Rhinitis - Bien

Japanese: 鼻炎 - びえん

There are four main types of inflammation of the nasal mucosa: acute rhinitis, chronic rhinitis, allergic rhinitis, and vasomotor rhinitis.

[Masami Kawamura]

Acute rhinitis

The most common conditions are colds and simple acute rhinitis caused by viral infections.

Simple acute rhinitis can be caused by one or more of the following triggering factors: inflammation of nearby organs such as sinusitis, tonsillitis, and adenoids, as well as dust, soot, tobacco, air pollution, extreme temperature changes, and excessive dryness or humidity. Symptoms begin with sneezing, followed by excessive nasal discharge, nasal congestion, and loss of smell. They are similar to those of a cold, but there are no systemic symptoms such as fever. The nasal mucosa becomes congested and swollen. It usually heals within 10 days, but sometimes bacterial infections occur, worsening the symptoms and causing a fever. If the condition continues for a long time, it can develop into sinusitis or chronic rhinitis. Treatment involves rest and keeping the patient warm, as well as symptomatic administration of antipyretics, analgesics, cough suppressants, and anti-inflammatories, and if a bacterial infection occurs, antibiotics.

[Masami Kawamura]

Chronic rhinitis

If the trigger of acute rhinitis is not improved, it will progress to chronic rhinitis. There are three types of chronic rhinitis: simple chronic rhinitis, hypertrophic rhinitis, and atrophic rhinitis.

(1) Simple chronic rhinitis The symptoms are roughly the same as those of hypertrophic rhinitis, including nasal congestion, excessive nasal discharge, olfactory impairment, and headaches. However, it differs from hypertrophic rhinitis in that swelling of the nasal mucosa can be improved with the use of vasoconstrictors. The most important treatment is to remove the trigger, and conservative treatments such as topical application of medicines and administration of anti-inflammatory drugs are also used.

(2) Hypertrophic rhinitis: This is the most common type of chronic rhinitis, and refers to a condition in which the nasal mucosa becomes significantly swollen and thickened.

(3) Atrophic rhinitis In this type, not only the mucous membrane but also the bones of the nasal turbinates atrophy. The cause is still unknown, but there is a theory that it is related to endocrine or vitamin disorders. Even though the mucous membrane atrophies and the nasal passages expand, the main symptom is nasal congestion, and the mucous membrane dries out and forms crusts. When the amount of dirty crusts increases, the odor becomes strong, and the condition is also called osmear nose. Treatment involves nasal irrigation and the use of topical antibiotics to prevent infection, and sometimes surgery to narrow the nasal passages.

[Masami Kawamura]

Allergic rhinitis

This is rhinitis caused by allergies, which are antigen-antibody reactions, and is also known as nasal allergy, and has been increasing recently.

[Masami Kawamura]

Vasomotor rhinitis

The symptoms are the same as allergic rhinitis, but no obvious antigens are identified and it is thought to be an autonomic nervous disorder. In response to the temperature and humidity of the outside air, sneezing, watery rhinorrhea, and nasal congestion occur. Antihistamines and antiallergic drugs are used for treatment.

[Masami Kawamura]

[References] | Allergic rhinitis | Cold syndrome | Nose | Hypertrophic rhinitis

Source: Shogakukan Encyclopedia Nipponica About Encyclopedia Nipponica Information | Legend

Japanese:

鼻粘膜の炎症で、急性鼻炎、慢性鼻炎、アレルギー性鼻炎、血管運動性鼻炎の4種類が代表的である。

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急性鼻炎

ウイルスなどの感染でおこる鼻かぜと単純性急性鼻炎が多い。

　単純性急性鼻炎の誘因としては、副鼻腔(びくう)炎、扁桃(へんとう)炎、アデノイドなど近接する器官の炎症をはじめ、塵埃(じんあい)、煤煙(ばいえん)、たばこ、空気の汚染、極端な温度変化、過度の乾燥や湿潤などがあげられるが、これらの誘因の一つ、あるいは複数の因子によっておこる。症状は、くしゃみに始まり、鼻漏（鼻汁）過多、鼻閉（鼻づまり）、嗅覚(きゅうかく)障害で、鼻かぜと似ているが発熱などの全身症状はない。鼻粘膜は充血し、腫脹(しゅちょう)する。通常、10日以内に治癒するが、ときに細菌感染をおこして症状が悪化し、発熱する。経過が長引くと副鼻腔炎や慢性鼻炎になる。治療は、安静や加温のほか、対症的に解熱剤、鎮痛剤、鎮咳(ちんがい)剤、消炎剤を投与し、細菌感染をおこした場合は抗生物質を投与する。

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慢性鼻炎

急性鼻炎の誘因が改善されないと慢性鼻炎に移行する。慢性鼻炎には三つの病態があり、それぞれ単純性慢性鼻炎、肥厚性鼻炎、萎縮(いしゅく)性鼻炎とよばれる。

(1)単純性慢性鼻炎　症状は肥厚性鼻炎とだいたい同じで、鼻閉、鼻漏過多、嗅覚障害、頭痛などがみられる。しかし、血管収縮剤によって鼻粘膜の腫脹が改善される点で、肥厚性鼻炎とは異なる。治療は、誘因の除去がもっとも重要で、薬剤塗布や消炎剤の投与などの保存的治療も行われる。

(2)肥厚性鼻炎　慢性鼻炎のうち、もっとも多くみられる病態で、鼻粘膜の腫脹が著しく、粘膜の肥厚した状態をいう。

(3)萎縮性鼻炎　粘膜ばかりでなく、鼻甲介の骨も萎縮する型で、その原因はまだ不明であるが、内分泌やビタミンの障害に関係があるという説もある。粘膜が萎縮して鼻道が拡大しているにもかかわらず、鼻閉が主症状であり、粘膜が乾燥して痂皮(かひ)（かさぶた）がつく。汚い痂皮の量が多くなると悪臭が強く、臭鼻症ともよばれる。治療は、鼻洗浄と感染予防のための局所的抗生物質の使用、ときには鼻道を狭くするための手術を行う。

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