Effective methods of treating nasopharyngitis and eliminating symptoms. Acute nasopharyngitis

Everyone without exception is familiar with diseases such as acute respiratory infections, flu and otitis media (ear inflammation), since every child “brings” these diseases from kindergarten or school more than once. However, there is another disease that is also very often diagnosed by otolaryngologists, both in children and adults - nasopharyngitis. The disease in its symptoms is very similar to rhinitis and pharyngitis at the same time, but, in fact, is a consequence of improper or insufficient treatment of these two diseases. The disease nasopharyngitis in adults and children covers the pharynx and mucous membranes of the nasal sinuses. How to treat nasopharyngitis and how can you prevent the development of the disease?

Rhinopharyngitis in adults: causes and symptoms

The main reason for the development of this disease is improper and untimely treatment of rhinitis (common runny nose) and pharyngitis (inflammation of the mucous membrane of the throat).

Rhinopharyngitis in adults, often called nasopharyngitis, is of viral origin in 90% of cases. The following viruses can cause viral nasopharyngitis:

influenza and parainfluenza;
adenoviruses;
rhinoviruses;
PC virus.

Much less often this pathology is allergic or bacterial in nature. Among the bacteria that can cause the disease are: anaerobic bacteria, chlamydia, mycoplasma, diphtheria bacillus, etc. Allergic nasopharyngitis most often results from contact with household dust, mites, and pollen.

It is very important to quickly eliminate the disease that has arisen, since after it becomes chronic, choose effective treatment it will be very difficult. Chronic nasopharyngitis practically cannot be treated; all measures provide temporary relief of the condition and soon the disease returns.

The symptoms of the disease combine the signs of rhinitis and pharyngitis. The main symptoms of nasopharyngitis are as follows:

discomfort is constantly felt in the nasopharynx area - it stings, burns and dries;
Periodically, there is an accumulation of difficult-to-remove mucus in the nose and throat, which can become bloody;
nasal breathing becomes difficult, one or both nostrils are constantly clogged, so the voice becomes nasal.

If the inflammatory process spreads to the membrane of the auditory tubes, severe pain in the ears, hearing loss and “sound effects” in the form of clicking may occur.

During the examination, hyperemia and slight swelling of the nasopharynx are detected, while the discharge is particularly viscous. Enlargement of the cervical and occipital lymph nodes may also be observed.

Symptoms of allergic rhinopharyngitis

Allergic rhinopharyngitis in its symptoms is very similar to the “traditional” form of the disease, caused by a protracted and extensive inflammatory process in the nasopharynx. But the nature of this disease is completely allergic, since the disease is caused by the action of a specific allergen, and not by a virus or bacteria.

With this type of disease, the nasopharynx becomes completely inflamed; most often the process begins in the nose and gradually descends into the pharynx. However, it may also be observed reverse stroke diseases when pharyngitis first occurs and the throat becomes inflamed, for example, when eating an allergen, and then the process rises higher and reaches the nose, rhinitis appears.

The patient experiences symptoms such as a low-grade inflammatory process, redness of the pharynx, mucus draining down its back wall, discomfort and feeling of a “lump” in the throat and cough.

Removing the source of the allergen from everyday life or the menu and eliminating further contact with it will help get rid of allergic rhinopharyngitis.

Symptoms and temperature for acute nasopharyngitis

A feature of the acute form of this disease is the presence of severe swelling and deep penetration of the inflammatory process into the tissues of the nasopharynx. In addition, there is a strong expansion blood vessels and an almost constant flow of blood to the nasopharyngeal area. The disease is characterized by rapid development and is detected by the following symptoms:

Availability large quantity mucus, often purulent;
itching in the nose and;
increased production of tears;
change in voice timbre;
observed constant feeling sore throat, especially when swallowing.

Temperature with nasopharyngitis acute course, in most cases, rises to subfebrile values of 37-37.8 degrees. In this case, the patient may feel unwell, dizzy, severe weakness and the desire to lie down.

Forms of chronic nasopharyngitis: subatrophic, hypertrophic and granulosa

Very often, due to the lack of proper treatment, acute nasopharyngitis becomes chronic. In this case, a runny nose and cough drag on for many years. Patients practically lose the ability to distinguish odors and complain of bad dream and difficulty breathing.

There are several forms of chronic nasopharyngitis, the treatment of which will differ slightly from each other:

subatrophic nasopharyngitis accompanied by unpleasant sensations in the throat area, namely soreness and soreness. The voice often becomes hoarse, the mucous membrane of the nasopharynx is pale and very shiny;
hypertrophic nasopharyngitis characterized by a clear and intrusive feeling of the presence of a foreign body. There may be pus in the mucous discharge, especially a lot of this discharge in the morning. The development of a gag reflex, enlarged tonsils with severe hyperemia are very likely;
granulosa nasopharyngitis – if it is present, the mucous membrane swells greatly and becomes loose, especially around the tonsils. Enlargement of the lymph nodes is also observed.

More often than not, nasopharyngitis is disguised as serious illnesses, such as scarlet fever or measles. The treatment regimen and plan for each disease is different, so it is extremely important to make a diagnosis as quickly as possible.

How to treat nasopharyngitis: inhalations and antibiotics

No matter how characteristic and similar the symptoms of the disease may be, therapy should be prescribed individually. Treatment for nasopharyngitis should be selected and prescribed only by a specialist after examining the patient and passing tests that will help clarify the type of disease and determine its causative agent.

Most often, treatment of symptoms of nasopharyngitis and subsequent restorative measures begin with inhalations, as well as frequent rinsing of the nasopharynx with various rinsing solutions. Inhalations for nasopharyngitis can be performed using soda solutions, Borjomi mineral water, chamomile and sage infusions.

Treatment of acute nasopharyngitis is carried out using various antibacterial, antimicrobial and antiseptic sprays (Dexamethosone, Fusafungin, etc.), since sometimes rinsing at the very beginning of treatment can be very difficult due to severe swelling of the mucous membrane. Antiangin, Dyclonin and Ambazon lozenges are also prescribed. If allergens are to blame, an appointment is prescribed antihistamines.

Except antibacterial agents Treatment of nasopharyngitis in adults and children can be carried out using anti-inflammatory and analgesic sprays. These drugs significantly improve the patient’s well-being and have a positive effect on the healing process.

Antibiotics for nasopharyngitis are not often prescribed, only in the case of clearly bacterial inflammation of an advanced, long-term course of the disease. However, the possibility of their use should not be completely ruled out, since the disease tends to “subside” and then recur with renewed vigor and more severe course. Therefore, sometimes you simply cannot do without antibiotics, and most often this is antibacterial drugs penicillin group.

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Nasopharyngitis (rhinopharyngitis, rhinovirus infection, less often - rhinonasopharyngitis or epipharyngitis), which in everyday life is called a cold - inflammation of the mucous membrane of the nasopharynx. It manifests itself in redness and swelling of the mucous membrane, its swelling, as well as in the formation and release of transparent, mucous or purulent exudate (liquid). The cause of the disease in most cases is infectious.

ICD-10	J00, J31.1
ICD-9	460
DiseasesDB	31088
MedlinePlus	000678
MeSH	D003139
eMedicine	aaem/118 med/2339

General information

Nasopharyngitis develops in 80% of cases during seasonal ARVI. According to statistics, every adult suffers from ARVI 2-3 times a year, and children suffer from this disease several times more often. The peak incidence occurs during the period of decreased immunity (late winter - early spring).

The onset of ARVI in most cases is accompanied by signs of nasopharyngitis, so nasopharyngitis in 90% of cases has a viral etiology.

Acute nasopharyngitis can be complicated by a bacterial infection.

Forms

Depending on the type of disease, the following are distinguished:

acute nasopharyngitis, which is often of viral origin, but allergic and bacterial etiologies are also possible;
chronic nasopharyngitis, which in most cases is caused by bacteria, and in some cases by fungi.

Acute nasopharyngitis Depending on the pathogen, it is divided into:

streptococcal;
staphylococcal;
chlamydial;
mycoplasma;
meningococcal, etc.

Chronic nasopharyngitis May be:

Hypertrophic. This type of nasopharyngitis is characterized by swelling and thickening of the mucous membrane of the nasopharynx and submucosal layer, sore throat, tickling sensation in the nose and increased secretion clear exudate in the morning. Tear production also increases.
Atrophic. This type is characterized by thinning of the mucous layer of the nasopharynx, a feeling of dryness, bad smell from the mouth and problems with swallowing.

Reasons for development

The main cause of the disease is an infection that has entered the body. Regardless of the type of pathogen, the decisive factor in the development of nasopharyngitis is a viral infection.

In some cases, nasopharyngitis is caused by fungi. The most common pathogen in this group is the Candida fungus. With candidiasis of the nasal cavity, inflammation develops in the area of the anterior or middle third of the nasal septum. May manifest as an isolated disease or be combined with candidiasis oral cavity.

Nasopharyngitis is also one of the most common manifestations of allergic reactions. Allergens that most often provoke allergic nasopharyngitis include:

pet hair;
plant pollen;
book dust;
food allergens.

Inflammation usually begins in the nasal cavity and then descends into the pharynx, but the reverse path of development of the disease is also possible.

Factors contributing to the development of nasopharyngitis include:

proliferation of adenoids;
deviated nasal septum;
trauma to the mucous membrane in the nasal cavity;
hypothermia;
weakened immunity;
hypovitaminosis;
smoking.

Nasopharyngitis also occurs as a complication of certain diseases of the heart, kidneys and liver, in which congestion occurs.

Pathogenesis

Under the covering epithelium of the mucous membrane of the nasal septum in humans there are:

a layer of loose fibrous connective tissue;
layer of glands;
a layer of dense fibrous connective tissue that covers the surface of cartilage and is rich in nerves and blood and lymphatic vessels.

In the vestibule of the nose, the mucous membrane is covered by stratified squamous keratinizing epithelium, which in the area of the septum turns into non-keratinizing, and then into ciliated multirow cylindrical epithelium. Goblet cells are found in the deep parts of the nasal cavity.

The nasal mucosa is formed by:

Loose fibrous connective tissue, which includes cellular elements, fibers and capillary-type vessels.
A layer of its own glands, which contains a large number of vessels. This layer also includes the serous glands.
The mucous membrane of the nasal concha, which is also characterized by a layered structure.

A pathogen that enters the nasopharynx or becomes activated actively multiplies when immunity decreases. The process of reproduction in the nasopharynx of any pathogen causes expansion and increased permeability of blood vessels, as well as infiltration of the mucous membrane with leukocytes.

Nasopharyngitis in its acute form causes hyperemia of the mucous membrane and cellular infiltration of the follicles, and in some places rejection of the epithelium is observed.

The inflammatory process is most pronounced in places where lymphadenoid tissue is well developed - in the area of the nasopharynx and pharyngeal mouths of the Eustachian tubes.

Acute nasopharyngitis goes through three successive stages:

The stage of dry irritation, in which dryness and hyperemia of the nasal mucosa are observed. Then the mucous membrane swells, the nasal passages narrow, making nasal breathing difficult, a nasal sound occurs, and taste sensitivity and smell decrease. This stage usually lasts several hours, but it can last longer (up to 2 days).
Stage serous discharge. At this stage, a large amount begins to be released serous fluid transparent color, to which the mucous secretion produced by goblet cells is gradually added. The composition of mucoserous discharge includes ammonia and sodium chloride, therefore in the area upper lip irritation occurs. Dryness and burning are replaced by copious discharge, nasal congestion and sneezing, and the mucous membrane becomes cyanotic.
Stage of resolution, which is characterized by the presence mucopurulent discharge. This stage begins 4-5 days after the onset of the disease. Since leukocytes, lymphocytes and exfoliated epithelium are added to the nasal secretion at this stage, the discharge acquires a yellowish-greenish tint. Over the course of several days, the amount of secretion decreases, and nasal breathing and general state are gradually returning to normal.

The acute form of nasopharyngitis ends 8-14 days from the onset of the disease.

With good immunity, nasopharyngitis lasts 2-3 days, and in weakened patients it can last up to 4 weeks with the risk of becoming chronic.

Acute nasopharyngitis in children thanks to anatomical features(short and wide auditory tube, into which the contents of the nasopharynx easily enter) often develops into acute otitis media.

Symptoms

Symptoms of the disease depend on the age of the patient and the form of the disease - acute nasopharyngitis in children occurs with more severe symptoms, while in adults some symptoms may be absent.

Nasopharyngitis in children is in most cases accompanied by:

high temperature (up to 39 degrees);
headache;
sneezing and dry cough, which worsens at night as a result of irritation by secretions in the back of the throat (cough may be absent);
sensation of itching and burning in the nose;
sore throat and/or sore throat;
nasal voice and shortness of breath;
muscle pain;
runny nose (clear, mucous or purulent);
enlargement of regional lymph nodes;
loss of appetite, weakness, tearfulness, sleep disturbance.

In adults, a significant increase in temperature and cough is rarely observed, nasal sound may be absent, and general malaise is less pronounced.

The spread of inflammation to the mucous membrane of the auditory tubes (eustachitis) is manifested in a clicking sensation, pain in the ears, and decreased hearing.

Meningococcal nasopharyngitis in most cases, it manifests itself in the same way as nasopharyngitis of another etiology (fever, runny nose, etc.), but in 30–50% of patients the disease precedes generalized forms of the disease with their characteristic symptoms.

Chlamydial and mycoplasma type of disease lasts more than 2 weeks and often develops into tracheitis and bronchitis.

Allergic nasopharyngitis in children and adults it is usually accompanied by redness of the throat and pharynx, profuse watery discharge and their flow down the back wall of the throat, swelling of the nose, coughing, redness and swelling of the eyelids, sneezing attacks that cause itching in the nose. These symptoms develop without a sequence of stages of acute nasopharyngitis.

Chronic nasopharyngitis(hypertrophic form) manifests itself during the period of exacerbation of the disease:

constant sore throat and itching sensation in the nose;
unproductive dry cough and, in some cases, pain when swallowing;
discharge of liquid transparent nasal mucus in the morning;
increased lacrimation.

Atrophic form of chronic nasopharyngitis is different:

a feeling of dryness in the throat (the patient wants to take a few sips of water during a conversation);
difficulty swallowing and a feeling of a lump in the throat;
unpleasant odor from the mouth;
the formation of hard-to-remove dense crusts from dried mucus.

Diagnostics

The basis for making a diagnosis of “nasopharyngitis” are:

Clinical signs of the disease.
Complaints of the patient and description by parents of the course of the child’s illness.
Pharyngoscopy data (examination of the pharynx), which reveals swelling, redness and infiltration of the posterior wall of the pharynx, palate, and arches. With lateral pharyngitis, the lateral ridges of the pharynx are inflamed. A mucous exudate may be present on the back of the throat.
Rhinoscopy data (examination of the nasal cavity), which can reveal swelling and hyperemia of the nasal mucosa, the presence of mucous or mucopurulent exudate.
A blood test, which in 50% of cases reveals the presence of moderately severe leukocytosis of a neutrophilic nature, and in other cases the picture of peripheral blood does not deviate from the norm.

If chronic nasopharyngitis is suspected, it is recommended to:

nasal endoscopy, which allows you to examine paranasal sinuses nose, determine the condition of the mucous membrane and collect secretions for bacteriological diagnostics;
radiography, which allows us to identify pathology of the paranasal sinuses and assess the condition of the nasopharyngeal space;
CT scan of the nasopharynx and sinuses;
consultation with an otorhinolaryngologist, and, if necessary, .

A throat swab that allows you to identify the pathogen and determine sensitivity to antibiotics.
If an allergy is suspected, skin tests are done.

It is necessary to differentiate this disease from acute sinusitis (inflammation of the sinuses), vasomotor-allergic rhinitis and exacerbation of chronic sinusitis.

Treatment

Since in most cases the cause of nasopharyngitis is a rhinovirus infection, patients are often prescribed antiviral drugs (Oxolin, Interferon, etc.), but they do not reduce the duration of nasopharyngitis and are drugs with unproven effectiveness.

The main method of treatment is symptomatic therapy:

Antipyretics for elevated temperature(if the temperature is above 38 C, with the exception of children prone to temperature cramps).
Vasoconstrictor drugs (“Naphthyzin”, “Glazolin”, etc.) for difficult nasal breathing. Since long-term use of vasoconstrictors causes drying out of the mucous membrane, it is recommended not to use these drugs in adults. longer than a week, and no more than 3 days for children. Rhinovirus infection in children under 6 years of age is treated with vasoconstrictor drops (sprays and gels are contraindicated). For children under one year of age, it is recommended to use Vibrocil drops if necessary.
First generation antihistamines, which relieve swelling and are prescribed mainly for the allergic nature of the disease.
Gargling with a warm antiseptic solution (furacilin, etc.), salt water, chamomile, sage for sore throat.
Nasal rinsing with Aquamaris and Aqualor.
Rhinopharyngitis of bacterial etiology requires treatment with antibiotics.

Nasopharyngitis is also treated with physiotherapy (Ural irradiation, UHF).

Chronic nasopharyngitis in adults treated with:

Irrigation of the pharynx. Herbal decoctions or antiseptics are used (“Chlorphyllipt”, “Tantum Verde”, etc.);
Local use of antiseptics in the form of tablets, lozenges, aerosols (Ingalipt, Lizobakt, Strepsils, etc.). If you are prone to allergies, it is better to refuse aerosols and use other dosage forms.

To restore adequate nasal breathing, adenotomy (removal of adenoids), submucosal resection of the nasal septum to restore its normal shape, polypotomy, etc. are used, if necessary.

For bacterial etiology of the disease, it is prescribed antibacterial therapy(for bacterial rhinopharyngitis in children, it is recommended to use Isofra nasal spray).

When treating nasopharyngitis, a gentle diet is recommended (exclude hot, cold, spicy and salty foods), as well as giving up alcohol and smoking. It is also important to maintain moist, cool air in the room to prevent mucus from drying out.

Possible complications

The prognosis for nasopharyngitis is favorable, but there is a danger:

development of otitis media in young children;
exacerbation of asthma and bronchiectasis in persons suffering from these diseases;
development of laryngitis and false croup(occurs in children under 7 years of age due to anatomical structure larynx);
development of tracheitis, bronchitis and in some cases pneumonia.

Prevention

Nasopharyngitis has no special methods of prevention. General recommendations aimed at strengthening the general and local immunity, include:

hardening activities;
playing sports;
regular walks;
maintaining a daily routine and proper nutrition;
giving up bad habits (smoking, alcohol).

During the period of exacerbation seasonal diseases It is advisable to avoid contact with sick people and places where large numbers of people gather. It is recommended to eat garlic and onions, rich in phytoncides - these substances inhibit the growth of bacteria, fungi and protozoa. You can also take multivitamins and lubricate oxolinic ointment external parts of the nasal passages.

To decipher this medical term knowledge will be required Latin language, translated from which rhino- means nose, and pharyng- refers to the pharynx, the ending -it expresses inflammation. Acute nasopharyngitis is an inflammation of the nasopharynx in the initial stage; if left untreated, the process can easily become chronic. The mucous membranes are affected, suffering from the introduction of viral and bacterial microflora.

Under the influence of local inflammatory factors, mast cells are drawn into the pathological zone, blood supply is increased here, and small blood vessels dilate. All this provokes swelling and redness. Characteristic symptoms rhinopharyngitis occurs in humans with any type of cold, and they can also appear with the development allergic reaction immediate type. Before starting treatment in children and adults, the cause of pathological changes should be identified and, if possible, eliminated.

What causes inflammation of the nasopharynx?

What factors can trigger the development similar disease? The causes that cause inflammation of the nasopharynx are divided into external and internal factors influence. The second group is relatively rare and mainly focuses on autoimmune disorders.

External causes of nasopharyngitis are:

seasonal viral respiratory infections;
consequences of lacunar, catarrhal or follicular tonsillitis;
chronic sinusitis of a bacterial nature (frontal sinusitis, sinusitis, sphenoiditis, etc.);
bacterial infection;
atrophic processes under the influence of polluted air, inhalation of tobacco smoke;
dryness of the surrounding air;
allergic reactions on house dust, the use of some medicines and food products.

For successful treatment the determining factor is the identification and elimination potential cause. Therefore, during the initial diagnosis, it is important to collect anamnesis and try to exclude negative influencing factors. In general, acute nasopharyngitis is not a life-threatening condition and is quite easy to correct. This even applies to allergic forms, which can be controlled by taking antihistamines without sedation.

Symptoms of rhinopharyngitis in children and adults

As a rule, the disease begins suddenly with a tingling sensation in the mucous membranes of the nose or throat. The onset may be in the form of separate forms of rhinitis or pharyngitis. In the first case, the first signs will be nasal congestion, copious mucus discharge, and active sneezing. In the second case, the symptoms of inflammation of the pharynx come to the fore. This is a sore throat when swallowing, slight hoarseness, difficulty in swallowing.

Symptoms of nasopharyngitis in children and adults are not much different:

increase in body temperature due to viral and bacterial infection, flu;
constant sneezing and lacrimation are more typical for the allergic form of the pathology;
general weakness and malaise;
can join headache due to disruption of the level of internal pressure in the frontal and maxillary sinuses;
the addition of a feeling of hearing loss and congestion in the ears can occur when the Eustachian tube is involved in inflammation (usually a similar symptom occurs 2-3 days after the onset of the disease).

Simultaneous runny nose, cough, sore throat and fever are signs of acute infectious nasopharyngitis.

It should be remembered that such a person poses a danger to others. The disease is very contagious - symptoms of acute nasopharyngitis can appear after 12 hours of contact with an infected patient.

The disease acute nasopharyngitis is divided into stages of its course:

the initial phase is characterized general weakness and increased fatigue, may occur discomfort nasal congestion, sore throat, dry mucous membranes - this is the active introduction of a pathogenic agent (virus, bacteria or allergen);
expanded clinical picture the second phase of the flow includes an increase in body temperature, aches in large joints and muscles, headaches, runny nose and severe pain in the throat - toxins and waste products of harmful bacteria and viruses begin to be released;
the resolution stage is manifested by an improvement in well-being, increased appetite, a decrease in secretions discharged from the nasal passages, a decrease in sore throat - the body has overcome the infection and is actively cleansing and restoring the mucous membranes - vitamin therapy and compliance are required proper routine day.

Recovery usually occurs within 7-10 days. Residual effects cough and slight weakness can persist for up to 15 days.

What is the difference between chronic nasopharyngitis?

Chronic nasopharyngitis develops more often under the influence of allergens and irritants external factors non-infectious etiology. How is it different from acute inflammation nasopharynx, what are the typical symptoms and pathological changes? First of all, there is no increase in body temperature and severe muscle weakness. At the same time, there is a dryness in the throat, and thick mucus is separated from the nasal passages. With a long course, atrophy of the mucous membranes occurs. When going out into the cold, rhinotheca occurs reflexively (secretion of mucus from the nasal passages). When trying to inhale cold air through the mouth, a reflex cough occurs without sputum production. The timbre of the voice changes, and the throat constantly feels dry.

In the allergic form of chronic nasopharyngitis, the conjunctiva of the eyes is involved in the process. This provokes lacrimation, redness of the eyes, and swelling of the eyelids. This is the most common form of allergy today. Causes may be plant pollen, Poplar fluff, pet hair, food products, cosmetical tools and house dust. For successful treatment it is necessary to identify the allergen and, if possible, exclude it from Everyday life. If this is not possible, correction is required immune status and regular use of antihistamines.

In the hypertrophic form of chronic nasopharyngitis, the patient feels the constant presence of a lump or foreign body in the throat. Nasal breathing can be difficult, but mucus secretion is either absent or minimal. This form is characterized by an almost constant increase in the submandibular nodes and palatine tonsils. An exacerbation occurs with any hypothermia of the body or exposure to a traumatic factor.

Treatment of nasopharyngitis and inflammation of the nasopharynx

Treatment of rhinopharyngitis in adults is carried out at home using standard scheme therapy respiratory infections or allergies. Acute nasopharyngitis in children can be treated in a hospital early age who are at risk of developing false croup and laryngospasm. In children, the disease can provoke the development of functional disorders gastrointestinal tract. This can happen multiple times loose stools, reflex vomiting. As a result, dehydration quickly develops.

Treatment of nasopharyngitis includes the following measures:

prescribing bed rest for 3-4 days;
ensuring access of fresh, moist air to the room where the patient is located;
drinking plenty of fluids– up to 3 liters of fluid per day for an adult and up to 2 liters for children;
appointment antiviral drug“Amiksin”, “Arbidol”, “Kagocel”, “Ingaverin”, “Oscillococcinum” in the presence of data indicating the viral etiology of the disease;
antibiotics are prescribed if fever, runny nose and cough do not go away within 5 days; Azithromycin, Azitral, Ciprofloxacin, Amoxicillin, etc. are used;
from the first day Ascorutin is prescribed or ascorbic acid 500 mg 3 times a day - these drugs strengthen the vascular wall of small capillaries and prevent the development of disseminated intravascular coagulation syndrome;
antihistamines are mainly used for allergic forms of the disease, these are Diazolin, Suprastin, Cetrin, Ketotifen, Claritin, etc.;
used locally vasoconstrictor drops in the nose: “Galazolin”, “Isofra”, “Pinosol”, “Nazivin”, “Polidexa”, etc.;
gargling with solutions of “Furacillin”, “Chlorhexidine”, soda and salt, chamomile decoction.

A sick leave certificate is provided for the entire period of treatment (on average 7-10 days). Children who have had acute nasopharyngitis are exempt from physical education lessons for 2 weeks. After recovery you need to do general analysis blood and urine to exclude possible complications.

- a predominantly acute, less often chronic inflammatory process that develops in the mucous membrane of the nasal passages and the back wall of the pharynx and is manifested by nasal congestion, rhinorrhea, sore throat, dry cough, and sometimes a disturbance in general well-being. The main causative factors are infection, occupational and household hazards, allergens. Diagnosis includes history taking, physical and instrumental examination(rhinoscopy, pharyngoscopy, radiography of the paranasal sinuses), sometimes the pathogen is identified. Treatment is symptomatic: nasal drops, gargling, expectorants, and for infections - antiviral and antibacterial drugs.

Rhinopharyngitis (nasopharyngitis) - acute or chronic inflammation of the upper respiratory tract more often of an infectious nature with predominant damage to the mucous membrane of the nasal passages and pharynx. Extremely widespread. In 70-80% of cases it is caused by viruses, and is one of the main clinical manifestations of influenza and other acute respiratory infections. In the autumn-spring period, up to 80% of the population suffers from the disease. The pathology can be detected in patients of any age, but is more often diagnosed in children, due to age characteristics structure of ENT organs. The inflammatory process in children and adults in most cases does not occur in isolation, but involves both the nasal passages and the pharynx. The disease may become chronic.

Causes of nasopharyngitis

Pathology occurs when pathogens penetrate the upper respiratory tract infectious diseases, exposure to allergens, physical and chemical irritants.

Viruses. The main causative agent is rhinovirus (about 50% of all cases of acute nasopharyngitis, more common in the spring and autumn months), as well as adenoviruses, PC (usually in winter) and ECHO viruses, influenza and parainfluenza viruses, coronaviruses.
Bacteria. The pathology is provoked by mycoplasmas, chlamydia, streptococci, staphylococci, and less commonly by meningococci (with carriage and meningococcal rhinopharyngitis). Bacterial agents (mainly due to streptococci, as well as associations of several microorganisms) more often cause the development of pharyngitis.
Allergens, irritants. Allergic nasopharyngitis occurs when plant, household, fungal, food allergens, and house dust, waste products of animals, birds and insects, household chemicals, tobacco smoke, etc. Predominant damage to the pharynx (pharyngitis) is often caused by mechanical and physical irritation when eating hot (cold) food and drinks, inhaling cold or contaminated air, smoking.

Predisposing factors contributing to the development of inflammation of the nasal and pharyngeal mucosa are hypothermia and poor nutrition with vitamin deficiencies. Pollution also contributes to the occurrence of pathology. atmospheric air harmful emissions, difficulty in nasal breathing, presence chronic diseases ear, throat, nose and internal organs.

Pathogenesis

Infectious agents, allergens and irritating factors cause damage to the cells of the ciliated epithelium of the nasal cavity and the mucous membrane of the posterior pharyngeal wall with the development of an inflammatory process, stimulation of sensitive nerve receptors, dilation of blood vessels, and increased permeability vascular wall, increased mucus secretion. Infiltration of the epithelial and submucosal layer of the mucous membrane with lymphocytes, desquamation and accumulation of effusion under the epithelium, and the appearance of mucosal erosions are observed. The presence of pain syndrome with pharyngitis is explained by the rich innervation of the posterior wall of the pharynx with the participation of sensory, motor and autonomic branches of the pharyngeal plexus (glossopharyngeal, nervus vagus, sympathetic fibers of the superior cervical ganglion).

Symptoms of nasopharyngitis

In case of acute nasopharyngitis of an infectious nature after a short incubation period(1-3 days) there is a feeling of dryness and burning in the nasal passages, sneezing, sore throat, worsening breathing through the nose, dry cough. Soon, abundant mucous discharge from the nose appears, pain and sore throat intensifies, and symptoms of general malaise may appear: headache, chills, weakness, sweating. When the inflammatory process transitions to auditory tubes I am concerned about pain and a feeling of congestion in the ears; if the paranasal sinuses are affected, there is pain in the forehead and bridge of the nose, which intensifies when the head is tilted. On days 4-6 of the disease, nasal discharge becomes mucopurulent, thick, its quantity decreases, nasal breathing is restored, and symptoms of general intoxication disappear.

With allergic nasopharyngitis, symptoms of irritation of the upper respiratory tract are more pronounced, which manifests itself frequent attacks sneezing, rhinorrhea, cough with difficult to separate sputum, difficulty breathing and a feeling of lack of air, as well as signs of an allergic process from other organs and systems (urticaria, atopic dermatitis, conjunctivitis, bronchial asthma). For chronic nasopharyngitis general reaction the body is not expressed. The main symptoms of the disease include a constant feeling of nasal congestion, a feeling of dryness in the throat, sore throat, coughing, frequent swallowing movements, difficulty during a long conversation (the need to clear your throat, drink water). Rhinopharyngitis can be complicated by the development of sinusitis, otitis, laryngitis, bronchitis.

Diagnostics

Correct diagnosis of nasopharyngitis requires a thorough history taking to identify possible etiological factor, a careful physical examination of the patient with the participation of a general practitioner or pediatrician, otolaryngologist, infectious disease specialist, and, if necessary, prescribing laboratory and instrumental studies. When performing rhinoscopy, hyperemia and swelling of the nasal mucosa, narrowing of the nasal passages are revealed, with prolonged and chronic process– signs of hypertrophy or atrophy.

During pharyngoscopy, along with hyperemia and swelling of the mucous membrane of the posterior pharyngeal wall, one can often notice the presence of individual lymphadenoid follicles in the form of bright red granules rising above the surface. To identify the pathogen, a study of discharge from the throat and nose can be carried out (culture on nutrient media, PCR). If complications develop with the transition of the inflammatory process to the paranasal sinuses, bronchi and lungs, radiography of the paranasal sinuses and organs is required chest. Differential diagnosis rhinopharyngitis is carried out with other diseases of the ENT organs (including sinusitis, foreign bodies in the nose, adenoids), infections and allergic reactions.

Treatment of nasopharyngitis

The basic principles of treatment of acute nasopharyngitis are adherence to a gentle regimen and diet, the use of medications that affect the causative factor and manifestations of the disease.

Regime, diet. IN acute period illness recommended bed rest, drink plenty of fluids, eat well, including easily digestible foods rich in protein, vitamins and microelements.
Symptomatic remedies. The use of intranasal vasoconstrictor drops(naphazoline, xylometazoline, oxymetazoline, etc.), antitussives and antipyretics, antihistamines. Locally, solutions with antiseptics and medicinal herbs are used to gargle the throat; the throat is lubricated and irrigated with isotonic and alcohol solutions, during the atrophic process, oil preparations are prescribed.
Antiviral and antibacterial drugs. For the viral etiology of nasopharyngitis, interferons, aminocaproic acid, acyclovir for herpes, and rimantadine for influenza can be used. If nasopharyngitis is bacterial in nature and complications develop (sinusitis, bronchitis, pneumonia), antibiotics are prescribed penicillin series, macrolides, cephalosporins.
Physio therapeutic treatment . For prolonged and chronic nasopharyngitis, physiotherapy methods such as electrophoresis with drugs, laser therapy, UHF and ultraviolet irradiation are widely used.

Hospitalization is required only if there are complications. Forecast at acute process favorable; for chronic atrophic nasopharyngitis, systematic maintenance courses of treatment are necessary.

A disease that is characterized by an inflammatory process that occurs on the mucous membrane of the nasal cavity and pharynx is called “rhinopharyngitis.” Symptoms and treatment of nasopharyngitis will be discussed in this article.

Often, patients hear from a doctor a diagnosis of “rhinitis” or “pharyngitis”. However, due to the fact that these anatomical sections are located very close to each other, inflammation of one of them never occurs in isolation, as a rule, and nearby areas are involved.

Therefore, the diagnosis “rhinopharyngitis” would be more correct and logical. The pharynx anatomically belongs to the digestive organs, but, in fact, it is the area where the respiratory tract begins. When an inflammatory lesion of the nasal cavity occurs, the pathological process in almost every case spreads to those parts that are located below - that is, the larynx, pharynx and trachea. This usually happens either mechanically, when liquid discharge from the nose flows into the throat, or by contact: direct spread of pathogens from the diseased mucous membrane to the healthy one.

The symptoms of nasopharyngitis are quite unpleasant.

Forms of the disease

Like many other pathologies inflammatory in nature upper respiratory tract, this disease can occur in acute and chronic form. The first develops suddenly, usually within a short period of time after the onset of the causative factor, and is characterized by very pronounced symptoms, and the second form is long-term, when clinical manifestations pathological process poorly expressed. Chronic nasopharyngitis is most often a consequence of acute nasopharyngitis.

Symptoms depend on the form. It has two varieties - purulent and catarrhal. Chronic inflammation nasopharynx can also be catarrhal in nature, and can be atrophic and hypertrophic. Classification into the above forms of the disease is carried out mainly according to the type of inflammatory process, and in medical practice doesn't really matter. We will consider the symptoms of nasopharyngitis below.

The main causes of the pathological process

The occurrence of inflammation of the mucous membrane of the pharynx and nasal cavity can occur according to the following scenarios:

The inflammatory process on the layers of cells lining these areas from the inside can occur as a result of various injuries and the addition of a concomitant infection. A large number of infectious agents live on the internal surfaces of the respiratory tract, and this is considered the norm. A healthy mucous membrane is able to successfully resist various attacks of harmful microorganisms on its own and the disease does not develop. Its occurrence may be due to a number of certain factors, which include temperature changes, exposure to respiratory organs foreign bodies or dust particles, irritation chemicals, and tobacco smoke- directly during smoking, or through passive inhalation.
The disease can be triggered by the activity of highly pathogenic microbes on the mucous membrane: various viruses, fungi, bacteria, mycoplasmas, which cannot reproduce on healthy mucous membranes, since their reproduction process is suppressed normal microflora body. These pathological microbes enter the mucous membrane, usually through airborne droplets. A person can become infected with these infections from a patient through direct contact, through saliva during kissing, as well as coughing or sneezing.
In addition to this, there is also allergic form of this disease. It is a direct consequence of dysfunction immune system person. Rhinopharyngitis in this situation occurs after exposure to allergens on the mucous membranes and an incorrect reaction immune defense on them. The triggering factor for the disease in this case is allergic rhinitis, which can be complicated by pharyngitis and inflammatory processes occurring in other parts of the respiratory tract.

One of the most common types among viral types of this disease is rhinovirus, and among bacterial types - pneumococcal, staphylococcal, meningococcal, streptococcal. In most cases, the pathological process begins with infections of viral origin, after which a bacterial or fungal infection joins it.

Factors contributing to the development of the disease

The prerequisites for the occurrence of symptoms of nasopharyngitis are any factors that reduce the natural defense human body and contribute to the introduction of infections. These include:

Diseases of the digestive system.
Pathologies of cardio-vascular system.
Functional impairment endocrine system.
Hypothermia.
Frequent stressful situations.
Hypovitaminosis caused by fasting and monotonous poor-quality nutrition.
Alcoholism, smoking, drug addiction.

Clinical symptoms of nasopharyngitis

The main manifestations of this disease in both adults and patients are childhood are:

Heavy discharge mucus from nose different colors and character.
Unpleasant painful sensations in the nasal cavity and throat - burning, soreness, dryness.
Cough of various etiologies.
Difficulty in nasal breathing, congestion.

These are the symptoms of chronic nasopharyngitis.

Pain syndromes are also possible varying degrees severity, especially when purulent processes, which are observed not only during swallowing, but also at rest. The patient may experience headaches, frequent sneezing, lethargy and weakness, fever, and with development purulent form rhinopharyngitis, the patient's condition may be accompanied by severe chills and fever.

This disease occurs the same in all people. age categories. However, in newborns and children in the first years of life, this pathology can occur very rapidly, accompanied by sharp increase temperature and quickly spread to the rest of the respiratory tract - trachea and bronchi. In the absence of adequate treatment, nasopharyngitis can cause serious complications, even severe inflammatory pathologies middle ear and lungs.

Now we know the symptoms. We will consider the treatment of chronic nasopharyngitis a little later.

Diagnostic methods for determining the disease

Diagnostics for the development of this disease, as a rule, is not required. The diagnosis is made based on the patient’s complaints, as well as data from a visual clinical examination by a specialist. Its results may include the detection of certain signs of the disease in a complex, or one of them. These signs are considered:

Swelling and redness of the mucous membranes of the nasal cavity and throat.
Nasal discharge.
Changes in voice characteristics.
The presence of mucous or purulent plaque on the back of the throat.
In childhood - swelling of the tongue. This common symptom rhinopharyngitis in children.
Increase cervical lymph nodes and their pronounced pain when palpated.

To make a diagnosis, a general blood test is usually performed, as a result of which the main signs of the presence of inflammatory processes in organism.

For severe forms infectious lesion held specific diagnostics, which involves determining the type of microbes that provoked the disease, and also determining their sensitivity to antibacterial medications. These measures are necessary for the appointment so that the specialist can prescribe the maximum possible effective antibiotics. To conduct such studies, smears taken from the mucous membrane of the nasal cavity, throat, as well as sputum, if available, are used.

When determining the causes of chronic long-term nasopharyngitis, additional medical diagnostics. This is done in order to identify factors that led to a decrease in immune defense.

If these studies determine the allergic nature of the disease, special tests are carried out to identify the type of allergen.

Therapeutic methods for eliminating pathology

Therapeutic measures to eliminate rhinopharyngitis are comprehensive. In classical medical practice for this disease there is a very wide range drugs that directly affect the causes of the pathological process. However, nasopharyngitis is a disease for which treatment is quite effective. folk remedies. The use of various decoctions and infusions is very common. medicinal herbs for gargling, as well as for oral administration.

Symptoms and treatment of nasopharyngitis in adults are also interrelated.

Thus, ethnoscience uses the following techniques:

Gargling with a weak solution baking soda, as well as using still mineral water.
For the same purposes, infusions of herbs such as sage, chamomile, oak bark, calendula, and St. John's wort are used.
Instillation into the nasal passages beet juice, as well as Kalanchoe or aloe extracts.
Infusions and decoctions are used for oral administration different parts medicinal herbs (plantain, coltsfoot, marshmallow, eucalyptus, chamomile, licorice, elecampane and others).

Conservative medical treatment

When a disease such as nasopharyngitis occurs, specialists prescribe medications from various pharmacological groups. Basically they are medications, eliminating symptoms when acute forms rhinopharyngitis, which is not accompanied by all sorts of complications. Antibacterial drugs are almost never used in this case.

The basis of therapy for uncomplicated nasopharyngitis is the following medications:

Painkillers.
Anti-inflammatory drugs
Antiseptics (containing iodine and others).
Antihistamines.
Nasal drops that reduce swelling of the mucous membranes (so-called decongestants).

Antitussives medications are used only in cases where the patient has an obsessive cough that greatly bothers him. For pediatric patients, this group of drugs, as a rule, is not used due to the development of multiple side effects.

Auxiliary methods for the treatment of nasopharyngitis

These activities are also very effective and are prescribed in order to remove the main unpleasant symptoms of this disease. These usually include all kinds of inhalations using moist hot air with the addition of extracts medicinal herbs or without them, as well as in the form of rubbing with warming ointments. Drinking plenty of warm liquid is also recommended.

At chronic symptoms rhinopharyngitis in adults may require the use of corticosteroids medicines local impact, which are available in the form of ointments or sprays.

In some cases, treatment of this disease may require the use of antibacterial medical supplies, however, the decision on the advisability of their use is made exclusively by a specialist. The choice of medication and its dosage is also made by the doctor.

We looked at the symptoms and treatment of nasopharyngitis in adults. Photos of people who have experienced this disease are presented in the article.

Disease prevention

In order to prevent the occurrence of this pathological process, it is necessary to implement individual measures to protect against various types of respiratory infections. Such measures usually include:

Wearing a mask during the height of the disease.
Avoid contact with sick people.
The use of oxolinic acid, as well as other antiviral ointments, which are applied to inner surface nose
Application restoratives And multivitamin complexes.
You need to install proper diet nutrition.
Maintaining a sleep schedule.
Fight with bad habits.
Avoiding hypothermia situations by wearing natural clothing and shoes that are appropriate for the season.
Maintaining cleanliness of premises.

Symptoms, causes and treatment of nasopharyngitis in children

The disease in infants may manifest itself with the following symptoms:

nasal congestion;
swelling of the mucous membrane;
mucus from the nose;
redness of the eyes and watery eyes;
cough;
difficulty breathing.

Children often suffer colds. Rhinopharyngitis in babies under one year of age occurs as a result of ARVI. Infants should be treated with the utmost care.

The following medications are used:

"Vibrocil";
"Cefekon";
"Erespal";
"Adrianol";
"Otrivin";
"Panadol";
"Nazivin";
"Nurofen";
"Protargol".

Here's how to care for a sick baby:

Mucus from the nose is regularly removed, and the child needs to be washed frequently.
At night, a garlic paste is placed near the baby’s crib in the head area.
The onion solution is dripped into the child's nose using a pipette.

We continue to study the symptoms and treatment of nasopharyngitis in children.

Children over one year old suffer from this disease more often due to numerous contacts with other children. The risk of viral infection increases.

The following therapeutic measures are carried out:

Steam inhalation (it is better to use a nebulizer).
Medicine solutions are used for rinsing.
Feet are floating in the bathtub.
Decoctions medicinal herbs taken orally with honey.

It is important to remember that when viral infections antibiotics are ineffective.

Symptoms and treatment of nasopharyngitis, as well as preventive measures we looked at it in detail.