Runny nose all. Rhinitis (runny nose)

Chief Freelance Specialist in Primary Health Care for Adults, Chief Physician, Consultative and Diagnostic Polyclinic No. 121 of the Moscow City Health Department, Ph.D.

Runny nose - inflammation of the nasal mucosa, in which mucous masses are released, and a burning sensation or dryness appears. For its treatment, drops, sprays, ointments and creams, as well as traditional medicine are used. With proper treatment, it disappears within a week.

Runny nose and its types

A runny nose or rhinitis is perfectly treatable if its type is determined in a timely manner. Absence proper treatment can lead to sinusitis, otitis or sinusitis, that is, give complications to the organs of smell and hearing.

He can be:

• a separate disease;
• Symptom of the majority infectious diseases(SARS, influenza, tonsillitis and others);
• The result of trauma to the nasal mucosa.

The development of a runny nose is greatly facilitated by hypothermia of a person, dustiness and gas contamination of the air.

Rhinitis is divided into 2 groups, infectious and non-infectious.

infectious

Spicy

Appears in infectious and viral diseases. Has 3 phases.

Phase initial symptoms- itching, burning in the nose, fever, headache.

Catarrhal phase - 2-3 hours after the first phase. There is mucus secretion and difficulty in breathing.

The recovery phase is on the 5th-7th day of illness. The sinuses are cleared, breathing is restored.

Chronic

It occurs when the mucosa is irritated by purulent discharge from the sinuses, congenital deformity of the septum, and circulatory disorders of the mucosa.

hypertrophic

Growth of the mucosa and submucosa. Mucopurulent discharge appears and breathing becomes very difficult.

atrophic

With thinning of the mucous membrane. Dryness, crusts appear, the perception of odors decreases.

Non-infectious

Allergic

It is a reaction to an allergen. It can be seasonal (in response to flowering, poplar fluff), and year-round, if dust, pet hair, and certain products act as an allergen. Difficulty breathing through the nose, watery mucus and sneezing appear.

Vasomotor

Appears with the expansion of the blood vessels of the mucosa. It occurs due to hormonal imbalance, emotional experiences, exposure to smoke, gas, food with spices.

medical

Appears with the constant use of vasoconstrictors. The mucous membrane contracts under their action, but then swells with even greater force.

Traumatic

The causes are mechanical injury, chemical exposure, frostbite or burns.

• Learn to blow your nose correctly by closing one nostril and opening your mouth;
• Avoid contact with irritants (dust, cold air, strong odors, cigarette smoke);
• When choosing drops or sprays, give preference to herbal preparations, such as Pinosol (pine, eucalyptus and mint oil) or Pinovit with a similar composition;
• Rinse the sinuses with salt water, but not more than 3 times a day, so as not to weaken the protective functions of the mucosa;
• Constantly ventilate the room and humidify the air.

Traditional treatment for the common cold

Treat a runny nose with drops, sprays, ointments and creams. Any drug has contraindications, side effects and the ability of the body to get used to it.

According to the effect, drops and sprays are:

• Moisturizers - Aqua Maris, Aqualor with sea water.
• Vasoconstrictor (reduce swelling and reduce the amount of mucus) - Naphthyzin, Sanorin, Nazivin, Xymelin, Dlyanos, Otrivin.
• Antibacterial - Bioparox, Isofra.
• Antiviral - Grippferon.
• Phytopreparations - Pinosol and Pinovit with pine, mint and eucalyptus oils.
• Combined (with vasoconstrictor, decongestant properties) - Hycomycin-teva.
• Antihistamines - Vibrocil, Allergodil to relieve allergic rhinitis.

Ointments are:

• Antiviral - oxolinic ointment 0,25%.
• Antiseptic - Vishnevsky ointment, tetracycline ointment.
• Combined - Levomikol, Evamenol with menthol and eucalyptus oil.
• Homeopathic - Doctor Mom, Asterisk, Tuya ointment.

Also, in the treatment of rhinitis, inhalations are made over steam or using an inhaler or nebulizer with nozzles.

To do this, use essential oils (eucalyptus, sage, fir, pine) and boiled water or saline.

Treatment with folk remedies

In spite of a large number of modern antiviral and antibacterial drugs, people do not stop using the advice of traditional medicine.

Here are the most effective ones:

Aloe Juice

Use neat or diluted with water at a ratio of 3:1. Do not be afraid of burning in the nose, it passes after a short time.

Kalanchoe

Make incisions on the washed Kalanchoe leaf, squeeze the juice and lubricate the sinuses with it.

Honey

Use neat (a small amount in each nostril) or dilute with water to make drops. For greater effect, make infusions with onions, beetroot juice, horseradish or aloe juice.

Salt

Take a small rag bag, calcine the salt in a clean, dry frying pan, put it in a bag and apply it to the bridge of your nose. Instead of salt, boiled eggs are suitable. In order not to burn the skin, lay a towel or napkin between your nose and hot eggs.

Onion

Take 1 tablespoon of squeezed onion juice and 5 drops olive oil, insist, instill in each nostril.

Take an onion, cut it, add half a glass of water and a spoonful of honey. Insist, strain and use as drops.

beetroot juice

Take 3 tablespoons of beetroot juice and one tablespoon of honey, insist and drip 2-3 times a day.

Garlic

Set fire to one head of garlic, and alternately bring the smoldering head to each nostril.

Treatment of the common cold in children

Runny nose in children is one of the most common diseases and does not always go away quickly. At the first symptoms, it is necessary to immediately begin its treatment in order to enable the child to breathe freely through the nose and sleep peacefully at night.

First, teach your child to blow their nose well, but gently. Then during the day, wash the nasal passages. For 1 cup of warm water, take half a teaspoon of salt and soda. Rinse with a teapot or from a saucer, drawing water in turn from each nostril, holding a little and blowing it back.

If the child is too small or the procedure is not good for him, then you can use drops based on sea water - Aqua Maris or Marimer.

The last step is the instillation of drops with a vasoconstrictor effect. For children, plant-based drops are suitable - Pinosol or Delufen, or chemicals Nizivin, Naphthyzin, Otrivin.

A very useful tool for children's runny nose there will be inhalations. They are made both over steam and with the help of an inhaler or nebulizer, using special nozzles.

Another useful advice- give the child as much to drink as possible, since when breathing through the mouth, he loses a large amount of moisture and the mucous membranes dry out. And do not forget about airing and ensuring the humidity of the room.

During pregnancy

A runny nose in women during pregnancy is very undesirable, like any other disease, especially if it is accompanied by fever.

When it appears, it is advised:

• Plentiful drink;
• Rinsing the nose with saline;
• Gargling with water and soda;
• inhalation or breathing over steam;
• Ventilation and humidification of the room.

Pregnant women should not take antibiotics, alcohol preparations, essential oils, vasoconstrictors without a doctor's recommendation.

Conclusion

Runny nose or nasal congestion brings a lot of discomfort to both adults and children. Treatment of rhinitis with early stage will allow him to get rid of it faster. Rinse your sinuses, ventilate and humidify the room, and most importantly - choose the right drops, spray, ointment or folk recipes based on the type of cold. This will make the treatment effective and shorter.

Rhinitis is an inflammation of the mucous membrane of the inner surface of the nose (nasal mucosa), resulting in swelling of the mucous membrane, impaired nasal breathing (nasal congestion) and copious discharge of fluid. It can be both an independent pathology and a symptom of other diseases.

What is the difference between rhinitis and sinusitis (sinusitis)?

The key difference between these diseases is the location of the inflammatory process. The fact is that inside the bones of the facial skull there are cavities, in medicine called sinuses, which are schematically shown in the photo.

The danger lies in the fact that the disease spreads deep into the head, where vital vessels, large nerve nodes, organs of vision and the brain are located.

The sinuses communicate with each other through thin and tortuous passages.

Infection and inflammation from the nasal cavity can spread to the mucous membranes that line the sinuses. This pathology is called common word sinusitis. The runny nose is limited only to the nasal cavity, and as long as the disease is limited to this area, rhinitis does not pose a significant threat.

In order to make an accurate diagnosis, it is necessary to make an x-ray of the skull. The pictures show a characteristic difference between rhinitis and sinusitis - these are blackout areas. In the illustration below, the arrows indicate characteristics darkening (visually in the picture, the darkened areas look light, and healthy dark ones).

At the same time, only the attending physician can conduct an accurate differential diagnosis, since in medical practice darkening or violation of sinus pneumatization can also be a sign of cysts, tumors, hematomas, and developmental disorders of the skull bones.

The symptoms will also help distinguish rhinitis and sinusitis from each other.

Sinusitis is usually characterized by pain in the area maxillary sinus, aggravated by tilting the head, as well as pain when pressed in the projection of the sinuses (for which it is necessary to step back from the wings of the nose towards the ear by one centimeter, in some people by 1.5 cm). Headache with a runny nose is much less pronounced.

Pain with sinusitis sometimes resembles a toothache, it can radiate to the cheek area, it happens that the whole head hurts. If patients say that: "the bridge of the nose hurts with a runny nose" or "pain between the eyebrows", then this may lead to suspicions of frontal sinusitis (inflammation of the frontal sinuses).

With sinusitis, the discharge (snot) from the nose is thicker, viscous, often purulent. The increase in body temperature is more significant than with a runny nose, and can reach 39-40 ° C.

You can find more complete and professional information about sinusitis in the article:.

Types of rhinitis and causes

To date, quite a few are open. various kinds rhinitis, the causes of which in most cases are clarified official medicine. To figure out where the runny nose comes from, the table below will help us, compiled on the basis of a guide for doctors Babiyak V.I. "Clinical otorhinolaryngology".

There are a large number of different classifications of the common cold, but doctors give priority to the ICD-10 ( international classification diseases 10 revision), where rhinitis is coded under headings J00 - J06, J30 - J31, this is especially important for filling out insurance documents.

From the table, we can conclude that most species develop against a background of weakened immunity. If it is maintained in a normal state, then there is a high probability that you will never know what ENT operations are, and life without drugs will be a reality for you. Details about human immunity are written in the article:.

Psychosomatics

Based on many studies, Wolter Breutigam (Professor at the University of Heidelberg, psychiatrist, director of the psychosomatic clinic) believes that one of the causes of acute rhinitis may be psychosomatics. Based on statistics, the scientist concluded that runny nose and colds occur in unskilled workers twice as often as in specialists. Quantity sick leave people who have low-responsibility jobs have much more than employees and officials. In lower social strata, complications after rhinitis also occur more often.

The psychosomatics of the common cold in these groups of people is due to increased stress from a poor quality of life, as well as as a result of self-hypnosis and the desire to get sick to get sick leave.

Rhinitis may have psychological reasons, So

V.V. Sinelnikov (writer, homeopath, author of books on improving the quality of life) defines a runny nose as internal crying. Thus, the subconscious mind tries to bring out the repressed feelings of disappointment, regret about broken dreams. In children, rhinitis occurs from constant quarrels and disputes in the family.

Acute rhinitis

We immediately define the key characteristics of any acute illness: it is intense, relatively short-term and, as a rule, ends with recovery.

Acute rhinitis - inflammation of the nasal mucosa as a result of infection or disorders in the nervous, circulatory or immune systems of the body. It is perhaps the most common type of rhinitis. It is this form that we most often get sick of.

The main factor in the development of the disease is a decrease in local (in the nose) and general immunity, which contributes to excessive reproduction. normal microflora nasopharynx (staphylococci, streptococci and others).

There are many interesting theories about the origin acute cold, so, for example, Professor M.I. Volkovich believes that acute rhinitis is a reflex manifestation of the body in response to thermal irritation of the lumbar region or lower extremities, as a result of which kidney function deteriorates. The nasal mucosa reflexively imitates the function of the kidneys, releasing a large amount of fluid. (Yu.M. Ovchinnikov “Diseases of the nose, pharynx, larynx and ear”, 2003)

Symptoms that characterize acute rhinitis, depending on the stage, differ:

Stage 1 (dry): lasts from several hours to a day, it is also called the stage of irritation. This stage is characterized by: dryness in the nasal cavity, a feeling of tickling or burning, this is accompanied by chills, headache, general malaise, a slight increase in temperature to 37 ° C and above is possible, nasal congestion is not very pronounced.

Stage 2 (wet): occurs on the second day of acute rhinitis, manifests itself in the form of abundant clear secretions(transudate), they contain a large amount of salt and ammonia. These substances irritate the skin, so there may be redness in the vestibule of the nasal cavity, which is especially pronounced in children. At this stage, lacrimation and the development of conjunctivitis are possible. The inflammatory process can capture the auditory tubes, as a result, nasal congestion and tinnitus may appear, nasal breathing is disturbed.

It is worth noting that it is at the second stage that it is important to blow your nose correctly. It is necessary to blow your nose through only one nostril, with your mouth slightly open. Never use excessive force when blowing. If you are healthy, you can try to pinch your nose and blow into two nostrils, you will hear distinct clicks, these are thin tubes connecting the nasopharynx and the middle ear. When the infectious process is in full swing, the pathogens of acute rhinitis through these passages can penetrate into the middle ear and cause a severe complication - acute otitis media. Be careful and teach your kids how to blow your nose properly.

Stage 3 (mucopurulent): manifests itself on the fourth or fifth day of the disease. In addition to other symptoms, yellowish viscous mucus appears in the nasopharynx, the causes are due to the appearance of blood cells in the secretions (neutrophils, lymphocytes, sloughing epithelium), so the discharge becomes thick yellow or green. Mucus flows down the back wall of the nasopharynx, then it can enter the respiratory tract and cause a cough.

Further, as a rule, recovery should occur, the process lasts about seven to eight days. But not every time the exit from the common cold is safe. Often there may be complications, such as pharyngitis, tracheitis, bronchitis (there may be cough and runny nose at the same time), acute otitis media, sinusitis (sinusitis), sometimes even pneumonia.

Chronic rhinitis

Chronic diseases are called diseases with a sluggish, long-term (months, years), undulating course, with constant improvements in the condition and relapses (repeated exacerbation).

Chronic rhinitis is a disease of the upper respiratory tract with a long course. It is characterized by recurrent inflammatory processes in the nose and degeneration of the nasal mucosa. It is represented by a wide group of pathologies, it is divided into:

1. Chronic catarrhal rhinitis.
2. Chronic hypertrophic rhinitis:
   • limited,
   • diffuse (from the Latin diffusio - spread, dispersion).
3. Chronic atrophic rhinitis:
   • simple shape,
   • offensive coryza or ozena.

Often this group includes vasomotor and allergic rhinitis.

The most widespread in ENT practice is chronic catarrhal rhinitis. It appears in the form chronic inflammation mucous membrane of the nasal cavity, impaired respiratory and olfactory functions, mucosal purulent discharge.

As you know, acute rhinitis does not last more than 6-7 days, so if a runny nose does not go away for 2 weeks or a month in an adult, a deeper medical examination is needed to make a possible diagnosis - chronic rhinitis, the symptoms of which are quite specific:

• The duration of the course is from 2 weeks or more (it can last several months and even years).
• Violation of nasal breathing is aggravated in the cold.
• Characteristic congestion of one nostril in the position "lying on its side."
• Stuffs up nose at night during sleep.
• Mucus constantly accumulates in the nasopharynx.
• Yellowish discharge.
• Decreased sense of smell.
• Headache.

Viral

Viral rhinitis is an inflammation of the nasal mucosa caused by various types of viruses. The most common viruses that cause this type of runny nose are:

• influenza viruses of various strains and other viruses that cause SARS;
• measles virus;
• encephalitis virus, poliomyelitis;
• smallpox viruses (the last case of infection was registered in 1977).

When infected with ARVI viruses, the symptoms are similar to acute catarrhal rhinitis, but, as a rule, are more pronounced:

• high body temperature
• constant sneezing (an attempt by the body to expel foreign elements);
• abundant secretion of fluid from the nose (the protective function of the body to neutralize and remove infection from the body);
• general weakness;
• joint pain, headache, pain on movement eyeballs(the result of intoxication - poisoning with toxins of viruses);

With this type of runny nose, there are more complications, such as acute otitis media, sinusitis, laryngotracheitis, if the mucus is allowed to dry (thicken) or when a bacterial infection joins.

The measles virus at the first manifestations causes a runny nose, which is also similar to acute rhinitis. A little later, a severe swelling of the mucous membrane of the nasal cavity appears, accompanied by a complete blockage of the nasal passages. Congestion is not amenable to the action of vasoconstrictors. The discharge is initially transparent, then becomes purulent. At the last stage, erosions and ulcerations begin to appear in the nasal cavity, which can even spread to the upper lip.

Complications are extremely severe - these are various types of otitis, sinusitis, laryngotracheitis, bronchitis, pneumonia. The greatest danger is the edema that accompanies each complication, especially with laryngitis, which can cause death from complete blockage of the airways (asphyxia).

With poliomyelitis and encephalitis, rhinitis is no different from mild form acute runny nose. Doctors begin to pay attention to him only after the onset of symptoms of encephalopathy.

Some forms of viral rhinitis can be an extremely dangerous pathology, in which you need to immediately seek professional medical help.

Bacterial

Bacterial rhinitis is an inflammation of the nasopharynx, specifically manifests itself in the form of viscous purulent mucus (snot). The causes are various kinds of bacteria, usually from the normal microflora of the nasal cavity. Often joins a second time to viral rhinitis.

There are specific types of bacterial rhinitis caused by:

• Staphylococcus aureus;
• group A hemolytic streptococcus (nasal scarlet fever);
• gonococcus;
• pale treponema (syphilitic runny nose);
• rickettsia;
• a bacterium from the genus Burkholderia (extremely rare) and others.

In the initial stages of the disease, the usual lung symptoms runny nose (tickling, burning in the nose, frequent sneezing, slight fever, malaise, chills), but after a few days more characteristic symptoms appear:

• thick yellowish or greenish discharge
• high body temperature
• severe nasal congestion
• headache
• severe general weakness, malaise

A bacterial runny nose, characterized by purulent discharge from the nose, is called purulent by some doctors.

The main complications of bacterial rhinitis are sinusitis, otitis media, laryngotracheitis, pharyngitis, bronchitis and others.

Often the causes of complications are:

• drying and thickening of the mucus, which prevents its outflow and promotes the development of bacteria;
• nasal congestion leading to the development anaerobic bacteria and preventing the outflow of mucus;
• low immunity of the body and concomitant chronic diseases.

allergic rhinitis

Allergic rhinitis is an inflammation of the mucous membranes of the nose caused by an allergic reaction of the body to various foreign substances. In fact, this is an allergy manifested as rhinitis.

It is often found in big cities and metropolitan areas. Almost every person in the city has an acquaintance who, in spring or summer, begins to indignantly expect the flowering of a plant. He is probably worried about a very unpleasant ailment - seasonal allergic rhinitis. In general, this is a global health problem, according to medical statistics about 10-20% of the population suffers from one form or another of this pathology.

Back in the days of Hippocrates (5th-4th century BC), cases were described when people could not tolerate certain nutrients. The Roman surgeon and philosopher K. Galen first described allergic rhinitis arising from the scent of a rose. And the term "allergy" itself appeared relatively recently, in 1906. It was proposed by the Austrian pediatrician Clemens Von Pirquet (C. Pirquet), describing the atypical reactions of the body of some children to anti-diphtheria serum.

To date, medicine represents an allergy as follows:

When complex foreign substances enter the body, the immune system creates completely new substances that did not exist before - antibodies necessary for protection. At this stage for various reasons, some errors may occur, as a result of which the reaction of the body becomes inadequate, harmful and even deadly ( anaphylactic shock or airway edema).

After that, the body becomes sensitive to this substance, and with each repeated entry of the allergen into the body, the same pathological reactions occur.

In more detail about what allergic rhinitis is, what varieties there are, how to determine an allergic rhinitis or not, what are the main causes and symptoms can be gleaned from the video of Elena Malysheva:

Official medicine identifies seasonal and year-round allergic rhinitis.

Seasonal

The seasonal runny nose is allergic reaction on the pollen of plants that bloom in certain months, manifesting symptoms of rhinitis, it is also called pollen fever. Most often, this pathology is inherited, pollen causes the production of antibodies to the proteins contained in it, sensitivity (sensitization) develops, and when the antigen enters the body again, an antigen-antibody interaction reaction occurs, manifested by signs of inflammation.

Thus, seasonal allergic rhinitis is born, the symptoms of which are presented below:

• seasonality of manifestations, as a rule, is the end of May and June;
• abrupt, paroxysmal onset;
• severe itching in the nose,
• frequent sneezing and runny nose without fever,
• very profuse discharge from the nose,
• nasal congestion,
• signs of conjunctivitis (redness of the eyes, lacrimation) join.

Attacks of allergic rhinitis usually last 2-3 hours and can be repeated several times a day.

Based on these symptoms, allergic rhinitis can be identified and distinguished from a viral or bacterial rhinitis.

An interesting observation was published in the guide for physicians V.I. Babiyak. Vyacheslav Ivanovich writes that in a state of psychological stress, the symptoms of allergic rhinitis become less pronounced, and the attack may even end. The Military Medical Academy notes that during the Great Patriotic War, doctors rarely recorded colds as such. This may indicate the important role of psychosomatics in the causes of the common cold.

year-round

Perennial allergic rhinitis, the symptoms of which are similar to seasonal ones, acts as a syndrome of the general allergic state of the body. The key difference between a permanent allergic rhinitis and a seasonal one is the absence of periodicity and the specificity of allergens. In the year-round form, the attacks are not so pronounced, the course is smoother, often accompanied by bronchial asthma.

Allergens in this form can be very diverse substances, ranging from house dust to nuts. It is impossible to list them within the framework of this article, however, in most cases, allergens are of domestic origin (dust containing mites of the genus dermatophagoides, pet hair).

It should be noted that perennial allergic rhinitis is much more serious disease rather than seasonal and getting rid of it is an extremely difficult task.

There are several stages in the development of the disease:

Therefore, the sooner you see a doctor, the less likely surgical treatment allergic rhinitis.

For allergic rhinitis, doctors often prescribe symptomatic treatment that only alleviates the disease, but does not cure. To date, there are very few professional ways to deal with the true causes of allergies. One of the advanced methods in this area is vibroacoustic therapy with the help of a medical device, you can read about research in this area.

Vasomotor rhinitis is a poorly understood form chronic rhinitis, characterized by the absence of an inflammatory reaction and dysfunction of the vessels of the nasal mucosa. Also, practitioners distinguish vasomotor rhinosinusitis. It is characterized by a more extensive spread of inflammation, when not only the nasal cavity is affected, but also the sinuses, usually the maxillary ones.

Coryphaeus of otorhinolaryngology V.I. Voyachek, in 1937, called vasomotor rhinitis false, since it was accompanied by bronchial asthma and was often a symptom of autonomic dysfunction (disturbance of the nervous system responsible for the functioning of internal organs and blood vessels).

To date, many authors distinguish true vasomotor rhinitis as a separate form, the symptoms of which do not suggest the presence of inflammatory reactions. In their opinion (Babiyak V.I. "Clinical otorhinolaryngology") an important role in the occurrence of this pathology is played by disorders of the autonomic nervous system. Some doctors in these cases make a diagnosis - neurovegetative rhinitis.

Vasomotor rhinitis may be the "tip of the iceberg" more serious illnesses: hypotension, neurocirculatory dystonia, angina pectoris. On the other hand, in medical practice, it happens that chronic vasomotor rhinitis serves as a kind of trigger for deeper pathologies, such as migraine, diencephalic syndrome (damage to the hypothalamic-pituitary region of the brain) and others. This once again confirms that everything in the human body is interconnected.

Vasomotor rhinitis is manifested by the following symptoms:

• watery discharge from the nose,
• itchy nose,
• sneezing,
• feeling of pressure in the back of the nose,
• the suddenness of the onset of the attack and its end (according to V.I. Voyachek "explosion of the vasomotor reaction"),
• it happens that stuffing up the nose at night, there is no runny nose during the day, which is due to an increase in the function of the parasympathetic nervous system at night;
• congestion of one half of the nose in the "lying on its side" position.

On the picture B vasomotor rhinitis during an attack.

With a long course, vasomotor rhinitis can be complicated by hypertrophic, it is mentioned below.

Vasomotor rhinitis is extremely difficult to treat. Babiyak V.I. in the work "Clinical otorhinolaryngology" writes: "The elements of treatment contain various, both local and at a distance, aimed at normalizing the autonomic nervous system, enzymatic activity, enhancing the processes of oxidation of biosubstrates, normalizing the function of cell membranes, etc."

One of the most effective methods normalization of the human vegetative system is vibroacoustic therapy, which can be found in the section:, and with vibroacoustic techniques.

Medicated rhinitis

Drug rhinitis (drug) is a pathology resulting from the excessive use of vasoconstrictor drugs, manifested by nasal congestion without inflammatory symptoms of the common cold.

The mechanism of occurrence of drug rhinitis is similar to the process of the emergence of drug addiction. Adrenomimetics (vasoconstrictor drugs), suppress the production of norepinephrine, which normally regulates the lumen of the vessels (narrows). After about two weeks of continuous use of such drops, the production of norepinephrine is reduced to such an extent that the patient is already forced to use these drugs, otherwise he will have a constantly stuffy nose without a runny nose.

With prolonged drug-induced rhinitis, with each new use of adrenomimetics, the patient approaches the point of "no return", when it is no longer possible to cure this pathology by simply refusing vasoconstrictors. Further, this form can be complicated by chronic, atrophic and vasomotor rhinitis.

Symptoms of drug rhinitis:

• nasal congestion without typical symptoms of a runny nose,
• there is no discharge from the nose, or they are scarce;
• possible tachycardia and increased pressure (with very long and heavy use);
• decreased sense of smell
• headache (not always).

Elena Malysheva will tell about drug rhinitis, rebound syndrome and dependence on naphthyzinum.

hypertrophic

Hypertrophic rhinitis is a chronic pathology of the nose, manifested as a thickening of the mucous membrane both locally and evenly over the entire inner surface of the nose.

For a deeper understanding of this pathology, it is worth understanding the terminology.

In Latin, the language of medicine, "hyper" means excessive, and "trophy" means nutrition. Next, we will consider other forms of rhinitis, the names of which are based on the word "trophia". In a particular case, hypertrophy means that the cells of the mucous membrane receive excessive nutrition, that is, they receive a lot of blood, which contributes not only to swelling of the mucous membrane, but also to an increase in the mass of the cell itself. The same thing happens with medical rhinitis.

According to generally accepted classifications, this pathology is referred to as chronic rhinitis. Hypertrophic rhinitis is characterized by constant inflammation and swelling of the nasal mucosa, growth (thickening) of the inner surface of the nose due to an increase in the volume of the cells themselves, while the number of cells does not change (hypertrophy).

It often represents the last stage of chronic catarrhal rhinitis, which lasted for many years in the patient. Sometimes the reasons are related to heredity and numerous external factors such as: alcoholism, smoking, bad ecology.

Hypertrophic rhinitis is characterized by the following symptoms:

• nasal congestion (vasoconstrictors slightly facilitate breathing),
• mucous secretions,
• dryness in the nose and mouth,
• nasal nasality of the closed type (associated with an obstacle to the passage of air through the nose),
• there may be signs of stuffy ears.

hyperplastic

Hyperplastic rhinitis is a type of common cold characterized by excessive proliferation (division) of mucosal cells and overgrowth of nasal cavity tissues. Hyperplasia (from Latin plasia - development, growth) - means an increase in the number of cells.

Symptoms are similar to hypertrophic rhinitis:

• persistent nasal congestion
• lack of effect from vasoconstrictor drugs,
• nasality,
• ear congestion,
• decreased concentration and attention
• headache (not always).

For a clear differential diagnosis, doctors conduct an adrenaline test. If thickening occurs due to excessive blood filling or edema, then adrenaline will narrow the vessels and the edema will quickly go away, and tissue hyperplasia remains unchanged.

atrophic

Atrophy means malnutrition. Atrophic rhinitis is a severe chronic pathology characterized by thinning of the nasal mucosa, a decrease in the volume of all tissue elements (glands, receptors nerve fibers, cilia, blood vessels), it is preceded by a milder form - subatrophic rhinitis, which occurs quite often.

Atrophic rhinitis is divided into primary (genuine or ozena) and secondary chronic atrophic rhinitis. The etiology of the primary is not fully understood. V.I. Voyachek suggested that this pathology is an extreme degree of development of atrophic rhinitis, photos of lakes look awesome.

Also Voyachek together with B.S. Preobrazhensky, G.Z. Piskunov suggested that the genuine runny nose (ozena) is a manifestation of a more systemic dystrophic process in the body, when not only the nasal mucosa is affected, but also internal organs. This type of disease is rare. Ozena is currently defined as chronic atrophic fetid rhinitis, characterized by atrophy not only of the nasal mucosa, but also of the bones of the nose. Distinctive feature is - a pungent odor that is felt at a distance, thick mucus with an unpleasant odor also accumulates in the nasopharynx

The causes of secondary atrophic rhinitis are environmental factors (cigarette smoke, chemical fumes, temperature changes, etc.), infections, injuries, chronic runny nose for many years, operations in the nasal cavity, drug-induced rhinitis and others.

Secondary atrophic rhinitis has symptoms that are not found in other forms of the common cold:

• dryness in the nose
• viscous mucus that is difficult to blow your nose;
• the appearance of yellowish-gray or brown crusts in the nasal cavity, which cause itching;
• intermittent bleeding
• ulceration, as a result - a runny nose with blood;
• decreased sense of smell and, in extreme stages, its complete absence;
• perforation of the nasal septum.

Purulent rhinitis

Some doctors can distinguish such rhinitis as purulent, while there is no separate form - purulent rhinitis does not exist. This is done for the convenience of describing symptomatic manifestations.

A runny nose with pus can be with the following forms of rhinitis:

• acute catarrhal,
• rear,
• bacterial,
• viral,
• chronic.

The presence of purulent discharge indicates that a bacterial infection has joined the process, and may also indicate that rhinitis is complicated by sinusitis. This pathology requires a mandatory visit to the doctor and a thorough diagnosis.

Dry rhinitis

Dry rhinitis is a chronic pathology characterized by dryness of the nasal mucosa due to a violation of its trophism (nutrition), is a type of atrophic rhinitis, this disease commonly referred to as subatrophic rhinitis.

The mechanism of occurrence and causes are similar to atrophic rhinitis, it is, as a rule, a long-term stay of a person in an aggressive environment with a high content chemical substances, constant exposure high temperature on the nasal mucosa, smoking, alcohol, ENT operations.

Symptoms are similar to atrophic rhinitis, but less pronounced:

• dryness in the nose
• formation of crusts in the nasal cavity,
• due to the thinned mucous membrane, blood vessels burst and snot with blood is released, which are hard to blow your nose;
• nasal congestion,
• sticky mucus.

With dry rhinitis, it is very important to immediately consult a doctor and begin treatment until the runny nose has become more atrophic.

persistent

Persistent rhinitis is an inflammation of the mucous membrane of a chronic type with an undulating course. This term usually describes the symptomatic features of chronic, allergic and vasomotor rhinitis. This means that a runny nose has a certain periodicity in its exacerbations, for example, symptoms can appear and grow every three to four days, or only in the evening.

Neurovegetative

In some versions of the classification of rhinitis, for example, in the guide for doctors Babiyak V.I., vasomotor rhinitis is divided into an allergic and neurovegetative form (detailed information was given above in the vasomotor rhinitis section).

Posterior and internal rhinitis

These are two names for the same form, scientifically called rhinopharyngitis.

Such terms, which clearly describe the location of the inflammatory process, exist for convenience. Posterior rhinitis is, as a rule, a severe runny nose, manifested by inflammation of the mucous membrane of the nasopharynx. The inflammation is caused by a bacterial infection.

Internal runny nose in adults occurs with the following manifestations:

• nasal congestion,
• burning and dryness in the nasopharynx,
• possible discomfort when swallowing
• increase cervical lymph nodes,
• thick yellow color nasal discharge,
• headache,
• mucus accumulates in the nasopharynx, sometimes with an unpleasant odor, it can also be a hindrance to breathing (especially dangerous for children),
• temperature 37 ° C, in adults it often proceeds without fever,
• general malaise, weakness.

Frequently asked Questions:

Vaccination is the introduction of weakened microorganisms into the human body to stimulate immune response in the form of the synthesis of antibodies to a specific antigen, while the pathogen itself cannot harm health. There are vaccinations in which not the whole microorganism is administered, but only parts of it. Such vaccinations less burden the immune system.

With any type of vaccination, there is an additional load on the body's defense mechanisms. Based on an understanding of the processes of vaccination, it is possible to draw conclusions about the possibility of vaccinating with a cold.

In order to answer this question, you need to understand what specific pathology you have. If it is vasomotor rhinitis or an allergic rhinitis, then, if absolutely necessary, the doctor can give permission for vaccination. In any case, this should be decided only by your doctor.

With severe manifestations of acute rhinitis or exacerbations of chronic rhinitis, immunity is reduced, and the vaccine administered can weaken the body, thereby increasing the risk of complications, which can be extremely severe, especially in children. Therefore, in such cases, the doctor will not give permission for vaccination. It is always better to play it safe and, after waiting for recovery, get vaccinated later.

Nasal congestion without a runny nose is characteristic of drug-induced and various types of chronic rhinitis.

With the medication option, the nose is blocked due to addiction to vasoconstrictors and suppression of the natural production of the hormone norepinephrine in the nasal mucosa, which is responsible for vascular tone.

As a result, without the drug, the vessels expand greatly, and the nasal passages narrow due to the thickening of the walls. At the same time, the patient can be completely healthy and wonder: “why the nose does not breathe, but there is no runny nose?”.

In chronic rhinitis, as a rule, there are phases of remission and exacerbation. During an exacerbation, the nasal mucosa thickens due to hypertrophy, which remains in a temporary recovery phase. There is also an increase in the corpora cavernosa, all this contributes to the narrowing of the nasal passages, therefore, in the remission phase, the nose can be blocked without a runny nose.

How long does a runny nose last in an adult?

It strongly depends on the type of pathology. So acute rhinitis (the most common form) should not last more than 7-8 days. If a runny nose does not go away for 2 weeks in an adult, then this is a sign possible complication in the form of sinusitis (sinusitis), nasopharyngitis or the onset chronic form which can even last for years. In these cases, it is strongly recommended to consult a doctor.

Is the common cold contagious?

When rhinitis is of an infectious nature, of course it will pose a danger of infection to others. If epidemics are recorded in your area, then the common cold can be contagious and, as a rule, shows all the signs of an acute cold. In any case, for a clear answer without laboratory research not enough.

I would like to note that for people with good immunity, most bacterial types of the common cold do not pose a threat, since they are most often caused by opportunistic microflora of the nasal cavity, which is normally present in every person. Our immunity needs to be monitored no less than appearance, so you should know how you can help your immune system.

A viral runny nose with SARS also does not pose a big threat and most often goes away with SARS within a week.

Can I take a bath with a cold?

Perhaps the most important contraindication for taking a hot bath is a body temperature of 37 ° C and above, which may be accompanied by a cough or runny nose.

If you follow the simple rules below, then taking a bath is even useful:

• Measure body temperature before taking a bath (should be no higher than 36.7 ° C).
• Measure the temperature of the bath (should not be higher than 37 °C).
• Stay in the bath for a short time of 10-15 minutes.
• Make sure the rooms are warm enough to avoid temperature fluctuations.
• Do not drink alcohol before or during your bath.

What causes snot with blood in a cold?

A runny nose with blood in an adult can be for the following reasons:

• with strong straining during blowing out, due to bursting blood vessels;
• with atrophic rhinitis, the mucous membrane becomes thinner, the vessels become defenseless and often burst;
• with vasomotor rhinitis, a vessel may burst under strong pressure;
• with an infectious lesion, there may be bleeding manifestations;
• when the mucous membrane is damaged during the removal of the crust from the nose.

Why does cough and runny nose occur without fever?

Acute and chronic rhinitis can occur without an increase in body temperature at all, this is normal. Cough joins either in the form of bronchitis, or as a reflex to the flow of mucus along the back wall of the nasopharynx, which enters the trachea. Sneezing, coughing and runny nose without fever occur in chronic types of rhinitis.

Why does mucus with an unpleasant odor accumulate in the nasopharynx?

As a rule, these symptoms are characteristic of purulent (posterior) rhinitis. It occurs as a result of the death of the epithelium of the nasal cavity, which, together with bacteria and cells of the immune system (leukocytes, lymphocytes), gives an unpleasant odor. Often the smell from the nose happens with sinusitis. Also, an extremely fetid odor with a rare manifestation of atrophic rhinitis - ozena.

Bibliography:

1. Babiyak V.I. Clinical otorhinolaryngology: A guide for physicians. - St. Petersburg: Hippocrates, 2005
2. Brautigam V., Christian P., Rad M. Psychosomatic medicine: A short textbook. - M.: GEOTAR MEDICINE, 1999
3. Soldatov I.B Lectures on otorhinolaryngology - M.: 1990
4. Ovchinnikov Yu.M., Gamov V.P. Diseases of the nose, pharynx, larynx and ear. Textbook. - M.: Medicine, 2003
5. Voyachek V.I. Fundamentals of otorhinolaryngology. - L .: MEDGIZ 1953
6. Palchun V.T., Magomedov M.M., Luchikhin L.A. Otorhinolaryngology. - M.: GEOTAR-Media, 2011

You can ask questions (below) on the topic of the article and we will try to answer them competently!

A runny nose, or it is also called rhinitis in medicine, is an actual problem in any off-season and cold weather. In this period human body weakened and rebuilt for a different time of the year. Many consider the topic of nasal congestion as an outstanding problem and do not ask a serious question how to quickly get rid of a runny nose and not provoke the appearance of various complications.

A runny nose is dangerous for a person because it has serious consequences. A common cold can lead to a deterioration in smell and a decrease in appetite, as well. For many people, a runny nose is not a serious threat to health, so patients do not give due importance to the treatment of the disease. However, this opinion is wrong. Therapy must necessarily include drops from the common cold, inhalation, physiotherapy and taking drugs that will affect not only the symptoms, but also the causes of the onset of the disease.

Etiology

A runny nose develops in the human body with colds, for example, etc. Allergies can also provoke the appearance of an ailment.

Before taking any remedy for a cold, the patient needs to understand the cause of the onset of the disease. Doctors' additional provoking factors include:

• hypothermia;
• surgical intervention in the nasal cavity;
• prolonged use of vasoconstrictor drugs;
• the influence of chemical or other irritants on the nasal membrane;
• nose injury;
• change in weather, seasons and climatic conditions;
• weakened immunity;

A runny nose during pregnancy is a fairly common occurrence, because a woman's body undergoes hormonal changes that can provoke a weakening of the immune system. Therefore, women are much more susceptible to viral infections. Also, a runny nose during pregnancy can occur with allergic reactions or inhalation of cold or humid air.

A runny nose in a newborn has the same causes of appearance as in an adult. Most often, the disease progresses with the development of a cold. In 95% of infants, the viral nature of the formation of a runny nose is noted.

The infant is exposed inflammatory process in the adenoids, if he develops. Its development becomes the formation of chronic rhinitis in childhood. Quite often, along with adenoid hypertrophy, doctors diagnose sinusitis. An increase in the volume of the tonsils leads to the multiplication of pathogenic bacteria that provoke inflammation of the tissues of the nasopharynx.

Also, a runny nose can appear from getting foreign body. This reason is a characteristic factor for the development of atypical rhinitis. The appearance of discharge from the nose is associated with the ingress of such objects:

Before treating a runny nose in a child, you need to understand the cause of its manifestation.

Doctors have identified that another factor in the progression of the common cold can be. The reason for their growth is a chronic lesion or an allergy. Benign formations grow to a considerable size, block the nasal cavity and interfere with normal breathing. Often polyps are diagnosed in adult patients, but can also occur in children. The disease can be accompanied by bronchial asthma, an allergic reaction to acetylsalicylic acid or yellow fruits and other allergens.

Classification

There are many varieties of the common cold, depending on the causes of the appearance, namely:

• - pathology progresses from external stimuli, for example, weather changes or the aggressive influence of the external environment. You can eliminate the disease by eliminating all irritants;
• - manifests itself when exposed to a particular allergen, for example, during the flowering period of plants, when eating products or from contact with dogs or cats. How to distinguish an allergic rhinitis from other types of the disease will tell the doctor during the examination. Often this type of pathology occurs in people suffering from any kind of allergy. It is quite easy to distinguish an allergic rhinitis from a cold, as it manifests itself sharply and also subsides quickly. You can eliminate it by simply changing the environment, excluding all allergens, sometimes doctors suggest using to quickly reduce an attack of rhinitis antihistamines;
• infectious - manifested in the disease of acute respiratory viral infections, acute respiratory infections and influenza. The patient is prescribed antiviral treatment, which eliminates the symptoms. Colds are easily treated within a week. As part of home therapy, salt baths can be done and inhalations are allowed for a runny nose;
• - is formed from the frequent use of drugs that provoke swelling and atrophy in the nose. This type of runny nose differs in that when the use of drugs is stopped, rhinitis subsides almost immediately. Therapy of the disease is preferably carried out in a hospital, so as not to provoke complications;
• traumatic - manifests itself with mechanical, chemical or thermal damage to the nose and mucous membranes. With a slight impact of irritants, rhinitis goes away on its own, but with a prolonged and painful runny nose, the patient should seek the help of a specialist;
• hypertrophic - the walls of the nose grow and thicken. During this period, a huge amount of nasty mucus. A mild remedy for a runny nose, used at home, will not help to fully eliminate such rhinitis, since the patient only needs prompt assistance;
• - the tissues of the nasal passages are depleted and dry. Delayed therapy can provoke a complete or partial loss of smell. Self-medication is contraindicated.

Depending on the course of the disease, doctors also identified two types of rhinitis:

• acute - manifests itself with a cold, allergies;
• chronic runny nose - manifested with frequent relapses viral pathologies.

Since a runny nose during pregnancy, in an adult and a child, often manifests itself precisely from the defeat of the body by infection and bacteria, doctors have identified three main stages in the development of an acute attack:

• initial;
• catarrhal - manifests itself after a few days;
• recovery - after a week of full-fledged treatment, nasal congestion completely disappears.

The chronic form of the disease also has several forms:

• catarrhal;
• hypertrophic;
• atrophic.

Symptoms

At the initial stage of the formation of the disease, the patient develops a characteristic burning sensation in the nose, itching, dryness, headache, sneezing and may appear. Further, the disease develops in a few days, and watery discharge is added to the initial signs. The patient may have a strong,. With the development, a runny nose during pregnancy in women, children or adult patients is often characterized by discharge mixed with blood.

In the last stage of rhinitis, the patient is relieved. It appears after a week. effective therapy. The patient's condition improves significantly, the amount of discharge from the nose decreases, breathing becomes clear and uniform. 10 days after therapy, rhinitis without complications completely disappears.

Sometimes doctors diagnose the development of a runny nose without fever. It has to do with the progression viral infection. This disease can be characterized by the following manifestations:

• stuffy nose;
• mucous secretions;
• headache;

With an allergic lesion of the nasal sinuses, the patient has the following symptoms:

• stuffy nose;
• runny nose with mucous, purulent, bloody discharge;
• sensation of transfusion of fluid in the sinus when tilting the head;
• sneezing
• headache;
• fever;

With neurovegetative rhinitis, to general symptoms pathology, the frequent release of a significant amount of liquid mucus after sleep is added.

You can recognize a viral rhinitis by the following indicators:

• dryness and swelling of the mucous membrane in the nasal cavity;
• sneezing

Bacterial damage to the nose, unlike other types of diseases, manifests itself in a cloudy thick discharge of yellow or green mucus.

And with traumatic rhinitis, the patient is worried about the difficult release of viscous mucus, which flows down the wall of the larynx into the pharynx.

A remedy for a cold should be chosen solely on the basis of the symptoms of the disease. Before proceeding with treatment, it is necessary to identify the underlying ailment after the diagnosis.

Diagnostics

Runny nose in a newborn or adult patient is diagnosed by symptoms. To distinguish one type of ailment from another, the doctor needs to clearly understand what the clinical picture of each type of rhinitis is and whether a person has individual characteristics organism.

If a frequent runny nose is detected, the patient should seek help from a doctor. The otolaryngologist will examine the nasal cavity and be able to give an accurate diagnosis, as well as prescribe therapy.

Treatment

Each person at least once faced the problem of the appearance of rhinitis, so everyone is interested in the question of how to get rid of a runny nose, what are effective ways for therapy at home. The secretion of mucus, as a rule, is eliminated precisely at home, because the disease often manifests itself from viral disease. In this case, the patient can get by with nasal drops or folk remedies. However, if the pathology manifests itself in a more complex and atypical clinical picture, then you can not do without the help of a specialist.

For symptomatic therapy, the patient is prescribed the following procedures:

• cleansing the nasal passages from mucus - you can carry out the procedure by blowing your nose or washing;
• relief of nasal congestion - a vasoconstrictor for the common cold is used.

If rhinitis provoked by a virus is detected, it is advisable for the patient to use antiviral drugs, drops from the common cold, medicines to strengthen the immune system.

A runny nose is also common during pregnancy. The etiological factors in the development of such an ailment are quite different, but the therapy of all of them should be as gentle as possible so as not to harm the fetus. Runny nose during pregnancy can be eliminated by washing the nasal cavity. The therapy is based on moisturizing the mucosa, and when washing the nose with salt water, the effect is improved by eliminating water from the mucous membranes and enlarging the respiratory passages.

Also, women are allowed to carry out warming procedures. You can warm the sinuses with warm salt or warm with blue light. Doctors also approve of inhalations for a cold. They can be made based medicinal herbs and essential oils, but not more than 4 times a day for 10 minutes.

Drug treatment of a runny nose during pregnancy is undesirable, and is used with the permission of a physician only if the general condition of the expectant mother worsens.

Acute rhinitis overtakes a person suddenly, in company with a cold or flu. It is caused by pathogenic viruses and bacteria: by secreting mucus, the body tries to cope with invaders.

Acute rhinitis is treated along with a cold, against which it arose, bed rest, drinking plenty of water, honey, lemons and vitamins. However, keep in mind that:

Warm milk, which is traditionally considered a panacea for colds, not only does not help with a runny nose, but, on the contrary, increases the flow. Other "mucus-forming" foods include sweets, wheat bread, smoked meats, white rice, pasta, muesli, and bananas.

Garlic, onion, horseradish, mustard, ginger, cranberries, carrot juice, lemon help to turn off the tap.

One of the most useful products for a cold is honey, which works as a bacteria killer no worse than antibiotics.

Cabbage also helps to cope with a runny nose - due to the sulforaphane contained in it, which has antibacterial activity. Most of this substance in broccoli and cauliflower.

Sometimes a chronic runny nose manifests itself against the background of a love for alcohol, usually such a reaction to alcohol occurs in men over 50 years old, but women are also at risk. According to scientists from the Danish Institute of Public Health, if a woman drinks more than 14 drinks a week, she has a 78% increased risk of developing foodborne rhinitis. One serving is equivalent to a glass of wine or a bottle of beer.

Healthy drinks

In a cup of hot water, put 1 tbsp. a spoonful of grated fresh ginger and honey, add a little black pepper, a couple of tablespoons of lemon juice, fresh mint. Stir and drink until cold.

Mash frozen cranberries or lingonberries in a mug, pour hot water, add a spoonful of honey and mix.

Brew dry rose hips with hot water (not boiling water!) in a thermos and let it brew for 3 hours.

Brew echinacea, chamomile, thyme, linden, mint, raspberry leaves or St. John's wort in a thermos - these herbs give a good antibacterial effect.

Beware newlyweds!

A common cause of chronic rhinitis is an untreated cold, “unfinished” bacteria that excite the body. There is only one recipe - to heal.

A constant leak from the nose can be provoked by air that is overdried by central heating - the body is trying to moisten dry mucous membranes. A humidifier will help out.

Another one possible reason chronic rhinitis - dust, dirt and gas contamination of the urban atmosphere. Escape to the ecological wilderness is not always possible, but buying an air purifier is easy.

Vasomotor rhinitis also belongs to chronic. The cause of a constant runny nose can be cold, and tobacco, and too strong odors, and tobacco smoke, and alcohol, too hot or spicy food (the so-called food rhinitis), and hormones, and stress. There is even "honeymoon" rhinitis!

Pranks of immunity

If your nose runs during or after eating, you most likely have allergic rhinitis. That is, the cause of a runny nose was a reaction to a specific product. Modern Western medicine associates up to 80% of cases of chronic rhinitis with food allergies.

Typical allergens are nuts, citrus fruits, sugar, milk, strawberries, chocolate, chicken eggs, fish, soy. A person can react to almost anything - it depends on the characteristics of the immune system. To identify the allergen, allergists conduct skin tests and other tests.

In addition to true allergies, there is also a false one, otherwise it is called food intolerance. It can be caused by problems with the gastrointestinal tract or insufficient production of digestive enzymes.

Common examples are milk intolerance and celiac disease. In the first case, there is not enough lactase enzyme to break down milk sugar - lactose. In the second - the body can not cope with gluten - a protein that is abundant in cereals, especially in wheat, oats, rye.

Food intolerances can be triggered by preservatives, flavors, and food colorings.

Foods containing histamine (a substance that plays an important role in the development of allergic reactions) and other substances with similar properties are often to blame: wine, beer, hard cheeses, smoked sausage, sausages, liver, canned tuna, herring and herring caviar, ketchup, sauerkraut , eggplant, bananas.

Also dangerous are foods that increase the amount of free histamine, which is usually in the body in a bound, inactive state: chicken eggs, fish, chocolate, strawberries, spinach, tomatoes, cocoa, ham, peanuts.

Examining the gastrointestinal tract and keeping a food diary, which should record everything that was eaten, and with what consequences, will help to figure out what exactly you had an allergic reaction to.