconasal mucus activates a specific protein (mucin), which has antibacterial properties.
3. In case of traumatic damage to the mucous tissue, the nasopharyngeal discharge performs a protective function, protecting and activating the regeneration process.

Etiologically, rhinitis is classified as follows:

• An allergic rhinitis.
• Allocations triggered by a virus or bacterial infection.
• Vasomotor rhinitis.
• Traumatic rhinitis.
• Medicamentous inflammation of the nasal mucosa.
• Atrophic rhinitis.
• Hypertrophic rhinitis.

The following diseases and conditions can be the provoking factors, the causes of rhinitis:

1. Congenital narrow nasal passages - lower, middle or lower.
2. Weak immunity.
3. VUI - intrauterine infections, which are clinically manifested by various symptoms, including a specific runny nose.
4. Hyperplasia of lymphoid, adenoids.
5. TBI (craniocerebral injury).
6. Acute respiratory infections, bacterial infection.
7. Curvature of cartilage septum nasi (nasal septum) of traumatic, physiological character.
8. Sinusit.
9. Foreign bodies in the nasopharynx.
10. Abuse of medications (vasoconstrictor drugs).

The types of muconasal secretions can be clearly differentiated by specific features, specified as a clinical sign by diagnostic methods. Treatment of the common cold is directly caused by the type of infectious agent or the cause of the primary disease.

[15], [16], [17]

Allergy discharge from the nose

Rhinitis of an allergic nature can be provoked by multivariate factors.

Allocations from the nose for allergies are classified as follows:

1. Seasonal intermittent discharge, rhinoconjunctivitis, hilar infection. Diagnostically differentiated according to the clinical manifestations and duration of the common cold - not less than 4 days during the week, in aggregate - about 4 weeks throughout the year in certain seasons.
2. Out-of-season, all-the-year-round, persistent allergic rhinitis. Nasal discharge of this nature differs from pollinosis by consistence, color and duration - more than a month during the year and more than 4 days a week.

Clinical manifestations of discharge from the nose for allergies are classified in this way:

• Allergic rhinitis in mild form, not interfering with activity and working capacity during the day and not disturbing sleep.
• Rhinitis in a moderate form, when sleep is already broken and allocation prevents a person from being active, fully and productively perform their functions throughout the day.
• Rhinitis in severe form is considered to be the most difficult in terms of anti-allergic therapy and is really capable of permanently depriving the patient of working capacity.

Allocations from the nose for allergies can be provoked by such factors:

• Exoallergenes are pollen of flowering plants, dust mites (house dust), allergy to domestic animals, mold allergens (fungi), microparticles of skin of domestic animals, insects.
• Professional provoking factors are chemical substances (household, professional chemistry), exhaust gases, synthetic polymers, products of oil refining.

Clinical manifestations of the common cold of the allergic etiology are:

• Problems with breathing, sensation of stuffy nose.
• Liquid in consistence, transparent discharge from the nose.
• Frequent attacks of sneezing, accompanied by pruritus.
• The causeless loss of the sharpness of smell, taste.
• Abundant mucous discharge, which is not similar to a runny nose, caused by a cold.
• Slime from the nose in combination with active lacrimation.

Allergic nasal secretions - this is not a disease, but one of the signs of an aggressive reaction of immunity to the invasion of the allergen. Treatment of a common cold of this nature is considered one of the elements of general antihistamine therapy.

[18], [19]

Nasal discharge in the cold

Reaction to cold air can manifest as a sudden cold, not justified by a cold, runny nose. Discharge from the nose in the cold is often confused with the usual symptoms of ARVI or ARI. However, such a runny nose quickly disappears, it is only necessary to get into a warmer room or just warm up. A distinctive marker of cold rhinitis is considered to be its "start" when the ambient temperature changes. Thus, pseudoallergia, which does not in fact have a provoking factor, begins with a physical phenomenon - a cold. The main danger of discharge from the nose in the cold is a careless attitude towards them. Most often people suffering from a cold cold are simply stored in handkerchiefs or paper napkins in the hope that this condition is temporary and will disappear on their own, without specific treatment. Nevertheless, the cold allergic rhinitis not diagnosed in due time can threaten urticaria, swiftly developing swelling, suffocation, up to Quincke's edema.

Check for cold rhinitis for "authentic" at home can be as follows:

• Observe the reactions of the body when leaving a warm room for cold air.
• Freeze a small amount of water and apply a piece of ice to any part of the skin on the body (forearm). If the itch is felt after 3-5 minutes, the skin is clearly visible on the skin, most likely it is really a reaction to the cold.

Discharge from the nose in the cold can be provoked by such causes:

• Previously transmitted infectious diseases - measles, mumps, rubella.
• Chronic diseases of the ENT system.
• Dysbacteriosis.
• Diseases of the liver and gallbladder, accompanied by intoxication of the body.
• Weakened immune system.
• Diseases caused by mycoplasma infections.
• Diseases of the pancreas.

A cold runny nose requires diagnosis and clarification of the provoking factor, in addition to the cold air itself. Symptomatic treatment is possible, but will not bring a lasting result. Moreover, the use of vasoconstrictors can aggravate the severity of the symptoms and provoke suffocation. An integrated approach to the therapy of rhinitis with signs of cold allergies can eliminate not only the discharge from the nose, but also the cause of their appearance.

Discharge from the nose with syphilis

More often, rhinitis caused by syphilis is diagnosed as a symptom of a congenital disease (in 75% of cases). The child is infected in utero, placental way from a mother already infected with syphilis. Allocations from the nose for syphilis are caused by pathological deformation of the anterior zones of the nose, less often the middle and posterior areas are damaged.

The clinical picture of congenital lues, specific symptoms of the common cold are as follows:

• Hypertrophic mucous membrane of the nose provokes noisy, shortness of breath.
• Catarrhal discharge from the nose with syphilis occurs in the baby, starting 2 weeks after birth.
• Obstruction of meatus nasi superior (upper nasal passage), meatus nasi medius (middle nasal passage) with abundant, serous discharge from the nose.
• Closer to the sixth week of the life of the baby, infected with lyues, a characteristic rhinitis with purulent contents appears.
• The skin in the zone of vestibulum nasi (nasal vestibule) is covered with bleeding cracks.
• On the upper lip, concurrent with the damage to the vestibule of the nose, ulceration (excoriation) is clearly visible.
• US of internal organs shows splenomegaly, enlarged liver.
• The mucous tissue of the digestive tract is covered with small ulcers, infiltrates.

Experienced pediatricians immediately notice the specific external "markers" of the congenital disease - syphilis. The baby can see such diagnostic signs:

• Wrinkled face with dry skin (senile face).
• Disproportionately large head with characteristic convex tubercles in the forehead area
• The head is abundantly covered with seborrheic crusts.
• Often in an infant infected with syphilis in utero, visually noted excessively concave, sunken nose (lornetovidny nose).
• Limbs - arms, legs of an atypically cyanotic shade.
• The kid lags far behind in development from his peers.
• The baby has difficulty breathing, the process of swallowing food because of persistent syphilitic rhinitis.
• In 65-70% of children with congenital lyues, hyperpigmentation of the skin is noted.

Diagnosis of syphilitic rhinitis, belonging to the category of congenital diseases, is helped by a characteristic rash (syphilis). The basic information is the triad Hutchinson (Hutchinson), a specific symptom that helps differentiate the discharge from the nose with syphilis and runny nose caused by other causes. Especially indicative of these three symptoms in the late period of the disease, when the child visually determined the following symptoms:

1. Eye damage is interstitial keratitis.
2. Degenerative lesion of the nervus acusticus (auditory nerve) and, as a consequence, deafness.
3. Dentes Hutchinson. Getschinsonovskie (barrel-shaped, with a characteristic notch) teeth.

The danger of syphilitic rhinitis in infants is the syphilitic infection of treponema (Treponema) nearby organs, the development of adenoiditis, otitis, adenophlegmons, deformities in the structure of the nose. The effectiveness of treatment directly depends on the early diagnosis, general health of the baby or adult patient, the presence of concomitant pathologies and therapeutic complex, including penicillin group drugs.

[20], [21], [22], [23], [24]

Risk factors

It is not possible to get rid of the cold for good. Discharge from the nose persecutes humanity from the beginning of the origin of life and is not considered a pathological symptom, provided that mucus is secreted as a tread and moisturizing physiological fluid. Risk factors are a description of situations, hazards that can cause a major, provoking atypical discharge, a disease.

In fact, risk factors refer to the generally accepted rules for the observance of a healthy lifestyle. Physiologically correct and comfortable for the body consider breathing a nose - not a mouth. Inside the nasal sinuses, the process of disinfection of the air, its moistening takes place. The first protection against the introduction of a bacterial or viral infection is muconasal mucus. If its little or too much is already a signal about the development of the disease, these signs can not be ignored.

Risk factors that can be noted as anxiety symptoms:

• Difficult breathing in or out, what the people call a "stuffy nose".
• Sensation of irritation in the nasopharynx, perspiration in the throat.
• Unpleasant, not too intense headache without fever (violation of venous outflow due to inadequate breathing).
• Tear.
• Suddenly, "starting" toothache as a sign of the spread of infection in the oral cavity.

The first "bells", the beginning of rhinosinusitis require immediate treatment, especially for young children, in the development of which breathing plays a major role.

We list the risk factors that can adversely affect the process of infectious infection, inflammation accompanied by a runny nose:

1. The decrease in immunity activity almost always leads to nasopharyngitis, rhinosinusitis with the slightest threat of viral diseases.
2. The most vulnerable in the sense of developing a pathological rhinitis are children under 5-7 years old.
3. In the ways of spreading infection with a bacterial or viral infection, the air-drop path and the contact path (diseases of "unwashed hands") are always leading. Therefore, in a season when large-scale acute respiratory viral infections are expected, influenza should be limited to visiting places with a large population of people.
4. Non-compliance with the rules of personal hygiene increases the risk of diseases in 1,5-2 times.
5. Poorly ventilated rooms, dry air, dust exacerbate the discharge from the nose. Humidification, systematic cleaning, dust neutralization, on the contrary, greatly facilitates breathing, especially when it comes to allergic rhinitis.

It should be mentioned that to activate mukonazalnye allocation can stress, banal hypothermia, excessively acute or sour food, too long stay in the open sun. It is not so difficult to protect yourself from these dangerous factors, the main thing is to support the work of the immune and nervous system and take care of the purity of the inhaled air.

[25], [26], [27], [28], [29], [30]

Pathogenesis

Rhinitis or varieties of rhinitis are primarily inflammatory pathologies. Clinically, rhinitis is manifested by swelling of the mucous tissue of the nasal cavity and muconasal secretions of various variants in terms of volume, composition and consistency. The pathogenesis of the discharge from the nose is a process that develops gradually from the initial stage to the acute phase. Without proper treatment, inflammation provokes a chronic runny nose and changes in the entire respiratory system of the body. The mechanism of development is that timely undiagnosed rhinitis can cause serious complications in the bronchopulmonary system, disrupt the function of the heart, provoke otitis, sinusitis, tracheitis, laryngitis, bronchitis and many other diseases.

The pathogenesis of atypical discharges from the nose is as follows:

• Nasal cavity due to secreted mucus normally performs a protective, moisturizing and antiseptic function.
• The inflammatory process in the nasal mucosa can develop with the combination of several unfavorable factors - hypothermia and viral infection, weakened immune response and bacterial invasion, nasal injury and the season of allergens.
• Mucous tissue of the nasopharynx includes a variety of bloodways, vessels, the work of which changes dramatically in inflammation or trauma.
• Response to the invasion of the infectious agent is a decrease in blood supply, swelling of the lining tissue.
• The mukonasal secret, exceeding the normal volume (more than 50 ml per day) is compensated.
• An acute condition is characterized by superficial nasal secretions, when the amount of mucus can reach up to 1.5 liters per day.
• A huge amount of secretions performs the function of moistening, neutralizing and removing bacterial, viral, allergic agents.
• Chronic rhinitis is dangerous because the specific composition of the discharge gradually changes, mucin ceases to function as an antibacterial component and begins to impart a viscosity to the nasal secretion.
• Stagnation of discharge in the nasal cavity is a favorable condition for the further multiplication of pathogens. Mukonazalnye "plugs" - an ideal environment for microorganisms that support the inflammatory process.

The pathogenesis of rhinitis development can be divided into three stages:

1. The stage of the first reaction to the stimulus, the reflex, the short-term stage.
2. The catarrhal period, when quite abundant mucous discharges begin to impede the breathing process.
3. The stage of bacterial or viral cold, when the nasal secret acquires a specific consistency, color and becomes a significant clinical symptom for differential diagnosis of the underlying disease.

The length of the acute form of the rhinitis rarely exceeds 2 weeks, chronic rhinitis can last for months, causing many problems and provoking a repeated inflammatory process in the nasal cavity.

[31], [32], [33], [34], [35], [36], [37], [38], [39]

Symptoms of the discharge from the nose

Rhinitis may be a short-term functional condition, but also the muconasal secret is one of the signs of an evolving disease.

Symptoms of discharge from the nose - this is clinical information that helps the doctor differentiate the disease and in time to prescribe effective treatment.

The most common cause of a cold is respiratory nosology, which also requires separation according to etiological factors. Competing for the championship in the list of causes and allergic rhinitis. Therefore, the symptoms of discharge from the nose can give a primary direction for diagnosis and detection of a true rhinitis-provoking disease.

Let's list the signs and possible reasons:

• Runny nose "starts" with abundant transparent secretions only when a person enters the zone of cold air. This is the so-called cold allergy.
• The normal rhythm of nasal breathing is disrupted, accompanied by the nasal congestion. Respiration is not restored even after the use of vasoconstrictor nasal agents. There is a periodic headache, worsening sleep. Zalozhennost and meager nasal secretions, or on the contrary - copious stagnant discharge, which accumulate and often fall into the nasopharynx - these are signs of chronic rhinitis.
• Both nostrils are laid, the person continuously sneezes, after which there may be thick discharge. This is repeated in series in response to a certain stimulus. The above symptoms of discharge from the nose most often indicate a vasomotor rhinitis.
• Before the sneezing reflex and liquid clear discharge appear, a person feels itching in the nostrils. Such a symptom in combination with a watery rhinitis is the first sign of rhinitis of allergic etiology.
• Sensation of a dry nasal congestion, loss of smell, headache, thick discharge with a characteristic yellowish tinge, odor from the nose - such manifestations may be signs of an ostreat (atrophic rhinitis).
• Difficulty breathing, often - suffocation in combination with obvious symptoms of intoxication and pain in the heart, characteristic films in the nasopharynx - signs of a dangerous condition caused by diphtheria bacillus.
• High body temperature, copious rhinitis, headache, aches in joints and muscles - symptoms of a viral disease.
• Rhinitis accompanied by inflammation of the conjunctiva, lacrimation and a specific rash in the nasolabial triangle are manifestations of measles.

Independently to differentiate symptoms of discharge from the nose is rather difficult, these are the functions of ENT doctors and general practitioners. Runny nose, which does not stop more than a day and causes obvious discomfort, should be the reason for seeking medical help.

[40]

First signs

The classic picture of the beginning cold is discomfort in the nostrils, shortness of breath, reflex sneezing and atypical discharge from the nose. Most often, the first signs of rhinitis are also symptomatology of the underlying disease causing rhinorrhea.

Inflammation of the mucous tissue of the nose begins with a slight swelling, which can be overlooked during the first hours of the process. Then there is a slight itch, burning, also often ignored by man. The initial period of discharge from the nose is especially specific in toddlers, when the mother notices that the child is restless, moody and less active in taking the breast when feeding. This is sometimes the only first signs of developing cold in infants.

The main initial manifestations of rhinitis are as follows:

• Swelling and stuffiness of the nose.
• The sternutatio series is a sneeze, an adequate response to the emerging inflammation process.
• Reduction of odor sensations due to the stuffiness of one or both nostrils.
• Isolation of mukonasal fluid, the onset of a common cold.

Rarely in the first stage rhinitis is combined with high fever, involuntary lacrimation and painful symptoms in the throat. If the patient makes such complaints, there are all signs of a viral infection or inflammation of the bacterial etiology in acute form.

Rhinitis has many species and subspecies and, in fact, in itself is a symptom, not an independent disease. His clinic is directly related to the form and stage of the disease and can be manifested as copious, transparent secretions, and rejection of purulent contents from the nasopharynx.

The nature and specificity of the signs of the common cold is an important diagnostic information that enables the doctor to accelerate the differentiation of pathology and prescribe an effective course of therapy. Undeclared first signs - a high probability of transformation of the disease into a chronic form, in which the process gradually spreads to the nearby zones of the respiratory system. Complicated rhinitis is a sinusitis, a rhinopharyngitis, a laryngitis and others, considerably reducing quality of a life, diseases.

Read also:

• The nature of discharge from the nose: dense, thick, foamy, liquid, mucous, bloody
• Color of discharge from the nose: yellow to black

[41], [42], [43], [44]

Discharge from the nose in the morning

The morning runny nose is a sure sign of dryness and irritation of the mucous tissue of the nasal cavity. Discharge from the nose in the morning can be plentiful, but also mucus is rejected and small portions when sneezing. This state is associated with certain factors:

• Allergic reaction, most often to dust, feather pillows.
• Reduced humidity in the room.
• Excessively cold air in the room where the person was all night.
• Allergy to indoor plants in the room.
• Drug allergy as a complication of taking specific medications.
• Chronic rhinitis.
• Sinusit.
• Polyps, neoplasm in the nasal cavity.
• Traumatic or congenital curvature of the septum of the nose.
• Adenoiditis.
• Vasomotor rhinitis.

Discharge from the nose in the morning, if they are caused by an allergy, almost always start with sneezing. Thus, the body tries to reflexively refresh itself from allergens. Morning rhinitis caused by polyps, adenoids is usually preceded by night snoring. Curvature of the septum of the nose, in addition to the morning discharge of mucus, may be accompanied by periodic nasal bleeding, a headache due to oxygen starvation of the brain. Vasomotor rhinitis is characterized by a specific nasal tone of voice, constant nasal congestion, lack of sensitivity to smells. If the runny nose becomes a constant companion in the morning, reduces daytime productivity and causes discomfort, it is necessary to be examined, find out the cause and start treatment for the underlying disease.

[45], [46], [47]

Sneezing and discharge from the nose

Runny nose, accompanied by sneezing, is an active reflex action, helping to remove the irritating element from the nasopharynx. Sneezing and discharge from the nose, as a rule, are considered the first symptoms of an allergic reaction.

The combination of such physiological acts indicates that cavitas nasi (nasal cavity) and pharynx (pharynx) undergo a process of purification from foreign microparticles, pathogenic organisms. Also, sneezing and discharge from the nose can be a reaction to an unusual odor or directional flow of light, including sunlight.

Slime, secreted from the nose, has a different consistency and color, depending on the provoking factor (serous, dense, purulent, bloody discharge).

Causes of a combination of cold and sneezing:

• Allergic reaction to dust particles, animal hair (allergic rhinitis).
• Pollinosis (an allergy associated with the pollen of flowering trees, plants).
• Individual sensitivity to certain irritants, without signs of pathology.
• Vasomotor rhinitis.
• Sinusit.
• The onset of the inflammatory process in the ENT organs.
• Sharp change of air temperature.
• Ingestion into the nasal cavity of a foreign substance.

The most disturbing combination of mucus and sneezing with such accompanying symptoms:

1. General malaise, joint aches.
2. Headache.
3. Irritation, perspiration in the throat.
4. Difficulty in swallowing food and liquids.
5. Increased body temperature.

Similar signs indicate the onset of an inflammatory process of viral or bacterial etiology. Inflammation can be stopped with the timely provision of care - examination of the nasopharynx, the appointment course of antiviral or antibacterial therapy. Allergic rhinitis and sneezing should also not be considered an easy malaise. Complex antihistamines will help to restore adequate functioning of the immune system and prevent the development of polyallergy.

Coughing and discharge from the nose

Rhinitis without hyperthermia, chills, accompanied by a cough, signals a chronic inflammatory process in the systema respiratoria - respiratory organs. Most often coughing and discharge from the nose provokes rhinopharyngitis - simultaneous inflammation of the nasalis pharyngis (nasopharynx) and throat. Causes of rhinopharyngitis:

• Rhinovirus infection.
• Inflammation of bacterial genesis.
• Enterovirus.
• Streptococcal infection.
• Measles virus.
• Allergy, chronic allergic rhinitis in lingering form.
• Complication after acute form of rhinitis.

Clinical manifestations of rhinopharyngitis:

• Difficulty breathing, stuffy nose.
• Persistent headache, often of a pulsating nature.
• A series of sneezing reflexes.
• In the initial stage - transparent discharge of liquid consistency.
• In the second stage of rhinopharyngitis, the runny nose becomes permanent, the mucus acquires a viscosity.
• Lack of appetite.
• Morning feeling of weakness, fatigue (bad sleep).
• Irritation in the throat, cough.
• Pain or sensation of stuffiness in the ears.
• Changes in the voice timbre (nasal).
• Sore throat when eating.
• Pain in the submandibular lymph nodes.
• Periodic increase in body temperature.

When examining the nasopharynx, redness, swelling and a purulent coating on the pharyngeal mucosa are clearly visible. Similar symptoms are demonstrated by allergy rhinopharyngitis, but unlike the usual form of the disease, the mukonasal fluid and nasopharyngeal irritation disappear under the condition of neutralizing the allergen. Coughing and discharge from the nose complete the clinical picture and make it possible to stop the disease without the risk of its transition into a protracted, chronic inflammatory process.

[48], [49], [50], [51]

Discharge from the nose and throat

A rhinitis is not a pathological condition or symptom as long as the nasal mucus is excreted and easily departs (vysmarkivaetsya). However, there are diseases in which the muconasal secretion accumulates and enters the nasopharynx (drains along its back wall). To the bacteria already present in normal physiological volumes, an additional "dose" of pathogenic microorganisms is attached. Discharge from the nose and throat is a sign of a locally developed disease that has spread ascending or descending. The result - a violation of the balance of microflora, the activation of the inflammatory process and the spread of infection to nearby respiratory organs. As a rule, the simultaneous accumulation of mucus in the nasal passages and throat is a post-nasal process, caused by such causes:

Causes of simultaneous congestion of mucus:

1. Inflammatory process in the walls pharynx (pharynx), pharyngitis.
2. Inflammation of sinus paranasales (accessory sinuses of the nose), sinusitis.
3. Retrondasal angina, inflammation of adenoides, adenoiditis.
4. Chronic bronchitis (less often - COPD).
5. Polyps.
6. Allergy.
7. Previous acute respiratory viral diseases.
8. BA (bronchial asthma).
9. Chronic gastrointestinal disease.
10. Endocrine diseases.

Discharge from the nose and throat can be a consequence of the impact of household, nutritional factors:

• Eating too hot food, or, conversely, excessively refrigerated, frozen foods.
• Smoking.
• Insufficiently good working conditions, polluted air, industrial dust.
• Non-compliance with the normal drinking regime, thirst for a long time.

The elimination of domestic causes is possible without medical intervention. If the congestion of mucus in the throat and nasal passages lasts more than 10-14 days, the condition interferes with productive work and reduces the quality of life, it is necessary to undergo examination and begin treatment.

Pain and discharge from the nose

The pain symptom often indicates an acute inflammatory process in the sinus paranasales - the sinuses of the nose. From the zone of inflammation localization, the name of the disease, sinusitis, also occurs. More than 50% of diagnosed cases of sinus inflammation are provoked by bacteria - Pfeiffer's stick (Haemophilus influenzae) or streptococci.

Sources of bacterial infection may include the following conditions:

• Diseased diseases of the dental category as a permanent source of bacterial infection.
• Allergic reactions (rhinitis of allergic etiology).
• Polyps of the nose.
• Mechanical damage to the nose (injury).
• Adenoids.
• Congenital deformities of the nose.

Sinusitis is considered to be one of the most severe inflammation symptoms, which is accompanied by such symptoms:

• Pain and discharge from the nose of a different consistency, depending on the stage of the process.
• Febrile state, fever.
• Insufficiency of breathing.
• Periodic expiration of purulent exudate from the nose.
• Disruption of perception of smells, taste.
• Signs of general intoxication of the body, nausea, vomiting.
• Pain can be localized in the area of the source of bacterial infection - in the jaw (upper or lower), and also give to the zone of the temples.
• If the frontal sinus becomes inflamed, the pain symptom irradiates upwards, into the forehead region.
• Pain and discharge from the nose are not always "neighbors". The separation of mucus can be difficult, and this aggravates the general malaise and symptoms of sinusitis.

Treatment of acute stage consists in immediate provision of outflow of mucous secretion, purulent contents. Simultaneously with these procedures, intensive antibiotic therapy is carried out.

Abundant discharge from the nose

Rhinitis, rhinitis passes through the typical stages of development:

1. Period of dryness and irritation of the nasal mucosa.
2. Wet stage, when the allocation is abundant and have a serous consistency.
3. Isolations containing pus, the so-called bacterial stage.

However, there are diseases for which abundant discharge from the nose is considered a characteristic clinical symptom. This is an allergy and vasomotor rhinitis. Let us examine in detail these nosologies, their manifestations.

BMP (vasomotor rhinitis) is based on the dysfunction of the vascular system, changes in the adequate reactive response to various stimuli. The causes of vasomotor rhinitis, when there are abundant discharge from the nose, are as follows:

• Adenoids.
• Chronic respiratory failure due to deformation of the nasal septum of a traumatic, congenital or compensatory nature.
• Pathological dysfunction of the endocrine system.
• Some diseases of the gastrointestinal tract.
• Nasal polyps.
• VSD (vegetative-vascular dystonia).
• Neurotic diseases.

Allergies, which are also accompanied by abundant discharge from the nose.

Most often, the allergic response of the immune system is associated with the specifics of the season - the flowering of trees, grasses, cereals. Seasonal rhinitis does not do without a permanent cold, abundant and frequent, causing pain and interfering with breathing and working normally. Clinical manifestations of seasonal allergies:

• Itching, sneezing, lachrymation.
• Abundant secretion of clear exudate from the nose.
• Runny nose and tear are paroxysmal, start with an obvious allergen-trigger, then repeat without contact with the stimulus.
• Inability to breathe normally, constant "blockage", stuffiness of the nose.

An abundant runny nose is fraught with a viral infection, especially in the initial period of inflammation. Typical signs of viral etiology:

• Temperature increase.
• Strong rhinitis with excretion of clear mucus.
• Symptoms of general malaise, weakness, aches, headache.
• Increased lacrimation, pain in the eyeballs.

Hyper secretion of nasal mucus can be provoked by various factors, to identify the main and accurately diagnose diseases - this is the prerogative of an ENT specialist.

[52], [53], [54]

Discharge from the nose and eyes

The condition, which many call a cold, entails a series of characteristic symptoms:

• Discharge from the nose and eyes.
• General feeling of weakness, weakness.
• Periodically, the body temperature rises.
• Often the common cold is combined with a cough.

In fact, the discharge from the nose and eyes is provoked not only by ARVI or other respiratory inflammatory processes. The reasons for the simultaneous release of fluid from the nasal passages and lacrimal ducts:

• Allergy, seasonal, chronic, food, medicamentous.
• Conjunctivitis as an independent disease.
• Sinusit.

Discharge from the nose and eyes are due to anatomical connection of the paranasal sinuses and ductus nasolacrimalis (tear ducts). If the nasopharynx is inflamed, the swelling of septum nasi (nasal septum) inevitably occurs, the consequence of this pathological chain is a violation of the normal drainage function of excreting mucus. The result is a mechanical pressure on the tear ducts in particular and on the orbit as a whole. Reaction - simultaneous allocation of accumulated nasal and teardish exudate. There are also cases when, on the contrary, the lacrimal nasal passage is blocked, then drainage occurs more due to the nose and muconasal secretions. It should be noted that for ARVI, especially in the initial stage, the simultaneous tears and nasal mucus are not characteristic. Rather, it is possible to suspect rhinitis of an allergic etiology or inflammatory process in the saccus conjunctivae (conjunctival cavity). A more accurate diagnosis requires the collection of an anamnesis, an analysis of the clinical picture of the condition. After the examination, an adequate treatment is identified.

[55], [56]

Discharge from the nose in the child

A child's runny nose always worries caring parents. Discharge from the nose in a child can not be considered a disease, rather it is the protective work of the mucous tissues of the nasal cavity. Warn complications, but start instillation and other medication procedures without consulting a doctor means to reduce the activity of local immunity. Remember that the nasal liquid performs an antiseptic, moisturizing and harmful function. To interfere with this process is to harm the body's natural work. Doctors diagnose rhinitis in children in every third case from all visits to the pediatrician and prescribe treatment only in the presence of serious complications.

When discharge from the nose in a child is considered normal?

• The child got into a dusty, polluted room. Mucus is a method of cleansing the nose and trying to resume the normal breathing process.
• The baby gets a little fluids. Extinguishing the mucous membrane can lead to tissue irritation, sneezing, and a runny nose.
• The initial stage of respiratory infection is also not considered a pathological condition. At this stage, vasoconstrictive drugs are ineffective.
• Small particles of food have got into the baby's nose, most often the kid reacts with a runny nose to spices or food, which has a strong smell.

Nasal discharge in a child is normal, if the slime has a liquid consistency, a clear color and a small amount.

A greenish hue, a yellow or brown runny nose, a smell of mucus are alarming signals indicating the inflammation of a viral or bacterial beginning.

Alarming signs accompanying a runny nose in a child:

• Bad sleep due to stuffy nose.
• Strong puffiness around the nasal sinuses.
• Lack of perception of odors.
• Heat.
• Headache, nausea.
• Increased tear.

In these cases it is necessary to visit a doctor and begin treatment in order to avoid complications. You also need to be attentive to mucous exudate in newborn babies and toddlers under the age of one and a half years. Their respiratory system is only forming. A stuffy nose, shortness of breath can negatively affect the overall development of the child.

[57]

Stages

Rinith has the property of developing according to its own "rules." The stages of the process are sufficiently well studied and are described thus:

1. First step. The so-called dry rhinitis.
2. The second stage. Serous rhinitis.
3. The third stage. Purulent mucous discharge from the nose.
4. The final stage. Recovering, mucus is transparent, excreted in normal amounts.

Stages of development of inflammation of the nasal mucosa can proceed without obvious signs in cases where the runny nose was stopped in time, at the first stage.

In addition, in ENT practice, it is customary to describe the stages of rhinitis as follows:

• Reflex, vasotonic stage, lasting several hours, less often 1 day. Vessels of the nasal cavity react sharply to the stimulus - temperature or pathogen, the mucous membrane is pale, swollen and drained.
• The stage of invasion of viruses or allergens. Lasts 2-3 days. There are additional signs of malaise - headache, ears and nose are laid, develops hyposmia. Runny nose acquires a color shade and changes the consistency.
• Bacterial stage, started forms of rhinitis. Slime yellowish, green hue, viscous, with a smell. The stage lasts 3-4 days if the immune system is active and symptomatic therapy is performed.
  The stages of the common cold can serve as one of the clinical signs, but they are never a basic symptom for diagnosis. Differential diagnosis requires a more detailed picture, clarification of health markers of nearby ENT organs and parameters of the patient's general condition.

[58], [59], [60], [61]

Forms

Infectious, allergic and non-infectious genesis of the common cold is divided into species.

The main types and forms of rhinitis:

1. Rhinitis in acute form, flowing with pronounced signs of the underlying disease.
2. Chronic form of the common cold is a prolonged pathological process, fraught with serious consequences for the nasopharynx and respiratory organs.

The species and subspecies of rhinitis are classified in this way, according to these characteristics:

Infectious etiology:

• Acute rhinitis.
• Chronic prolonged runny nose - catarrhal, hypertrophied, atrophic rhinitis, ozena.
• Vasomotor noninfectious genesis rhinitis - neurovegetative rhinitis, allergic rhinitis.

According to the pathogenesis, the species are distributed in this way:

• Serous rhinitis.
• Exudative rhinitis.
• Purulent sinusitis.
• Catarrhal rhinitis.
• A productive cold.
• Proliferating sinusitis.
• Hyperplastic sinusitis.

Also there are names of subspecies - a medicinal rhinitis, hormonal, staphylococcal, professional, psychogenic, idiopathic, NAERS - eosinophilic rhinitis.

According to the morphological principle, rhinitis is divided into the following types:

• Catarrhal runny nose.
• Rhinitis is hypertrophic, including diffuse and limited subspecies.
• Atrophic rhinitis - diffuse, simple, limited, fetid (ozena).

The most extensive group of chronic colds, it is most difficult to treat. To prevent and avoid the development of protracted discharge from the nose is possible at the initial stages of inflammation of the nasal mucosa. For this, it is necessary to consult with a doctor, to examine and follow the recommendations of an ENT specialist.

[62], [63]

Complications and consequences

The most dangerous, which can lead to untimely diagnosed lingering rhinitis - is complications, the spread of infection from the nasal cavity up to the nearby ENT organs, as well as the descending way into the broncho-pulmonary system:

Consequences and complications of rhinitis:

• Sinusitis and its subtypes - emoitidite, sinusitis, pharyngitis, frontalitis, sphenoiditis, hyperplastic sinusitis, purulent, fungal, allergic, odontogenic sinusitis.
• Inflammation of the larynx is laryngitis.
• Inflammation of the ear canals - otitis.
• Bronchitis.
• Bronchotracheitis.
• Chronic tonsillitis.
• Abscesses in the nasal cavity and mouth.

Less common are the effects and complications of the common cold, caused by a protracted course of the main, provoking rhinitis, disease. The list of other risks is as follows:

• Sprouting in the nasal cavity of benign genesis - polyps.
• Dacryocystitis is a chronic inflammation of the tear ducts of bacterial etiology.
• Persistent lack of perception of odors - hyposmia.
• Intrauterine hypoxia of the fetus in pregnant women suffering from trophic, vasomotor runny nose.
• Infringement of an occlusion of a teeth at children till 3-4 years because of insufficiency of breath and kompensatornoj deformations of jaws.

In addition, the consequences and complications can affect the dentoalveolar system. A constant source of infection produces the spread of bacteria and increases the risk of caries, stomatitis, periodontal disease. Serious negative risks of the development of the pathological process can be minimized with the help of regular preventive visits of the attending physician and timely started treatment of the first signs of malaise.

[64], [65], [66], [67]

Diagnostics of the discharge from the nose

To determine the triggering coryza, to find the root cause is not an easy task facing the ENT specialist. Diagnosis of discharge from the nose at first glance is quite simple, because the character of the mucus can make an initial conclusion. However, the difficulty lies in the fact that the runny nose is immediately treated, and independently and with the help of popular vasoconstrictors. Thus, an important symptomatic picture is erased and rhinitis often becomes a latent chronic form fraught with complications.

The basic principles on which diagnostics of discharge from the nose are based are as follows:

• The doctor collects anamnestic information.
• Excludes congenital pathology of the nose, ENT organs with visual inspection. It may be necessary to confirm the radiography.
• A rhinoscopy can be prescribed.
• Purulent mucus is likely to require the delivery of tests (OAK, blood biochemistry, urinalysis), tomography of the sinuses of the nose.
• Transparent abundant mucus in combination with increased lacrimation induces a version of allergic rhinitis. In this case it will be necessary to take allergens, including IgE in vitro.
• Rhinitis of infectious genesis needs to determine the type of bacteria, it will be necessary to pass bacterial culture from the nose.
• Doctors increasingly began to use a provocative nasal test - rhinomanometry.
• Very rarely, histology is prescribed for suspected oncology in the nasal cavity.

The most difficult is differential diagnosis of chronic forms of rhinitis. The procedure takes time, the appointment of many types of surveys, without which it is impossible to begin an adequate, effective treatment of the underlying cause of the common cold.

[68], [69], [70]

Analyzes

A list of additional types of surveys may include analyzes.

In rhinitis, such tests are prescribed:

• General blood test, especially important leukocyte formula
• General urine analysis.
• Bacterial sowing from the throat and nasal cavity.
• Assays for the detection of an allergen
• It is extremely rare - histology.

In general, the diagnosis of the common cold does not require multiple versions of laboratory tests. Since the nose is a cavity organ, to identify the cause of the disease, the physician can use the help of instrumental methods to identify the symptom.

[71], [72]

Instrumental diagnostics

To clarify the root cause of the disease, ENT doctors need instrumental diagnostics.

Types of instrumental examination of rhinitis:

• Rhinoscopy (internal examination of the nasal cavity).
• Endoscopy of the nose.
• Radiography of the adnexal areas of the nose (sinus).
• Diaphanoscopy.
• Seldom is CT scan - computer tomography with suspicion of massive proliferation of polyps, oncological disease of the nasal cavity.

Instrumental diagnosis of discharge from the nose is part of the examination complex with symptoms similar to chronic, neglected processes. In general, rhinitis is diagnosed by visual examination, collection of anamnesis and does not require complicated instrumental methods to detect the cause of the common cold.

Differential diagnosis

Rhinitis has many forms, species and subspecies. By itself, it is not considered a disease, but it can be evidence of a hidden pathology that does not show any other signs.

Differential diagnosis of rhinitis is conducted to exclude such nosologies:

• Diphtheria.
• Scarlatina.
• Syphilis.
• Streptococcal massive infection of the nasal cavity and mouth.
• Odontogenic diseases (stomatology).
• Perch.
• Tuberculosis.
• Gonorrhea.
• Oncological diseases of the nose and larynx.
• The established form of pneumonia.

Differential diagnosis of allergic rhinitis is needed to separate such types of disease:

• Pollinosis.
• Out-season allergic rhinitis.
• Allergic tracheitis.
• Rhinitis of infectious genesis by signs similar to allergy.
• Vasomotor allergic rhinitis.
• Rhinosusopathy.

Distinguish between the preliminary etiologic signs of the cold helps the consistency and color of mucous secretions:

• Transparent copious exudate is a sign of allergy
• Dense viscous mucus of green color - a harbinger of a viral infection.
• Yellow discharge - a sign of purulent process in the sinuses of the sinus sinusitis, or a variety of sinusitis - frontal, etmoiditis.
• Fetid smell of mucus - ozena.

Precise diagnosis of rhinitis types helps to assign an effective course of treatment and improve the overall health of the patient.

Treatment of the discharge from the nose

The main task of terpenitis is to alleviate the drainage function, to normalize breathing.

Treatment of discharge and nose can be as follows:

• Ensure the outflow of mucus from the nose.
• Removal of edema of the mucous tissue of the nasal cavity.
• Relief and normalization of free breathing with the nose.
• Prevention of the development of rhinitis and its transformation into a chronic form.
• Treatment of the main, provoking a runny nose, disease.

Prevention

Ordinary rhinitis is not considered a serious symptom, but its complications are easier to prevent than to treat the effects in the form of otitis, tracheobronchitis, rhinopharyngitis, laryngitis (laryngitis), frontalitis and other serious diseases. Prophylaxis of discharge from the nose and minimization of the risk of development of pathologies of the respiratory system consists of the following measures:

• Carry out prophylaxis of respiratory diseases of viral or bacterial origin:
  • Avoid sudden hypothermia, sudden changes in food temperature (in the heat, too cold drink).
  • Carry out hardening procedures, to teach them children.
  • Regularly ventilate the living and working area.
  • During epidemics of ORVI, sanitize air in rooms with the help of aerosols, ethereal antiseptic, antiviral oils, and conduct wet cleaning.
• In time, consult a doctor with the first uncomfortable symptoms, especially with a prolonged runny nose with atypical color and consistence secretions.
• Systematically take care of the stable function of the immune system and gastrointestinal tract (gastrointestinal tract).
• Observe the hygiene of the nasal cavity and mouth.
• During massive colds, avoid visiting crowded places and activities.
• If the disease has already begun, adhere to a special water regime to avoid dryness of the mucous membranes of the nose, nasopharynx (irrigation, rinsing).
• On the recommendation of the treating therapist to systematically take vitamin preparations (multicomponent, including the necessary for the immune system trace elements).
• During the start of the disease, strictly observe the regime of individual use of hygiene items in order to reduce the risk of spreading the infection to others.
• During mass influenza diseases, protect the nose and mouth with a special mask, change it in the recommended by the doctors mode.
• During the flowering of plants, trees and grasses, try to avoid even the slightest contact with possible allergic carriers.
• Follow the tone of the vascular system of the mucous membrane of the nasopharynx, periodically rinse the nose with special saline solutions.
• Refuse from harmful to the whole body habits - smoking, abuse of alcohol-containing drinks, energy.
• Pass an annual check-up in the clinic, keep in touch with the treating therapist.
• Do not engage in self-treatment in cases where discharge from the nose lasts more than 10-12 days.

Prevention of various types of rhinitis differs little from preventive measures to prevent any disease. The main thing is to follow simple rules, be attentive to the signals of your own organism.

[73], [74], [75]

Forecast

As a rule, the runny nose associated with temporary physiological conditions passes by itself, without prejudice to human health. The prognosis for rhinitis is generally favorable in 85-90% of cases. Exceptions are such categories of patients:

• Infants (up to 1, 5 years old). Babies with nasal secretions require more careful treatment and care in order to avoid respiratory failure.
• Food workers (food, canteens, cafes) - the risk of contact spread of infection by viral, bacterial etiology.
• People of advanced age.
• Patients who have a history of serious chronic diseases, when there is a threat to disrupt the function of the cardiovascular system due to inadequate breathing.

In addition, an optimistic forecast can be postponed in such situations:

• Diagnosed inflammatory process in the catarral stage with the risk of infection spreading in the ascending vector to the nearby organs of the respiratory system.
• Rhinitis atrophic, ozona have a delayed prognosis, which depends on the duration and quality of the therapeutic prescriptions.
• Vasomotor rhinitis is considered a complex violation of the tone of the vascular system of the nose and can not be fully cured. The prognosis depends on the identification of the root cause, its elimination and comprehensive, fairly long-term therapy, including adherence to the aeration regime, diet, the rejection of harmful habits.
• Forecasting the treatment of the common cold as one of many symptoms in severe diseases (tuberculosis, syphilis, oncology processes in the nasal cavity) should be included in the overall prognostic picture of the treatment of basic nosology.

In general, the rhinitis is not an independent health problem, it is always a sign of the underlying cause - allergies, viral or bacterial inflammation. In order to prevent the transformation of mucus secretion into a chronic form and not to disrupt the normal function of breathing, it is necessary to observe elementary hygienic nasal procedures and adhere to all known rules of a healthy lifestyle. Systematic prevention, examinations and visits to an ENT doctor, therapist, timely prevention of respiratory diseases by strengthening the immune system and aeration, humidification of air - these are simple techniques that help to neutralize risks and maximize the favorable prognosis in the treatment of rhinitis.

[76], [77], [78]