Chronic rhinitis (chronic runny nose) - Symptoms

Chronic catarrhal rhinitis

The main symptoms - difficulty in nasal breathing and nasal discharge (rhinorrhea) - are expressed moderately. Patients usually do not complain of difficulty in breathing, and only after careful questioning it is possible to find out that they have difficulty breathing periodically. It should be noted that sometimes difficulty in breathing bothers patients, but this symptom is not of a permanent nature. Difficulty in breathing through the nose occurs more often in the cold, the most constant congestion of one half. In the position lying on the side, congestion is more pronounced in the half of the nose that is lower, which is explained by the filling of the cavernous vessels of the underlying turbinates with blood, the venous tone of which is weakened in chronic rhinitis. Mucous discharge from the nose, usually there is little of it, but during an exacerbation of the process it becomes purulent and abundant. Impaired sense of smell (hyposmia) is often temporary, usually associated with an increase in the amount of mucus.

Chronic hypertrophic rhinitis

The clinical picture of the disease depends on the form of rhinitis. However, the main complaint is the disruption of nasal breathing. With bone hyperplasia of the turbinates and diffuse fibromatous changes in its mucous membrane, difficulty breathing can be pronounced and constant. With the cavernous form, congestion of both halves of the nose can occur alternately. Limited forms of hyperplasia of the anterior ends of the turbinates are accompanied by a sharp difficulty in nasal breathing, while a sharp thickening of the anterior parts of the inferior nasal concha can compress the opening of the lacrimal-nasal canal, which causes lacrimation, inflammation of the lacrimal sac and conjunctivitis.

When the posterior ends of the nasal conchae change (especially with the polypoid form of hypertrophy), a valve mechanism may be observed, in which only inhalation or exhalation is difficult. The hypertrophied posterior ends often compress the pharyngeal openings of the auditory tubes, thereby causing eustachitis (otosalpingitis). The hypertrophied inferior nasal concha can press on the nasal septum, which reflexively causes headaches and nervous disorders. Patients with hypertrophic rhinitis sometimes complain of nasal discharge, which is explained by congestion in the mucous membrane or concomitant catarrhal changes. Due to difficulty in nasal breathing, a decrease in smell and taste, and a closed nasal voice may occur.

Chronic atrophic rhinitis

Non-specific chronic atrophic process of the nasal mucosa can be diffuse or limited. Often there is a slightly expressed atrophy of the mucous membrane, mainly of the respiratory area of the nasal cavity - this process is sometimes called subatrophic rhinitis. Frequent symptoms of the disease include scanty viscous mucous or mucopurulent discharge, which usually adheres to the mucous membrane and dries, resulting in the formation of crusts. Periodic difficulty in nasal breathing is associated with the accumulation of crusts in the common nasal passage, most often in its anterior section, patients complain of dryness in the nose and throat, a decrease in one degree or another in the sense of smell. Crusts in the nose often cause itching, so the patient tries to remove them with a finger, which leads to damage to the mucous membrane, usually in the anterior section of the nasal septum, the introduction of microorganisms here and the formation of ulcers and even perforation. Due to the rejection of the crusts, minor bleeding often occurs, usually from the Kiesselbach zone.

Vasomotor rhinitis

Vasomotor rhinitis is characterized by a triad of symptoms: paroxysmal sneezing, rhinorrhea, and difficulty breathing through the nose. These symptoms are intermittent. Sneezing is usually associated with itching in the nose, and sometimes in the mouth and throat. Nasal discharge can be abundant, watery, or mucous. Attacks often occur only after sleep or are repeated many times with changes in air temperature, food, fatigue, emotional stress, increased blood pressure, etc. Vasomotor rhinitis is often accompanied by a deterioration in the general condition, sleep disturbances, and some disruption of the nervous system.

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