Rhinitis

Rhinitis is inflammation of the mucous lining of the nose.

Description

Rhinitis is a nonspecific term that covers infections, allergies, and other disorders whose common feature is the location of their symptoms. In rhinitis, the mucous membranes become infected or irritated, producing a discharge, congestion, and swelling of the tissues. The most widespread form of infectious rhinitis, is the common cold.

The common cold is the most frequent viral infection in the general population, causing more absenteeism from school or work than any other illness. Colds are self-limited, lasting about 3-10 days, although they are sometimes followed by a bacterial infection. Children are more susceptible than adults; teenage boys more susceptible than teenage girls; and adult women more susceptible than adult men. In the United States, colds are most frequent during the late fall and winter.

Causes and symptoms

Colds can be caused by as many as 200 different viruses. The viruses are transmitted by sneezing and coughing, by contact with soiled tissues or handkerchiefs, or by close contact with an infected person. Colds are easily spread in schools, offices, or any place where people live or work in groups. The incubation period ranges between 24 and 72 hours.

The onset of a cold is usually sudden. The virus causes the lining of the nose to become inflamed and produce large quantities of thin, watery mucus. Children sometimes run a fever with a cold. The inflammation spreads from the nasal passages to the throat and upper airway, producing a dry cough, headache, and watery eyes. Some people develop muscle or joint aches and feel generally tired or weak. After several days, the nose becomes less inflamed and the watery discharge is replaced by a thick, sticky mucus. This change in the appearance of the nasal discharge helps to distinguish rhinitis caused by a viral infection from rhinitis caused by an allergy.

Diagnosis

There is no specific test for viral rhinitis. The diagnosis is based on the symptoms. In children, the doctor will examine the child's throat and glands to rule out measles and other childhood illnesses that have similar early symptoms. Adults whose symptoms last longer than a week may require further testing to rule out a secondary bacterial infection, or an allergy. Bacterial infections can usually be identified from a laboratory culture of the patient's nasal discharge. Allergies can be evaluated by blood tests, skin testing for specific substances, or nasal smears.

Treatment

There is no cure for the common cold; treatment is given for symptom relief. Medications include aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs) for headache and muscle pain, and decongestants to relieve stuffiness or runny nose. Patients should be warned against overusing decongestants, because they can cause a rebound effect. Antibiotics are not given for colds because they do not kill viruses.

Supportive care includes bed rest and drinking plenty of fluid.

Treatments under investigation include the use of ultraviolet light and injections of interferon.

Alternative treatment

Homeopaths might prescribe any of ten different remedies, depending on the appearance of the nasal discharge, the patient's emotional state, and the stage of infection. Naturopaths would recommend vitamin A and zinc supplements, together with botanical preparations made from echinacea (Echinacea spp.), goldenseal (Hydrastis canadensis), licorice (Glycyrrhiza glabra), or astragalus (Astragalus membraneceus) root.

Prognosis

Most colds resolve completely in about a week. Complications are unusual but may include sinusitis (inflammation of the nasal sinuses), bacterial infections, or infections of the middle ear.

Prevention

There is no vaccine effective against colds, and infection does not confer immunity. Prevention depends on:

• washing hands often, especially before touching the face
• minimizing contact with people already infected
• not sharing hand towels, eating utensils, or water glasses