There is probably no-one who hasn’t been exposed to the world’s most common disease, the common cold and a runny nose. But how to treat the common cold and why you need to be careful with cold remedies was asked from Meliva ear, nose and throat specialist Dr Marina Tšerkassova by journalist Kristina Traks.
First of all, it’s worth knowing that the nose has many different functions – cleaning, warming and humidifying the air you breathe. It is the mucus that is responsible for the latter, which is also necessary for the removal of irritating microbes, potential inflammatory agents, dust or other inhaled irritants and potential allergens. In most cases, therefore, a runny nose is the body’s defence response – a process that helps the body to fight the irritant.
Dr Tšerkassova explains that the world’s most common disease, the common cold, is classified as acute if it lasts up to 12 weeks. If the sniffling does not stop within that time, the cold is already called chronic. Viruses are the most common cause of the common cold, according to Tšerkassova. The increased mucus production caused by these is called a contagious cold.
Allergic rhinitis is also common, and is caused by irritation from dust (often pollen, industrial or household dust). This type of runny nose can also be the body’s reaction to food or other allergens that enter the body not only through the nose but also through the mouth or skin.
A runny nose that has already started usually leads to other unpleasant problems. Breathing through the nose becomes difficult or impossible, which can lead to headaches. Mucus running down the nasopharynx can make you cough. Another function of the nose – the sense of smell – is also impaired, and sometimes the sense of taste is lost during a runny nose, and the person cannot taste food. If the cold is caused by a virus entering the body, it often occurs against a background of general feeling of ill health.
A runny nose usually lasts a week
It is said that the cold lasts 7 days if treated and over a week if not. How long it actually lasts depends, of course, on the body’s immune system, says Dr Tšerkassova.
“If the body’s immune system is functioning normally, the cold will pass within 7-10 days. However, if the immune system is weakened, the cold can last for weeks or even longer,” she adds.
Everyone has experienced that the sniffles are annoying and uncomfortable. “Even if it does not cause discomfort, it is important to know that a cold, especially one that does not go away for a long time, can lead to a number of complications, and if you suspect it, you should seek medical advice. For example, inflammation of the mucous membranes of the nose can spread to the sinuses (sinusitis) or the lower respiratory tract (tracheitis, laryngitis, bronchitis). In addition, complications of the common cold include otitis media. However, nasal mucous membrane irritation should be treated at an early stage,” she says. “The treatment of rhinitis is primarily aimed at restoring nasal breathing. In this case, over-the-counter vasoconstrictors, i.e. blood vessel constrictors – drops and aerosols – available over the counter from pharmacies, provide a rapid effect. These reduce nasal swelling and facilitate nasal breathing. Examples of preparations include Xymelin, Otrivin and Galazolin.”
The active ingredient in these medicines, the doctor explains, is not just local – the effect is not just limited to the nose where they are administered, but also has a certain general effect – affecting the blood vessels of the heart, brain and even the uterus. It is precisely for this reason that these nasal decongestants should not be used for long periods of time, and this is especially true for pregnant women and people with high blood pressure.
Addiction to nasal medicine – it’s serious
There is a lot of talk about becoming addicted to nasal medicine. This is a serious issue that cannot be ignored. According to Dr Tšerkassova, when using vasoconstrictors, tolerance to the active ingredients of these drugs develops quite quickly.
“This means that to get relief, you have to take the medicine too often and exceed the recommended doses, because after the temporary relief, the runny nose and stuffy nose come back quite quickly. The uncontrolled use of such medicines is called drug-induced rhinitis (drug-induced rhinitis). It can occur even within 72 hours of starting treatment.”
Drug-induced rhinitis is associated with loss of sense of smell, throat irritation, general discomfort and emotional instability. According to the doctor, this type of rhinitis definitely requires treatment and is difficult to cure without medical help. “First and foremost, you have to understand that this is an addiction to taking cold medicines,” says Dr Tšerkassova. She stresses that only a doctor can make the correct diagnosis and treatment, and only after examining the patient.
According to Dr Tšerkassova, addiction to cold medicine is more common in young and middle-aged people, with roughly the same frequency in women and men.
“The frequency of referrals to a doctor is around 1-7 per cent of all referrals for ear, nose and throat conditions. This type of rhinitis can develop as early as the 3rd to 5th day of medication. It can occur as early as on day 3 or as late as within 4-6 weeks – time varies from person to person,” she explains. Dependence develops particularly quickly in young children. Children under the age of two should not use these drugs at all, and older children should use them in lower concentrations than adults and under adult supervision. In addition to the duration of use, attention should be paid to the frequency of administration.
The key point in the treatment of drug-induced rhinitis is the complete withdrawal from addictive over-the-counter medicines. The doctor may prescribe nasal sprays, which ease breathing through the nose but have no side effects mentioned. These are corticosteroid sprays that relieve inflammation and swelling of the nasal mucosa and improve its condition. In cases where conservative treatment is ineffective, surgical treatment is even used.
Runny nose has it’s motives
According to Dr Tšerkassova, it is possible to cure a runny nose, but the cause of the irritation must be identified. Treatment of a runny nose is particularly effective once the cause has been eliminated. In addition to allergic and infectious colds, colds can also occur for hormonal reasons, for example. An example of this is a cold caused by hormonal changes in the body during pregnancy.
But parents should not forget children’s ingenuity – young children find the nose an interesting place to stick toys or other small foreign objects. And, of course, such things will start to cause irritation and runny noses.
Some people may have very narrow nasal passages, either congenitally or as a result of life. In itself, an anatomically narrow nasal passage is not a pathology, according to the ENT surgeon, as long as the nose is able to perform its function.
“Breathing through the nose is also made difficult by mechanical obstructions, such as the presence of polyps in the nasal cavity, a deviated septum or enlarged nasal turbinates. In such cases, surgical treatment can help: removing polyps, straightening the septum and reducing nasal congestion,” says Dr Tšerkassova.
When to see a doctor with a runny nose? “It is recommended if the cold lasts for more than 10-14 days, if the discharge is bloody or has an unpleasant smell, if there is a fever with a persistent cold, if the cold is accompanied by facial pain, or if the cold has developed after a nasal or head trauma. In infants, however, if a runny nose develops against a background of high temperature, making it difficult for the baby to breathe and feed. In young children, it is worth noting that the nasal discharge is unilateral and purulent, which may indicate a foreign body in the nasal cavity. In adults, however, the common cause of this symptom is unilateral sinusitis due to a tooth infection,” explains the doctor.
