RHINITIS

• Rhinitis is inflammation and swelling of the mucous membrane of the nose, characterized by a runny nose and stuffiness and usually caused by common cold or a seasonal allergy
• Acute (short-lived) - Acute rhinitis commonly results from viral infections but may also be a result of allergies, bacteria, or other causes. Types of acute rhinitis- a)Viral rhinitis b)Bacterial rhinitis c) Irritative rhinitis
• Chronic (long-standing)- recurrent attacks of acute rhinitis in the presence of predisposing factors results in chronicity
• Chronic simple rhinitis : early stage of hypertrophic rhinitis, where swollen turbinates do not have permanent hypertrophic changes
• Hypertrophic rhinitis - characterized by thickening of mucosa, submucosa, seromucinous glands, periosteum and bone. Changes are more marked on the turbinates
• Atrophic rhinitis (ozaena) - a form of chronic rhinitis in which the mucous membrane thins (atrophies) and hardens, causing the nasal passages to widen (dilate) and dry out
• Rhinitis sicca - It is also a crust-forming disease seen in patients who work in hot, dry and dusty surroundings
• Rhinitis medicamentosa - is a form of drug-induced non allergic rhinitis which is associated with nasal congestion brought on by the use of certain oral medications and topical decongestants
• Rhinitis caseosa - It is an uncommon condition, usually unilateral and mostly affecting males. Nose is filled with offensive purulent discharge and cheesy material

ACUTE RHINITIS

Viral rhinitis

• Caused by viruses like adeno virus, CORONA virus, picorna virus and sub groups like rhinovirus ,coxasackie, and ECHO
• Influenza rhinitis –Influenza viruses A,B or C
• Rhinitis associated with exanthemas- measles, rubella, chickenpox are often associated with rhinitis

Bacterial rhinitis

• It may be Primary or Secondary
• Primary bacterial rhinitis is seen in children and usually with infection of streptococcus , pneumococcus ,staphylococcus
• Secondary bacterial infections occurs after an attack of viral infection

Irritative rhinitis

• It is caused by exposure to dust ,smoke, or irritating gases such as ammonia , formaline, acid fumes etc or it may result due to trauma caused on nasal mucosa during intra nasal manipulation

CHRONIC RHINITIS

• Persistence of nasal infection due to sinusitis, tonsillitis and adenoids
• Chronic irritation from dust, smoke, cigarette smoking, snuff etc
• Nasal obstruction due to deviated nasal septum, synechia leading to persistence of discharge in the nose
• Hereditary factors
• Endocrinal disturbance
• Nutritional deficiency - deficiency of vitamin A, D or iron or some other dietary factors
• Autoimmune process

Acute viral rhinitis

• Burning sensation at the back of nose
• Nasal stuffiness
• Rhinorrhoea - Watery discharge and later become mucopurulent
• Sneezing
• Chills
• Low grade fever, head ache and myalgia

Acute bacterial rhinitis

• Mucopurulent discharge
• Nasal stuffiness
• Sneezing
• Greyish white tenacious membrane in nose
• Low grade fever

Acute irritative rhinitis

 Soon after the exposure to irritative factor there will be immediate reaction like

• Sneezing
• Rhinorrhoea
• Nasal congestion

All symptoms will disappear with removal of the irritative agent 

Chronic simple rhinitis

• Nasal obstruction- Usually worse on lying and affects the dependent side of nose
• Nasal discharge- may be mucoid or mucopurulent, thick and viscid
• Headache
• Postnasal discharge

 Chornic Hypertrophic rhinitis

• Nasal obstruction is the predominant symptom
• Hypertrophied turbintes, which does not pit on pressure especially in the inferior turbinates
• Nasal discharge is thick and sticky
• Headache
• Heaviness of head
• Transient anosmia

Atrophic rhinitis

• Commonly seen in females and starts around puberty
• Foul smell from the nose with marked anosmia (merciful anosmia)
• Atrophic changes make nasal cavities roomy
• Nasal obstruction
• Greenish or greyish black dry crusts covering the turbinates
• Atrophic changes seen in the pharyngeal Mucosa
• Atrophic laryngitis

Rhinitis sicca

• Crust forming rhinitis
• Usually associated with hot dry and dusty surroundings e.g. iron and gold smith ,bakers
• Crust is confined to anterior third of nose particularly of the nasal septum
• Removal of crusts causes ulceration epistaxis and may lead to septal perforation

Rhinitis caseosa

• Usually unilateral and mostly affecting males
• Nose is filled with offensive purulent discharge and cheesy material
• Bone walls of sinus may be destroyed
• Must exclude malignancy

• Clinical diagnosis
• Rhinoscopy
• Blood TC ,DC and ESR to find out infections

• Treat the cause with particular attention to sinuses, tonsils,adenoids, allergy, personal habits
• Nasal irrigations with alkaline solution
• Nasal decongestants
• Antibiotics
• Surgical

Ayurvedic Treatment

• Advice to avoid seetha viharas and aharas
• Irritative Rhinitis – Measures to avoid allergens

Internal Medicines

• Dashamoola katutraya Kashaya
• Elakanadi kashaya
• Vyaghradi kashaya
• Ardraka ksheera prayoga
• Surasaasavam
• Punarnavasvam
• Amrutharishtam
• Mukkamukkatuvadi gutika
• Sudarshanam gutika
• Vilwadi gutika
• Lakshmi vilasa rasa
• Thaleesadi Choorna
• Vyoshadi vataka
• Haridrakhandam
• Dashamoola rasayana
• Agasthya rasayana

Procedures

• Kabala - Triphala kashaya +Trikatu choorna
• Dhoopana - Haridra varthi
• Nasya - Surasa swarasa + Saindava + Honey (Chronic cases)