How to distinguish a cold from allergic rhinitis？ The famous doctor has something to say
Nose uncomfortable, is it a cold or rhinitis? If it is rhinitis, is it allergic rhinitis? This is a puzzle that many people encounter.
A cold, also known as acute rhinitis, is usually caused by viral infection, which manifests as acute inflammation of nasal mucosa. It can be divided into prodromal stage, catarrhal stage and recovery stage. Patients will experience systemic discomfort such as nasal dryness, burning, foreign body sensation accompanied by chills, to symptoms such as nasal congestion, sneezing, watery nasal discharge, nasal sound, etc., accompanied by low fever and fatigue, and then nasal mucus becomes sticky and systemic symptoms are relieved. The course of disease is 7-mdash; About 10 days. The degree of severity can be different due to the different types of viruses infected and the age and physical state of patients. Therefore, systemic symptoms and short-term course of disease are important characteristics of colds.
As a kind of chronic rhinitis, patients with allergic rhinitis will have a long-term course of disease that lasts for several months or recurs, and can’t return to normal during the intermittent period. The initial symptoms are similar to colds, but they appear because patients are exposed to environmental irritants such as dust mites, pollen and animal fur. There is no clear pathogenic microbial infection, which is also one of the important characteristics different from colds. These allergens can stimulate the body to produce an immunoglobulin called IgE, which eventually leads to various symptoms through a series of inflammatory reactions and becomes chronic inflammation of nasal mucosa. Therefore, the detection of IgE is very important in the diagnosis of allergic diseases. Of course, the premise of the patient’s attack is that his body itself has been sensitized, and this kind of reaction will occur. Recurrent nasal itching occurs first, followed by sudden or continuous sneezing. It can occur in the morning or before going to bed at night, or it may occur immediately after contact with allergens. At the same time, it is accompanied by a lot of nasal discharge. In severe cases, the nasal congestion is serious and the sense of smell is reduced. Other patients suffer from sore throat, dry throat and even symptoms such as asthma, itchy eyes and tears due to long-term breathing.
If the onset of the disease has a very obvious seasonal correlation, it is likely to be seasonal allergic rhinitis. The main allergen is seasonal pollen, and patients will have very obvious symptoms in the time interval when pollen spreads, especially in sunny or windy weather. Eye, pharynx and even airway symptoms may be accompanied at the same time, and the symptoms will disappear after the pollen stage has passed.
The perennial allergic rhinitis caused by dust mites, molds, cockroaches, animal fur and so on is considered. The severity of symptoms is related to the concentration of allergens in the environment, and may also induce allergic asthma. Some patients even have sinusitis and nasal polyps, which require repeated surgical treatment, increasing the physical and economic burden.
According to the statistics all over the world, the prevalence of allergic diseases is increasing year by year, and it has become one of the chronic diseases that threaten human health. At present, the research on the pathogenesis of allergic diseases has not been conclusive. For children, if one or both parents have allergic diseases, the chances of children having allergies are greatly increased, which shows that heredity is also an important factor.
Allergic rhinitis is different from a cold, and refusing to take medicine can not play a role in "enhancing immunity". On the contrary, on the premise that contact with allergens cannot be avoided, if it is not controlled by drugs, it is likely to aggravate the condition and even evolve from allergic rhinitis to allergic asthma. For asthma patients with rhinitis, the treatment of rhinitis should not be ignored. Allergic rhinitis in the upper airway is not well controlled, and asthma in the lower airway is difficult to control effectively.
(The author is the executive vice president of Beijing Tongren Hospital and the chief physician of otorhinolaryngology head and neck surgery.)