Rhinitis Symptoms, Causes and Prevention

It is defined as inflammation of the mucous membrane lining in the nasal passage, presents as nasal congestion/sneezing/nasal and palatal itching/ rhinorrhea, and postnasal drainage and it includes allergic, nonallergic, and infectious. 

In Ayurveda, Rhinitis is generally categorized in kaphaja and raktaja pratishyaya which is based on signs and symptoms that occur due to doshas.

Types of Rhinitis

1. Acute Rhinitis
2. Chronic Rhinitis
3. Hypertrophic Rhinitis
4. Allergic Rhinitis
5. Atrophic Rhinitis
6. Vasomotor Rhinitis

Acute Rhinitis can be viral/ bacterial. Commonly Rhinitis is known as Common cold (=coryza). The incubation period generally lasts for 1 - 3 days.

Rhinitis Symptoms & Signs

• Burning sensation in the nasopharynx.
• Rhinorrhoea.
• Sneezing.
• Nasal blockage
• Shivering
• Low-grade fever
• Sneezing/ coughing/ runny nose.
• Itching in eyes / nose/ mouth/ throat/skin.
• Stuffy nose.
• Headache
• Sore throat.
• Pressure in the nose & cheeks.
• Watery/ red/ swollen eyes.
• Dark circles under eyes.
• Smelling trouble.
• Hives.

Rhinitis Causes

• Recurrent nasal infection
• Chronic sinusitis.
• Allergen such as pollen & spores.
• House dust mites.
• Pet dander.
• Inhalants 
• Climate/ air pollution.
• Oversensitive immune system.
• Work-related allergens.

Rhinitis Prevention & General Tips

• Avoid touching your head/rubbing eyes/ nose
• Close windows in-home/ car when pollen counts usually go high.
• Enclose pillows/ mattresses in separate dust mite covers.
• Keep pets off couches/beds
• Wash your hands after touching/playing with pets.
• Wear a hat/sunglasses to protect eyes from pollen and dust.
• Avoid allergen exposure.
• Use HEPA filters(high-efficiency particulate air) to reduce allergens in your home.
• Probiotics may help improve symptoms of rhinitis.
• Use of honey in dietary supplements
• Spirulina diets
• Use of vitamin-c to maintain histamine levels.
• Use of some essential oils like peppermint/ eucalyptus, etc.

When to see your Doctor for Rhinitis Disease?

When signs and symptoms like occur and persist for a longer duration and when your allergies are causing symptoms such as chronic sinus infections/ nasal congestions/ difficulty breathing/ experience hay fever/ other allergy symptoms, then you should consult the doctor.

Risk Factors of Rhinitis

• Allergic diseases (asthma/ eczema)
• Aeroaallergens
• Obesity
• Exposure to pets/ parental smoking
• Parental rhinitis
• Genetic predisposition
• Traffic pollutants
• Poor ventilation 
• Air pollutants
• Immune deficient
• High total serum (IgE)
• Livestock breeders
• Farmers
• Veterinarians
• Bakers

Diagnosis for Rhinitis

• Is represented by sneezing/ nasal congestion/nasal pruritus/rhinorrhea.
• When an allergic disease is suspected=skin prick test can be performed for confirmation.
• When skin testing is difficult to interpret / not feasible (ie, dermatographism), allergen-specific IgE serum testing based on the patient’s history can be useful for diagnosis.

WHAT TO AVOID IN RHINITIS?

• Day sleep
• Cold drinks
• Oily foods
• Eliminate meat/ dairy products/ white flour foods/ sugar
• Stop using nasal drops unnecessarily as they aggravate the condition by stopping the drainage & hardening the mucous.
• Decongestants should be avoided as they can increase blood pressure too.
• Avoid cold/ damp living/ working/ sleeping quarters.
• Avoid smoking
• Refined sugar
• Avoid gluten food
• Avoid chocolate/ cheese/congestion food

WHAT TO EAT IN RHINITIS?

• Light diet
• Ginger-treated water for drinking.
• Decoction prepared from Dashamula & Trikatu with honey can be taken.
• Neti pot use found effective
• Drink a lot of fluids to thin your mucus.
• Drink lots of water cause Good hydration helps keep the mucus thin and loose.
• Vitamin c intake in your daily diet.

Question & Answers

Q.1 What is Hay Fever?
Ans. Hay fever, also known as allergic rhinitis, is an allergy-related inflammation of the nasal passages/ throat/ eye membranes usually caused by sensitivity to airborne pollens/molds/ some other reactions. It can have more adverse effects on a person with a family history of allergies. 

Q.2 What are the differences between acute and chronic rhinitis?
Ans. Depending upon the duration with some signs and symptoms differences arise. Acute rhinitis usually lasts only for a few days/ up to 4 weeks with some signs and symptoms. But, in the case of chronic rhinitis, duration lasts for more than 4 consecutive weeks with signs and symptoms.

Q.3 What is a Skin prick test?
Ans. It is the most common skin allergy test. Firstly, you will get a series of tiny drops of allergens on the skin usually on the back surface/ area. After that, you will get a quick needle prick in the skin underneath each drop. If you are allergic to it, you will get a dime-sized hive that’s red and itchy at the needle prick site, if this happens then it is recommended to go for a follow-up to check the results.

Q.4 What is the role of histamine in rhinitis?
Ans. Histamine plays an important role in rhinitis more in allergic rhinitis. In susceptible individuals, allergen induces degranulation of mast cells of the nasal & release of histamine into the nasal mucosa. It has been detected after some controlled challenges with allergen & when administered into the nasal cavity too. Histamine receptors demonstrated in the nasal mucosa.

Q.5 What are the differences between sinusitis and rhinitis?
Ans. Allergic rhinitis (=hay fever) happens when someone breathes to allergic substances/ allergens and it results in inflammation and swelling occur inside the nose. On the other side, sinusitis is an inflammation of the lining of sinuses which can be acute/chronic depending on the causes.

Q.6 What are the impact of allergic rhinitis?
Ans. Impact of allergic rhinitis can influenced productivity, absent in work/school days / reduced activity/ comorbid diseases/ sinusitis/ asthma, etc.

Q.7 How allergens can cause allergic rhinitis?
Ans. Antigen-presenting cells, dendritic cells in the mucosal surface, process allergens & some peptides from allergens on the major histocompatibility complex(MHC) class 2 molecule. The MHC & antigen complex take a role as the ligand of T-cell receptors on naive CD4+ T cells, results in differentiation of naive CD4+ T cells to allergen-specific Th2 cells. Activated Th2 cells secret several cytokines, which induce isotype switching of B cells to produce specific IgE and proliferation of eosinophils, mast cells & neutrophils. Antigen-produced IgE binds to high-affinity IgE receptors on mast cells/ basophils usually.

Q.8 What is a pollen allergy?
Ans. Pollen= is a very fine powder produced by trees/ flowers/ grasses/ weeds to fertilize other plants of the same species. In many people, pollen can cause adverse immune responses. People who get pollen allergies have an immune system that identifies the harmless pollen as a dangerous intruder, and begins to produce chemicals to fight against the pollen causes allergy. It is known as an allergic reaction,& the specific type of pollen that causes is known as an allergen. Reaction leads to numerous irritating symptoms, such as sneezing/ stuffy nose/ watery eyes, etc.

Q.9 What is Rhinitis according to the Ayurveda concept?
Ans. In Ayurveda, Rhinitis is generally categorized in kaphaja and raktaja pratishyaya which is based on signs and symptoms occur due to doshas.

Q.10 How Ayurveda treatment works on Allergic Rhinitis?
Ans. Treatment is basically done on shamana and shodhana chiktsa with some classical formulations of Laxmi Vilas rasa/godanti bhasma etc. by Ayurveda physician after examining the patient carefully. It is recommended that to consult the doctor before taking any kind of medications.

REFERENCES :

1. Abhinava Shalakya Vigyan 2nd edition (2019) by Dr. Aparna Sharma, Nasa Roga.
2. Sushruta Samhita by Dr. Ambikadatta Shastri
3. Diseases of Ear, Nose and Throat & Head and Neck Surgery 6th edition by PL Dhingra and Shruti Dhingra.
4. Longmore, Wilkinson, Davidson, Foulkes, Mafi, Oxford Handbook of Clinical Medicine 8th Edition.
5. K Sembulingam, P Sembulingam, Essentials of Medical Physiology 6th Edition.