Not everyone knows that long-lasting allergic rhinitis can damage important nasal functions and cause severe health complications. Understanding the essence of health risk is often an incentive to take rational treatment.
In allergy sufferers, for unknown reasons, the immune system "blots" harmless flower pollen, food particles and other substances that are normally health-neutral with dangerous germs or parasites. It mobilizes immune cells to strenuous and chronic struggle with the apparent but mass influxing "aggressor" - an allergen. The result of this fight are symptoms that cause serious damage to health.
EASY NOSA RELAY CELLS
Contrary to common beliefs, the nose is not only for inhaling and exhaling the air. The physiologically important and surprisingly effective functions include air cleaning from dust, allergens and germs as well as temperature and humidity control
Structure of the mucous membranes of the nose and throat
Few people know how the nasal mucosa and paranasal sinuses and throat, bronchi and bronchioles (and trachea) are built, and how important it plays in our physiology. In 80% it consists of ciliate cells, and in 20% of goblet cells, capable of very high secretion of mucus. To understand how the epithelium performs its rather complex functions, however, one should look at the structure of a single mucous cell.
Both larger and smaller cilia are visible only under the microscope.
How is a single nasal ciliary cell constructed?
On the surface of each ciliary cell there are about 40 small cilia, capable of making wavy movements and "removing" foreign bodies, allergens, dust, germs from the nose. Between them there are many times more (250-400) - even smaller cilia (in the drawing in red), which support their movements with their movements
What is the role of microscopic cilia?
Millions of "waving" cilia are a "broom" that does not sweep "dry". They are immersed in a viscous mucus, secreted by goblet cells. The viscosity of mucus is similar to that of flyflies "overpowering" microscopic particles of germs, allergens, dust, etc. The source of mucus supply is the secretion of goblet cells found in the epithelium. The optimal density of mucus determines the appropriate stickiness in relation to foreign particles, and at the same time allows the cilia to move freely "paddling" and sweeping.
How does the architecture of the nose affect air filtration?
The proper shape of the nasal cavities - especially their front part - creates specific turbulences, as a result of which impurities inhaled with the air hit the viscous mucus layer covering the epithelium of the upper respiratory tract and stick to it. When the particles of contamination are larger (over 10 micrometers) they settle in 90%, just behind the vestibule of the nasal cavity, and when they are smaller - almost half sticking a bit further, at the level of the inferior turbinate.
What else should we know about the mucosal epithelium?
The characteristic of the mucous epithelial cells is the presence of serous and mucous glands and the aforementioned goblet cells. For example, serous glands, in the number of several dozen, are located mainly in the anterior part of the nasal cavities on the nasal septum and lateral wall of the nose. Their abundant secretion removes large particles of dirt depositing in the front of the nasal cavities.
How is the air in the nose moisturized and heated?
Heating and humidifying too dry air enables the network of small arteries and a special design of venous vessels inside the nose. If e.g.we breathe winter air at a temperature of - 12 C - after just a second of warming in the nose - it has as much as 20 C in the throat! The humidity of too dry air is similarly high, which is necessary for the health of the bronchi and lungs. This humidification is especially important in homes with air overheated by radiators.
When does the airway cleaning system stop working efficiently?
If we breathe too much too dry, dry, overheated air or are exposed to irritant, toxic tobacco smoke, dust, solvent fumes, dust or toxic fumes in the workplace - inflammation occurs in the mucous membrane of the upper respiratory tract. This stops the cilia and the process of cleansing the nose. Some medicines also cause some cilia to stop moving. A serious consequence of the mucociliary transport disability and nasal self-cleaning may be intensive exposure to germs and inhalant allergens initiating the allergic reaction and chronic inflammatory rhinitis.
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DISEASES AND TOXINS FOR ALLERGY?
The environment in which we live often threatens the nasal mucosa
Smoke, car fumes, industrial vapors or very toxic tobacco smoke cause chronic irritation and inflammation of the nasal mucous membranes. These toxic substances are one of the important reasons for the disappearance of the protective barrier, which is the nasopharyngeal mucociliary system. The primary cause of inflammation may also be too dry air from overheated apartments, some overused medicines, etc. The nose then becomes an open gate for numerous germs, allergens and toxins from the outside world.
How is a single nasal ciliary cell constructed?
On the surface of each ciliary cell there are about 40 small cilia, capable of making wavy movements and "removing" foreign bodies, allergens, dust, germs from the nose. Between them there are many times more (250-400) - even smaller cilia (in the drawing in red), which support their movements with their movements
What threatens the disability of the mucociliary mechanism of nasal cleansing?
Any damage to the mucociliary barrier increases the number of allergens, viruses, particles of toxins and dust deposited directly on the mucous membrane. Foreign bodies irritate the nasal mucosa, while viruses and toxins can penetrate inside the epithelial cells. This eventually leads to the collapse of the so-called cellular defense of the immune system, because leukocytes (white blood cells) are unable to cope with such a large number of "aggressors". Then, as a result of many reactions - the "last line" of self-defense of the organism, in which mediators of inflammatory processes participate: especially histamine, as well as leukotrienes, prostaglandins, etc. The result of their abundant production is inflammation - the heaviest weapon that the body has to fight toxins or germs. However, inflammation is deadly to the nasal mucosa. It increases the damage to the ciliary epithelium and the vicious circle closes. Chronic inflammation of the nose gradually degenerates the remaining healthy elements of the mucociliary system. As a result, nasal mucosa without protection from plant pollen, house dust allergens and other antigens is more easily allergenized. According to the research, long-lasting inflammation, which occurs at that time - also called year-round (or chronic) rhinitis, is most often allergic.
What does chronically stuffy nose and mucus burning mean?
Symptoms such as prolonged nasal congestion and "burning" of the nasal mucosa, abundant secretion - may be a symptom of a viral or bacterial infection, or a result of a bent nasal septum, hypertrophy of the nasal turbinates, and in children between 3 and 9 years - due to nasal hypertrophy -sardary - this ailment in 6 out of 10 cases is a symptom of allergy.
Can we determine the cause of rhinorrhea due to the appearance of secretions?
Yes, although it is not a diagnosis, but just a reasonable guess - the appearance of the secretion allows for a preliminary diagnosis of the cause of its leak:
1. Mucous secretion, may be a preliminary symptom of allergic or infectious rhinitis (runny nose)
2. Aqueous secretion - similarly to mucous - indicates an infection (mainly viral) or inhalation allergy
3. The green-colored secretion may be evidence of purulent inflammation, most often the back group of the paranasal sinuses
4. The yellow-colored discharge may be the result of intense infiltration of the nasal mucosal secretion
5.A foamy one-sided leak suggests the presence of a foreign body
6. Blood stained unilateral leak indicates the possibility of malignant neoplasm of the nasal cavity or paranasal sinuses
How to distinguish chronic rhinitis from the effects of its faulty construction?
Symptoms of chronic rhinitis, as well as defects in the nose, are nasal congestion. The basis for the diagnosis are special tests that differentiate the above causes of a blocked nose. They consist of various reactions of the nasal mucosa to popular anti-keratin preparations - so-called alpha-mimetic (xylometazoline, oxymetazoline), which shrinks the inflamed nasal mucous membrane and clears the air flow. The rhinoscope, rhinomanometer, acoustic rhinometry, etc. method allows to objectively distinguish the causes of nasal congestion. If the nasal patency under the influence of the above drugs does not improve - the cause of obstruction is the defective structure of the nose, and in children, hypertrophy of the nasopharyngeal tonsil.
How to distinguish allergic rhinitis from ordinary?
To resolve this issue, specialist tests should be carried out to differentiate allergic rhinitis from non-allergic rhinitis. For this purpose, typical methods for the diagnosis of allergies are used. They are based on skin tests, provocative tests, testing of IgE antibodies and cytology of the nasal mucosa
. Does the patient's age affect the frequency of allergic catarrh?
Yes. For example, children and young people have primarily allergic rhinitis. In people of middle age, infections are a common cause. In the elderly, non-allergic mucositis predominate. An important role is also played by the sex of the patient. Typical for women, especially during pregnancy, are hormonal rhinitis. In turn, men, especially after 40-50 years of age, often have polyposis of the nasal mucosa.
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How chronic rhinitis affects the health of the patient?
Chronic nasal dysfunction always leads to bad mood, physical and mental discomfort. Patients suffering from chronic rhinitis - as we already know most often on allergic grounds - whether nasal blockages are less intellectually efficient, have weaker effects at work, in science, and inferior physical capacity. Qatar, without being a fatal disease, impairs the efficiency of the human body to a degree that often prevents normal functioning, leading to significant sickness absence and considerable costs associated with the necessity of using pharmacological agents and resulting from impairments in psychophysical fitness. A serious risk is complications: rhinosinusitis, bronchitis, and especially asthma.
Can chronic allergic rhinitis cause nasal polyps?
Yes. For many years now, allergy doctors have recognized the role of allergy in nasal polyps. Some doctors also pay attention to the role of food allergy in the initiation of polyps. The fact is that polyps usually accompany chronic allergic rhinitis, chronic nasal obstruction or asthma.
Can chronic allergic rhinitis cause nasal sinusitis?
Yes, chronic allergic rhinitis can lead to inflammation of the nasal sinuses. This can not be caused by, for example, a common cold catarrh, which lasts about a week. Swelling of the nasal mucous membranes and sinuses is then not large and there is an outflow of secretions from sick sinuses. When a runny nose is allergic, it lasts longer - the swelling becomes larger and the outflow for the secretion may no longer be. The fluid then accumulates in the sinuses, which leads to pain over the sinuses, i.e. around the forehead and upper jaws. It can also appear behind the eyes - in the middle of the forehead, if the so-called sinuses. Remember, however, that the pain in the sinus area, the feeling of hypertension may also be the result of an acute infection, overlapping with allergy (or spontaneous infection) and require specialized treatment. Swelling of the frontal sinus area may be a complication of acute frontal sinusitis and requires the prompt consultation of a specialist ENT specialist including hospitalization.
And what about smell at the time of a runny nose?
The nausea disappears temporarily during acute inflammation, not only allergic, but also viral and bacterial. A longer loss of smell is indirectly related to allergies - when it is caused by nasal polyps or acute drug-induced nausea.
And drying up, scarring and bleeding from the nose?
Allergy generally does not cause nosebleeds.Its cause may be hypertension, long-term use of acetylsalicylic acid microdips, systemic diseases (associated with blood coagulation disorders). Bleeding can also result in reflex nose gouging. It is different with drying up and nose scarring, which is usually a symptom of atrophic rhinitis.
What pathologies can cause symptoms of nasal obstruction?
These can be chronic blockages of the nasal passages resulting from: nasal septum, neoplastic or non-neoplastic
