Symptoms and treatment of drug-induced rhinitis. What will help with drug-induced rhinitis? Treatment of drug-induced rhinitis

Drug-induced rhinitis- This chronic inflammation nasal mucosa, initiated by prolonged and uncontrolled use of pharmacological drugs for the treatment of runny nose.

Unfortunately, along with their widespread use and active use to treat rhinitis symptoms, the number of cases of this disease is constantly growing.

The situation here is simple and understandable. A person has a runny nose. What would most of us do in such a situation? How do we determine the remedy for treatment? Shall we go to an appointment with an ENT doctor? No matter how it is! We will go to the nearest pharmacy, buy nasal drops there and begin to actively treat ourselves.

Vasoconstrictor drugs are extremely effective at first. They relieve swelling of the mucous membrane and quickly clean the nasal canals. But they don’t cure – rhinitis simply recedes. However, not for long. When his symptoms return, we use the miracle spray again.

The result of even short-term abuse vasoconstrictor drops can be medicinal form rhinitis That is, we become dependent on the drug used, and our body loses the ability to fight nasal congestion on its own (without constant replenishment of the drug).

Why does the disease develop?

The composition of vasoconstrictor drops includes ephedrine (or its analogues). When treated with such drugs, these substances quickly narrow the nasal vessels.

However, you need to understand that ephedrine suppresses the synthesis of the hormone norepinephrine in our body, which is responsible for regulating the tone of blood vessels. That is, without constant use of the medicine, the vessels lose the ability to narrow and expand on their own.

Drug-induced rhinitis can also occur due to the use of tranquilizers, hormonal drugs and antihypertensive drugs(lowering drugs arterial pressure).

Attempts to treat yourself with such medications without prior consultation with a doctor and in violation of the instructions for use of these drugs also contribute to the development of atrophy of the nasal mucosa and vascular dystonia.

Symptoms of the disease

The main symptom is a persistent runny nose and nasal congestion. Normal nasal breathing requires constant use of the drug, which is addictive.

The following symptoms can also be identified:

headache;
swelling of the nose;
partial or complete loss of smell;
burning and itching in the nasal passages;
bad and restless sleep.

Treatment

The simplest and effective way cure medicinal rhinitis - stop taking the drug that is addictive. According to doctors' observations, addiction goes away in one and a half to two weeks. Nasal breathing gradually returns to normal.

However, this method of treatment is possible only if the disease is not old and neglected. In this case, you can’t do without visiting an otolaryngologist.

Remember, only a doctor can choose the methods of counteracting the disease that are suitable specifically for your case, which will allow you to cure a medicinal runny nose in the shortest possible time and without harm to health.

Pharmacological agents

It is necessary to replace the drug that is addictive.

Rhinitis can be treated with drops or sprays based on sea water. These drugs include:

AquaMaster;
Nazol Aqua;
Morenasal;
Aqualor (and many others).

These drugs gently treat the nasal mucosa. They do not irritate her and are not addictive.

You can also treat such a runny nose with intranasal corticosteroids:

Avamis;
Flixonase;
Nasonex;
Nasobek (and others).

Such medications are prescribed exclusively by an ENT doctor.

Surgery

Allows you to treat the most complex and severe cases. Surgical intervention is used when pharmacological methods are no longer effective.

Currently, vasotomy is most often performed. This is the most gentle and effective operation, which is performed within 5-7 minutes under local anesthesia.

There are also:

surgical treatment with laser;
conchotomy;
cryotherapy;
turbinoplasty;
Septoplasty.

In any case, the choice of surgical intervention method is the prerogative of the doctor.

Folk remedies

Application of funds traditional medicine also allows you to treat drug-induced rhinitis.

Aloe is an indispensable assistant in the fight against this disease. Its juice will quickly and effectively eliminate all negative symptoms of the disease, relieve irritation and restore the nasal mucosa. will help eliminate this pathological condition.

To prepare the product, dilute aloe juice with filtered water in a ratio of 1:2. Drip the medicine 4-5 times a day, 3-5 drops into each nostril.

You can also treat this form of rhinitis with onion juice. We soak cotton or gauze turundas in the squeezed juice and insert them into the nasal canals for 3-5 minutes. For a milder effect, the nostrils should be lubricated with Vaseline.

We can’t help but say about honey. Mix it with water in a 1:1 ratio. Drip 4-5 times a day into each nostril. Adults take 6-7 drops, and children 2-3.

Drug-induced rhinitis is a very current problem in otolaryngology. Today, the symptoms of a runny nose are observed in a large number of people, since it has become widespread allergic rhinitis.

Many patients complain of dependence on nasal drops and their ineffectiveness.

This is due to the lack of knowledge about how to properly prescribe treatment and prevent drug-induced rhinitis.

What is a drug-induced runny nose?

Drug-induced rhinitis is an inflammation of the nasal mucosa that develops as a result of long-term use of nasal drops or sprays that have a vasoconstrictor effect.

Drug-induced rhinitis has chronic course, because it develops against the background of developed tachyphylaxis to decongestants (vasoconstrictor drops). Tachyphylaxis is usually called the phenomenon of addiction to frequent use. medicines.

An early symptom of addiction to nasal drops is a decrease in the effectiveness of their use. The disease gradually becomes chronic and the patient becomes dependent on the use of the nasal spray.

The best remedy to combat medicinal (drug-induced) rhinitis is

Then there is a complete lack of result from the use of the drug. This is due to the fact that the nasal spray stimulates a constant narrowing of the vessels of the nasal cavity, but since the vessels subsequently become resistant to its effects, their constant expansion develops, which leads to the round-the-clock release of liquid contents from the nasal cavity.

By the type of exudation, medicinal rhinitis resembles vasomotor rhinitis, since the secretion of nasal secretions develops as a result of the chemical influence of the medication.

Drug-induced rhinitis due to drops

The main reason for the development of drug-induced rhinitis is long-term use of nasal drops with a vasoconstrictor effect or their use in a dosage that exceeds the maximum daily dose for treatment.

Especially important!

Drug-induced rhinitis develops after daily use of nasal drops for more than 2 weeks to treat nasal catarrh.

Reduced sensitivity of the nasal mucosa to norepinephrine.

Norepinephrine is a hormone of the adrenal medulla, the main function of which is to regulate vascular tone. Long-term use of nasal drops leads to the fact that the receptors of the mucous membrane become less sensitive to its effects. Gradually, changes in the mucous membrane lead to the fact that the receptors stop responding to changes in the concentration of norepinephrine in the blood.

Formation of polyps and crusts in the nasal cavity.

Constant use of vasoconstrictor medications leads to the development of polypous changes in the nose. They fill the nasal passage to some extent, which in turn leads to aggravation of nasal breathing.

Also in large quantities crusts form in the nose. The result of such changes is a narrowing of the overall nasal passage. The flow of air through a narrowed nasal passage leads to increased breathing and irritation of the mucous membrane, which provokes the release of mucus from the nose. Often such changes require surgical treatment.

Atrophic changes in the nasal mucosa.

Permanent introduction pharmacological drug into the nasal cavity provokes a decrease in the mobility of the ciliated epithelium. “Paralyzed”, the ciliated epithelium does not fulfill its functional purpose, which leads to the gradual development of death of the mucous membrane.

Dystonia of nasal vessels.

Changes in vascular tone are a direct effect of the use of decongestants. Their administration stimulates vasoconstriction, which gives way to irreversible dilatation and the development of a runny nose in the patient.

Long-term use of drugs such as antihypertensives, tranquilizers, hormones.

Antihypertensive drugs for the treatment of pathology of cardio-vascular system have a systemic effect and lead to vasodilation. Dilated vessels of the nasal cavity stimulate copious discharge liquids.

Therefore, a slight runny nose is typical for people suffering hypertension. Taking hormonal drugs with vasodilator properties leads to the appearance of constant nasal discharge. The most modern tranquilizers, in addition to their basic functions, affect tone vascular wall, stimulating a decrease in its tone and an increase in exudation from the nose.

Work in hazardous enterprises.

Work in chemical, pharmaceutical and toxic industries often leads to constant exposure to harmful chemicals of various origins on the mucous membrane and leads to the development of chronic secretion of mucous contents from the nasal cavity. This type of rhinitis is difficult to treat.

There are the following symptoms of drug-induced rhinitis:

Microscopic symptoms;
Macroscopic symptoms;
Clinical symptoms.

Can rhinitis medicamentosa lead to death?
These cases in medical practice has not been established. But with medicinal rhinitis, snoring appears during sleep, which is deadly.

Clinical symptoms of drug-induced rhinitis include

Insomnia.
Development of changes in blood pressure.

At the onset of the disease, nasal sprays have vasoconstrictor properties, which led to vasoconstriction. As a result, blood pressure increases. Subsequently, the vessels become resistant to the action of decongestants, and arterial hypotension develops in patients with drug-induced rhinitis.

Tachycardia under the influence of decongestants gives way to chronic bradycardia.
Development of vegetative-vascular dystonia.

Violation of vascular tone develops as a result of the use of decongestants. In such cases, it is recommended to prescribe treatment for rhinitis, which helps the symptoms of VSD disappear.

Feeling of increased heartbeat and tightness in the heart area.

Variable fluctuations in blood pressure, as well as vascular tone, lead to the development of such pathological sensations as a feeling of increased heartbeat and a feeling of tightness in the chest.

Microscopic symptoms of rhinitis medicamentosa include

Atrophy of the cilia of the ciliated epithelium.
An increase in the size of glands and goblet cells with the development of hypersecretion.
Increased permeability of the vascular wall.
Development of edema.
Transformation of single-layer multirow ciliated epithelium into flat non-keratinizing epithelium.

Microscopic symptoms make it possible to confirm the diagnosis of drug-induced rhinitis, as well as to carry out differential diagnosis with other forms of the disease.

Macroscopic symptoms

Decreased sense of smell.

Hyposmia is a consequence of such local changes in the nasal cavity as atrophy of the mucous membrane, dysfunction of the ciliated epithelium, as well as the formation of crusts and polyps.

Discharge of mucus from the nose.
Burning and itching.

Nasal secretions contain salts that irritate receptors and cause the development of hyperemia in damaged areas of the nasal cavity.

Why is it impossible to sleep due to medicinal rhinitis?
Snoring with a drug-induced runny nose develops as a result of narrowing of the lumen of the nasal passages. The air flow becomes turbulent, which also provokes the development of snoring. This provokes a person to constantly wake up from oxygen deficiency.

Treatment of drug-induced runny nose

There are conservative, surgical and physiotherapeutic treatment of drug-induced rhinitis. The basis for the treatment of drug-induced rhinitis is the refusal to use nasal drops.

How to treat drug-induced rhinitis?

Especially important!

Stopping the use of vasoconstrictor drops should be gradual. If you abruptly stop using drops, the risk of developing symptoms of acute drug-induced rhinitis with characteristic discharge and swelling of the nasal mucosa.

In severe cases It is not always possible to cure medicinal rhinitis and get rid of the symptoms of a runny nose in this way. The following medications are highly effective in treating severe drug-induced rhinitis:

Corticosteroids (Fluticazole, Avamys).

For surgical treatment Medication-induced rhinitis is used in the following cases:

Ineffectiveness of conservative therapy.
Lack of response to treatment with Avamys in pregnant women.
Extensive polyps of the nasal cavity.

Surgery Today's advanced treatment for drug-induced rhinitis involves:

Conchotomies (partial or complete removal nasal mucosa in the lower or middle region).
vessels of the nasal mucosa.
Turbinoplasty and septoplasty.

After surgical treatment, the use of those nasal drops that provoked the development of a runny nose is strictly contraindicated.

At easy degree of rhinitis, for treatment it is enough to stop using drops. Thus, treatment of drug-induced rhinitis depends on the severity.
At average severity, treatment of drug-induced rhinitis is based on the additional use of additional drug therapy.
At severe degree of severity shown surgery medicinal rhinitis.

To get rid of drug-induced rhinitis, it is recommended to prescribe such physiotherapeutic procedures:

Ultraviolet irradiation;
Inhalations medicinal herbs;
Electrophoresis;

Also, in order to improve the results of treatment, it is recommended to do daily wet cleaning, walk on fresh air and during treatment and prevention of respiratory diseases.

In the off-season and cold season, the problem of nasal congestion becomes especially important. What does the average person do when they find themselves with a runny nose? That's right, he goes to the pharmacy for vasoconstrictor drops. This is how a common disease is provoked - drug-induced rhinitis. In this article we will look at the causes, symptoms and treatment of the disease.

Drug-induced (or medicinal) rhinitis is inflammatory process on the nasal mucosa, caused by the negative chemical effects of vasoconstrictor drops. The disease can also occur due to an allergy to the components of the drug. The disease occurs after prolonged use of nasal drops. As a result, sensitivity to the drug decreases and disappears completely over time.

In rare cases, the disease occurs due to the use of hormones, oral contraceptives, tranquilizers, antihypertensives and other substances.

Drug-induced rhinitis is just as likely to occur in a child as in an adult. However, children are less susceptible to this disease because their medications are supervised by an adult.

Causes

The main cause of the disease is long-term use of vasoconstrictor drops or sprays in a dosage exceeding the daily average.

Important! For the development of the disease, 14 days of daily use of drugs is enough.

Further, the sensitivity of the nasal mucosa to hormones decreases. Specifically, to norepinephrine secreted by the kidneys. Its task is to regulate vascular tone. Due to prolonged exposure to this substance, the receptors in the nose lose sensitivity to it and stop responding, remaining constantly dilated.

If the disease occurs as a result of the use of drugs that have a systemic effect (hormones, tranquilizers, etc.), then chronic vasodilation is explained by the side effects of these drugs.

Constant, prolonged contact with chemicals and toxic substances can also lead to the development of rhinitis medicamentosa. Workers in pharmaceutical and chemical production are most at risk.

Symptoms

At an early stage, the appearance of the disease can be predicted by reducing the body’s sensitivity to drops/spray. The usual dosage of the medicine does not cause the usual effect, a runny nose develops into chronic stage, the dosage is gradually increased.

At the next stage, sensitivity to the drug disappears completely. Due to increased resistance to the drug, the vessels remain dilated despite treatment. Characteristic symptom– constant runny nose.

At the last stage, the patient develops dependence on the vasoconstrictor drug, which requires special attention from the doctor and professional treatment.

Other manifestations:

constant nasal congestion;
headache;
dizziness;
decreased sensitivity to odors;
burning in the nose, itching;
snore.

Also, drug-induced rhinitis causes less noticeable local symptoms: atrophy of the epithelial cilia in the nose, swelling, weakening of the protective functions of the vascular wall, etc.

This disease can affect the body systemically, so the following general manifestations occur: blood pressure changes, tachycardia appears, discomfort in the heart area, instability of the emotional state.

Complications

Various complications may develop during the course of the disease:

The appearance of polyps and crusts in the nasal cavity. Filling the respiratory passage, they narrow it, making breathing difficult. To compensate for the lack of oxygen, the patient begins to breathe more often, causing irritation of the nasal mucosa and increased mucus secretion.
Atrophic pathologies leading to a decrease in the activity of the ciliated epithelium, which may result in the death of the mucous membrane.
Vascular dystonia in the nose.

Important! To avoid complications, you must consult a doctor at the first manifestation of the disease. A general practitioner or otolaryngologist treats drug-induced rhinitis.

Diagnosis of the disease

It begins with a history taking by the attending physician. At this stage, it is important that the patient is as honest as possible and provides complete, reliable information to the doctor. Otherwise, difficulties may arise in making a diagnosis and errors in prescribing medications. The doctor needs to describe the duration and intensity of the symptoms and name the drug that was used for treatment.

The next diagnostic stage is visual inspection. The doctor examines the nasal mucosa: its color, structure; collects mucus for further bacteriological research. After collecting and processing the data, the doctor makes a diagnosis of medicinal rhinitis, determines the degree and severity of the disease, the presence of complications and, based on the information received, prescribes therapy.

Treatment of rhinitis

How to get rid of medicinal rhinitis? For this purpose, comprehensive treatment is carried out, which is simultaneously aimed at both relieving symptoms and alleviating the patient’s condition, and eliminating the cause of the disease. To achieve high effectiveness of therapy, various methods can be used.

Drug treatment

How to treat drug-induced rhinitis? With the help of two types of medications: glucocorticosteroids and antihistamines. The former are a group of hormones secreted by the adrenal glands. They have an anti-inflammatory effect, help remove toxic substances from the body. Avamis, Nazofan, Nazonex are usually prescribed.

The second group of drugs helps to cope with unpleasant symptoms that make breathing difficult (swelling, itching, burning). The course of treatment ranges from a week to 10 days. Drugs: Zyrtec, Zestra, Instaril.

A major role in treatment is the use of local funds in the form of solutions for rinsing the nose (Aquamaris, Sterimar) and ointments placed in the nasal passage (Lorizan).

Surgery

Treatment of drug-induced rhinitis is promptly used in severe cases of the disease or the occurrence of complications in the form of polyps and crusts. Surgery is also recommended in cases of low effectiveness of drug therapy. The main task surgical procedures– expand the respiratory passage, remove tumors, restore respiratory function. Using this technique, drug-induced rhinitis during pregnancy can be treated, since it avoids negative impact drugs for the embryo.

To cure drug-induced rhinitis, the following surgical interventions are used:

Laser therapy. For treatment, a carbon dioxide laser is used, which affects the mucous membrane. This method allows you to achieve good results without destroying the structure and functions of tissues. Under the influence of a laser, they improve metabolic processes, restoring airway patency.
Conchotomy is a partial or complete removal of the nasal mucosa. The procedure is also carried out using a laser, the duration of the operation does not exceed 3 hours.
Turbinoplasty or septoplasty is surgical methods correction of the nasal concha. It can be carried out using different techniques: radiofrequency, laser, endoscopic, etc.

Don't be scared if you are scheduled for surgery. Majority modern methods, used to treat rhinitis medicamentosa, do not leave large scars and do not require a long hospital stay. These techniques are safe and highly effective.

Physiotherapy

How to cure the disease using other methods? To increase the effectiveness of the two treatment methods described above, the otolaryngologist can refer the patient to physiotherapeutic procedures.

Acupuncture. By acting locally on the affected area, acupuncture relieves symptoms such as difficulty breathing and widens the nasal passage.
UHF therapy involves influencing the patient’s body electric field high frequency, which is supplied to the tissues using special plates applied to the skin or mucous membranes.
Phonophoresis is a procedure that combines the effects of medicinal solutions and ultrasound radiation. Cotton swabs with a solution are placed in the patient's nose, and applicators that conduct ultrasound are attached to them.
Electrophoresis is based on the introduction of drugs into the body through mucous membranes or skin using direct electric current.
Inhalations. They are carried out using medicinal herbs and steam. IN in this case The well-known “grandmother’s” method of inhaling vapors from boiled potatoes under a blanket works well. Here you can resort to treatment with folk remedies and prepare flocks based on oregano, St. John's wort, and sea buckthorn.

Prevention

Take care of your health, timely visit to the doctor and conscientious treatment.
Use vasoconstrictors for no longer than 10 days in a row.
Treatment of runny nose and colds under the supervision of a doctor.
Avoiding hypothermia, choosing clothes according to the weather.
Promoting health with easy physical activity: jogging in the morning, swimming, yoga, fitness, etc.
Regular use vitamin complexes in the off-season.
Restriction of stay in in public places during epidemics of influenza and other colds.

Compliance with the rules of prevention will benefit both healthy people who want to avoid illness, and those being treated to speed up the recovery process.

Conclusion

This article discussed the disease medicamentous rhinitis and its treatment, as well as possible complications. We noted the causes and symptoms of the disease so that you can recognize the disease in time. Remember that if you consult a doctor in a timely manner, complications can be avoided. Also presented general information on methods of treating rhinitis. Under no circumstances should you prescribe therapy for yourself without first consulting your doctor. You can harm your health!

Drug-induced rhinitis – chronic inflammatory disease nasal mucosa, due to prolonged use or allergy to their components. This is a special pathology that occurs with the development of a specific reaction of the body to regular administration of nasal cavity vasoconstrictors. The sensitivity of the nose to the drug first decreases and then disappears completely.

Chronic runny nose is a side effect of various medications: contraceptives, antipsychotics, tranquilizers, antihypertensive drugs, nonsteroidal anti-inflammatory drugs NSAIDs, vasoconstrictor nasal drops.

Nasal drops and sprays are an integral part complex treatment any respiratory infection. At the beginning of therapy, such drugs quickly eliminate the main symptom of the pathology -. Vasoconstrictor drugs cleanse the nasal passages, reduce swelling of the mucous membrane and significantly facilitate nasal breathing. The first symptoms of the disease are eliminated, and constant, uncontrolled vasodilation occurs - expansion of blood vessels and lymphatic vessels. Over time, their tone decreases, the nasal mucosa swells and then atrophies. Such changes lead to development. Any drug must be taken strictly according to the instructions and under the supervision of a physician. Nasal drops and sprays are no exception. If you treat yourself, without medical advice, the outcome of therapy can be disastrous.

Drug abuse makes treatment ineffective. The mucous membrane ceases to function properly, which leads to chronicity of the process and the patient's dependence on the medicine. Swelling and hyperemia of the mucous membrane is a special reaction of the body to uncontrolled use of drugs. In patients, painless formations appear on the dry mucous membrane - polyps, which complicate nasal breathing and completely clog the nose. Their removal is accompanied acute pain and the appearance of blood. Gradually, the inside of the nose becomes a large and bleeding wound. The disease lasts for years or even decades in most patients. Getting rid of such a problem is quite difficult.

Experienced otolaryngologists treat drug-induced rhinitis. They carry out conservative or surgical therapy. Drug-induced rhinitis in children occurs in the same way as in adults, but it is much more difficult to cure. The child does not understand why he cannot use a remedy that brings relief and allows him to breathe freely. It is better to prevent the occurrence of this problem: harden children's body, often walk in the fresh air, strengthen your immune system.

Etiology

The main cause of drug-induced rhinitis is long-term use of vasoconstrictor nasal medications that eliminate unpleasant symptoms, or allergic reaction to their components. Their frequent and uncontrolled use first leads to atrophy and dysfunction of the nasal mucosa, and ends with the development of rhinitis of drug origin.

Many people believe that a runny nose is not a disease, but a mild ailment that can be easily treated with any nasal spray. Patients are in no hurry to visit a doctor and go to the nearest pharmacy. The use of vasoconstrictor drops day after day leads to the development of dependence and pathological changes in the nasal cavity. The disease is based on the “rebound symptom”, the meaning of which is as follows: blood vessels they no longer narrow, but begin to expand, causing swelling and swelling of the mucous membrane. Over time, the symptoms of the disease become obvious. A person cannot do without his favorite bottle of nasal drops and cope with chronic pathology on his own. Nasal drops suppress the production of its own vasoconstrictor substance, norepinephrine, and the body ceases to independently maintain the tone of the nasal vessels. Time is lost, and the disease progresses.

Drug-induced rhinitis can be considered one of the varieties of allergic or vasomotor rhinitis. The mucous membrane reacts in a special way to long-term use of certain medicines. It is important to promptly identify and promptly treat allergies.

Symptoms

Nasal congestion and rhinorrhea are the main symptoms of drug-induced rhinitis. Nasal breathing first becomes difficult and then impossible without the use of vasoconstrictor drops.

The disease also manifests itself:

Migraine-like pain
Decreased olfactory sensations
The appearance of copious watery discharge,
Tickling and
Dryness and tingling of the mucous membranes,
Insomnia,
The appearance of snoring
Difficulty breathing,
swelling of the nose,
Redness or blueness of the skin of the nose,
Tearing and sneezing,
Irritability,
Hypertension,
Tachycardia,
Pressing pain in the heart.

If such symptoms appear, you should consult a doctor and begin treatment. Clinical signs intensify in the evenings, when motor activity decreases, and the tone of capillaries and arterioles reflexively decreases.

During an examination of the nasal cavity, the ENT doctor notes hyperemia and swelling of the mucous membrane with noticeable hemorrhages, transformation of the ciliated epithelium into squamous epithelium, hyperproduction of mucous gland secretions, and increased permeability of blood and lymphatic vessels. The capillaries become brittle, and the mucous membrane thins and atrophies.

Taking medications long time, it’s important not to miss the first ones warning signs diseases.

Complications of medicinal rhinitis:

Increased blood pressure,
Cardiovascular diseases,
Endocrine pathologies,

Diagnosis and treatment

Diagnosis and treatment of the disease is carried out by otolaryngologists. They listen to patients' complaints, conduct a thorough examination of the nasal cavity, and send nasal and throat discharge to a microbiological laboratory for bacteriological examination. Differential diagnosis carried out with allergic and vasomotor rhinitis. For this they use instrumental methods - radiographic, tomographic, endoscopic, microscopic examination nasopharynx.

Treatment of medicinal rhinitis is complex, including conservative therapy, general stimulating and sanitation procedures, physiotherapeutic methods, and, if necessary, surgical intervention and the use of folk remedies. This is a long and complex process that requires time and patience. The first thing the specialist will recommend is to completely stop using drops. This is not easy to do, because they make breathing easier and improve your condition immediately after use. In particularly severe cases, the dose may be reduced gradually. Taking antihistamines will make the process of weaning off the medication easier.

Experts recommend starting treatment for medicinal rhinitis with hardening the body and strengthening the immune system. In some cases, this may be enough to fix the problem. Patients are shown:

Spa treatment,
Trips to the mountains
Swimming,
Daily, long walks in the fresh air.

This will help increase the body's overall resistance and improve the regenerative ability of the nasal mucosa.

Before starting drug therapy for rhinitis, you should stop using vasoconstrictor drugs. If patients endure 2-3 weeks without drops or replace them with more gentle ones, the dependence and symptoms of the pathology disappear, and nasal breathing is completely restored.

Experts advise gradually reducing the dosage or replacing your drops with softer ones - “Vibrocil”, drops based on sea water: "Aquamaris." Adult drops can be replaced with children's drops, for example, "Otrivin Baby". The active components of these drugs do not irritate the mucous membrane, tone blood vessels and make treatment more effective.

Pharmacological treatment

Drug therapy includes:

“Avamys” is the most popular glucocorticosteroid drug, produced in the form of a spray. It has a powerful anti-inflammatory effect, gradually improving nasal breathing. "Avamys" has a pronounced therapeutic effect against the background of rarely occurring side effects.

The duration of treatment with endonasal steroids is 1 month. If conservative therapy turned out to be ineffective, they proceed to surgical treatment.

Physiotherapy

UHF therapy,
Acupuncture,
Phonophoresis,
Electrophoresis,
Laser therapy,
Ultrasound,
Inhalations.

The listed methods, in combination with the gradual abandonment of vasoconstrictor drugs, lead to the patient’s complete recovery. To speed up the healing process, patients are advised to perform a variety of breathing exercises daily.

Surgery

Rhinitis medicamentosa can now be treated surgically. Surgery is used in cases where conservative treatment turned out to be ineffective. If there are irreversible changes in the nasal mucosa, surgery will help the patient regain health and easy nasal breathing.

Main types of operations:

Laser cauterization,
Shaver vasotomy,
Conchotomy,
Cryotherapy,
Septoplasty and turbinoplasty,
Traditional vasotomy.

The surgical intervention is aimed at removing blood plexuses in the submucosal layer, restoring nasal breathing, and relieving the patient of rhinitis. Radio wave and laser vasotomy- the most popular and gentle operations. During tissue dissection, coagulation of blood vessels occurs, which significantly reduces the risk of bleeding in the postoperative period.

Palliative treatment of medicinal rhinitis consists of increasing the diameter of the nasal passages by reducing the nasal ridges or turbinates in volume. This minor operation improves nasal breathing. It is performed using different methods: using ultrasound, laser, mechanical or electrical influence.

Alternative therapy

Traditional medicines cope well with the symptoms of rhinitis. They do not irritate the mucous membrane and do not cause complications. Folk remedies can be used independently, without the use of any medications, or to supplement the main treatment of the disease.

Folk remedies that eliminate inflammation in the nose:

To get rid of the disease quickly and without consequences, it is necessary to follow the recommendations of doctors and coordinate the traditional medicine recipes used with them. Self-medication can lead to exacerbation of the disease.

Video: doctor about drug-induced rhinitis

What is rhinitis medicamentosa? What are the main reasons for its development? How is the disease characterized? What treatments for medicinal rhinitis are most effective?

Drug-induced rhinitis is a type of runny nose that occurs as a result of prolonged or frequent use of vasoconstrictors (decongestants), which leads to chemical damage to the nasal mucosa. For this reason, the disease can develop in both adults and children.

ICD-10 code: J30 – vasomotor and allergic rhinitis.

Causes and mechanism of development of pathology

The nasal cavity is covered with a layer of cavernous tissue, which can quickly increase in size when significantly filled with blood. At the same time, the rate of heating of the inhaled air increases. Once a person enters a warm room, heating is no longer required, so the tissues return to their normal state.

Vasoconstrictor drops affect the capillaries of the nasal cavity, forcibly compressing them, regardless of the air temperature. Nervous system does not recognize the command and causes the blood vessels to dilate, causing swelling and nasal congestion.

Reactive hyperemia, which develops several hours after local applicationα-adrenergic agonists, forces the patient to increasingly use these drugs. This leads to reactive hyperplasia of the mucous membrane and impaired vasomotor function.

The more often vasoconstrictors are used, the greater the swelling of the nasal mucosa. In some cases, a patient who is dependent on drops uses a bottle of the drug per day.

With prolonged use of vasoconstrictors, the patient experiences snoring and sleep apnea (apnea). Often, people with addiction experience arrhythmia, tachycardia, and disruption of the nervous and endocrine systems.

In rare cases, the cause of the development of drug-induced rhinitis in adults may be the use of medications from the following groups:

sympatholytics (Adelfan);
α-blockers (Doxazosin, Prazosin);
adrenergic agonists (Methyldopa, Clonidine).

These drugs are used to treat hypertension or adrenal tumors. The drugs act on the nasal mucosa and cause swelling of the cavernous epithelium.

2–3 months after starting to take these medications, the same side effects, as well as as a result of therapy with vasoconstrictor drugs.

Symptoms of drug-induced rhinitis

Drug-induced rhinitis is characterized by the following symptoms:

a constant feeling of nasal congestion, which disappears only after using vasoconstrictors;
impairment or complete absence of sense of smell;
itching and burning in the nose;
the appearance of night snoring;
severe nasal discharge (in some cases).

Diagnosis and treatment of drug-induced rhinitis

If symptoms of the disease are detected, you should consult an otolaryngologist. The doctor examines the nasal mucosa using an endoscope or rhinoscope. At the same time, it can reveal the following defects of the nasal mucosa:

severe swelling resulting from impaired capillary permeability;
absence of many ciliated cilia on the surface of epithelial tissue;
an increase in the volume of glands resulting from excessive production of mucous secretion;
transformation of epithelial tissues.

To objectively assess the depth of the lesion, additional research methods may be prescribed.

Treatment of medicinal rhinitis - maximum difficult task, since independent regeneration of the mucous membrane takes a long period of time, attempts to abandon the use of decongestants usually do not lead to the desired result.

How to treat medicinal rhinitis with pharmacological agents? Corticosteroids are most often prescribed. This hormonal drugs, which help alleviate withdrawal symptoms, eliminate the inflammatory process and reduce swelling. They do not have a systemic effect, active ingredients settle on the surface of the nasal mucosa and are practically not absorbed into the bloodstream.

Most effective medications in this case, drugs based on mometasone (Avamys, Nasonex) are considered. On average, they are prescribed for a course of 30 days. This avoids the use of decongestants. In some cases, medications based on fluticasone (Flixonase) are used, but they are considered less effective.

If it is not possible to completely abandon the use of decongestants, you can use a gentle method, using drugs with lower concentrations active substance(children's forms).

Antihistamines (antiallergic drugs) may be prescribed in combination with these medications. They help reduce swelling and the amount of nasal discharge.

If within a month the patient’s condition does not improve and nasal breathing is not restored, then treatment must be stopped. In this case it is shown surgery. The following methods can be assigned:

laser cauterization. Radiation is applied to the nasal mucosa, as a result of which the vessels are compressed and swelling is eliminated. The procedure is carried out under local anesthesia. Recovery period on average is 3 weeks. The effect of treatment lasts for several years, and in some cases for life;
ultrasonic disintegration. Using ultrasound, capillaries that have lost their ability to contract are destroyed. Subsequently, new vessels are formed that function normally. The procedure is performed under local anesthesia. The next day, the affected area is treated with drugs that accelerate regeneration and eliminate the inflammatory process. Nasal breathing is restored after a few days.

On initial stages You can get rid of a drug-induced runny nose on your own. This will require willpower and perseverance, since the process of weaning is quite complex. Dr. Komarovsky advises treating the disease by abruptly stopping the use of vasoconstrictor drugs. After this, within four days the vessels will partially restore their functions.

If it is not possible to completely abandon the use of decongestants, you can use a gentle method, using medications with a lower concentration of the active substance (children's forms). You can also pre-dilute the product with saline solution or instill the solution into only one nostril. The interval between the use of drops should be maximum.

You can completely get rid of addiction at home 2-3 weeks after stopping decongestants. To increase efficiency, the following folk remedies can be used:

aloe juice In order to prepare a product based on this plant, the leaves must first be cut and placed in the refrigerator for a week. Then they are crushed and the resulting juice is mixed with water. Drop 2-3 drops into each nasal passage 3-4 times a day;
onion juice. A medium-sized onion is crushed and the juice is squeezed out of it, which is mixed with the same amount of hot corn oil. After the product has cooled, it is placed in a glass container and stored in the refrigerator. Apply one drop in each nostril morning and evening;
chamomile infusion. A pinch of dried flowers is brewed with boiling water and filtered after cooling. Place in the nose up to five times a day.

Complications

If you ignore the symptoms of the disease and do not start treatment on time, the following complications may develop:

lack of nasal breathing;
severe chronic headaches associated with oxygen deprivation;
impaired sense of smell;
memory impairment that occurs against the background of hypoxia;
immunity disorders;
sleep problems;
frequent colds.

With prolonged use of vasoconstrictors, the patient experiences snoring and sleep apnea (apnea). Often, patients with addiction experience arrhythmia, tachycardia, and disruption of the nervous and endocrine systems.

Antihistamines (antiallergic drugs) may be prescribed in combination with these medications. They help reduce swelling and the amount of nasal discharge.

With timely initiation of treatment, the prognosis of the disease is favorable. You can completely get rid of addiction within 1–2 months.

Prevention

In order to avoid the development of medicinal rhinitis, before using drops with a vasoconstrictor component, you should carefully study the instructions. It is important to follow the recommended dosage and not exceed the indicated duration of use.

Before using decongestants, you should try to cure a runny nose using other medications, inhalations, or nasal rinses with herbal decoctions and saline solutions.

In the future, after getting rid of addiction, you should stop using vasoconstrictor drops to avoid the development of pathology again.

To prevent rhinitis, you need to ventilate the room more often and regularly carry out wet cleaning. It is also recommended to keep healthy image life, strengthen the immune system.

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