What are the diseases of the upper respiratory tract. How to treat the upper respiratory tract. Why do diseases of the respiratory system occur?

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With normal respiratory function of the nose, many atmospheric occupational hazards (dust, vapors and gases of aggressive chemicals, various biological allergens) act on its mucous membrane, even when working in a respirator. In addition to direct local action (beryllium, strontium, magnesium, chlorine, etc.), these substances have a resorptive toxic effect on distant organs and the body as a whole.

In production conditions in which harmful substances are the main industrial hazard (mining and coal, flour milling, papermaking, tobacco, chemical and chemical-pharmaceutical, etc.), most workers suffer from nasal diseases. The protective mechanisms of the mucous membrane are quickly depleted on contact with these substances, which causes their penetration to the lower respiratory tract. Therefore, damage to the organs of the nasal cavity is only the initial stage of a systemic dystrophic process that affects all the upper respiratory tract. The presence in the nasal mucosa of a large number of nerve endings of the sensory and trophic types determines, on the one hand, a number of pathological reflexes that disrupt vasomotor and trophic reactions, on the other, atrophy of the local regulatory systems themselves. The resulting vicious circle intensifies the pathological process, often causing the stage of an irreversible pathological condition.

Influence of dust

When exposed to dust particles, depending on their state of aggregation, first on the nasal mucosa and then on the underlying respiratory tract, small mechanical damage may occur in the form of excoriation or pressure sores, causing itching, pain, and foreign body sensation. The most traumatic effect is possessed by metal, silicon and coal dust particles, which can accumulate in the nasal cavity in large quantities. Cement dust causes great harm, contributing to the occurrence of atrophic rhinitis, pharyngitis, laryngitis. Perforation of the nasal septum, frequent nosebleeds, metaplasia of the epithelium with the formation of polyps and rhinolitis may occur in the nose.

Chalk and gypsum dust particles, due to their fine dispersion, clog the ducts of the glands, which leads to their atrophy, increases the dryness of the mucous membrane and causes vulgar inflammation of the nasal mucosa and paranasal sinuses. Dust has similar properties in flour milling, textile and woodworking industries.

Dusts of chemical compounds of copper, lead, zinc, beryllium, manganese, mercury, and especially dust of heavy metal oxides are capable of resorptive and local toxigenic action.

Influence of aggressive vapors and gases

The influence of these occupational hazards is determined by a number of factors: chemical property (the ability to react with liquid media of the mucous membrane and lipoids of its cells, solubility and affinity for tissue substances); concentration in the inhaled air, exposure determined by the length of service. Caustic substances have, in addition to toxic, also a cauterizing effect. This effect is especially pronounced in vapors of acids and alkalis, which, with prolonged contact, even in low concentrations, leads to primary atrophy of all elements of the mucous membrane and early hyposmia, which is the earliest sign of occupational damage to the nasal cavity.

At significant concentrations of vapors and aerosols of caustic substances, long-term non-healing areas of necrosis can appear on the nasal mucosa. When they heal, whitish scars remain on the lower nasal concha and the nasal septum against the background of a red atrophic mucous membrane.

The described clinical picture is observed in gas and electric welders, who in the process of work come into contact with the metal oxides in the gaseous state that are part of the electrodes and welded metal products. A harmful effect on the nasal mucosa and VAR in general is exerted by smoke, soot and soot, the appearance of which is observed in those industries in which coal and fuel oil are used.

Toxic substances can be selective or polytropic. For example, chlorine, nitrogen oxides, beryllium compounds and a number of metal oxides have a selective effect on the respiratory system. Many of these substances also have a polytropic effect, in which lesions occur in the nervous and bone systems, lymphadenoid apparatus and in parenchymal organs.

Protection against aggressive atmospheric hazards consists in the use of individual means (various kinds of respirators). However, their long-term wearing has its drawbacks, first of all, it is the greenhouse effect caused by an increase in humidity in the nasal cavity and the upper respiratory tract in general, and the lack of proper ventilation. This effect, according to Ya.A. Nakatis (1998), causes pathological changes in the auditory tubes, a violation of hemodynamics in the structures of the nasal cavity, trophic functions, an increase in the permeability of histohematogenous barriers, a decrease in local immunity and, as a result, frequent inflammatory and allergic diseases of the nose, paranasal sinuses and upper respiratory tract in general. This is facilitated by professional hazards of biological nature.

Influence of organic substances on VAR

In industrial production, workers can be exposed to organic matter through inhalation. Many of these substances can cause allergic reactions. These include derivatives of formaldehyde, epichloridine, furan, diisocyanate, nitrobenzene, as well as salts of chromium, nickel, cobalt, beryllium and platinum. Chemical allergens are part of many complex organic compounds, among which synthetic polymers, which are part of various industrial and household products (resins, adhesives, varnishes, elastomers, plastics, etc.), have the greatest ability to induce an antigen-antibody reaction.

Long-term influence of even small concentrations of these substances causes sensitization of the body to them, manifested by general allergy and local changes in the form of proliferative processes in the mucous membrane of the upper respiratory tract, in particular, allergic rhinosinusopathy. If by the end of the first half of the XX century. among workers of various chemical industries, this form among all ENT diseases ranged from 16 to 28%, in our time, according to WHO, it exceeds 42%.

Industrial biological allergens (antibiotics, fungi-producers, enzymes, protein-vitamin concentrates, etc.) occupy a special place among allergens of organic origin. Their adverse effect is based on the interaction of the body with a foreign protein of natural or synthetic origin. In the pathogenesis of the effects of these allergens on the mucous membrane of the upper respiratory tract lie autoimmune processes that can cause the emergence of several forms of a pathological condition. These include: a) violations of the hematocellular barrier, promoting the release of the so-called autonomous antigens playing the role of a foreign protein; b) violations caused by affinity tissue components of the body with exoantibodies, in which the immune response can be directed against its own tissue; c) dysfunction of lymphoid tissue with the appearance of cells that destroy the body's own tissues.

In persons with a predisposition to allergic reactions, their manifestations during initial contact with an industrial allergen (edema of the mucous membrane, vaso-paretic reaction of the corpora cavernosa of the turbinates, profuse rhinorrhea and the corresponding parasensory reactions) may occur several minutes or hours after exposure to the allergen.

The clinical picture of occupational diseases of the upper respiratory tract

The clinical picture of chronic occupational catarrhal, subatrophic, atrophic, hypertrophic rhinopharyngolaryngitis is characterized by changes in the mucous membrane of the upper respiratory tract, extending to all the upper respiratory tract (total localization), which can be catarrhal, subatrophic, atrophic, less often - hypertrophic in nature. This largely depends on the duration of contact with toxic substances: with a relatively short work experience, catarrhal changes predominate, with more work experience, subatrophic and atrophic changes are revealed. The duration of work in conditions of exposure to irritating substances determines the prevalence of the lesion: first, there is a predominant lesion of the nasal mucosa, then the changes spread lower, capturing the pharynx and larynx, chronic pharyngitis and laryngitis develop, as well as combined forms - rhinopharyngolaryngitis.

Subjective disorders in these cases are manifested by complaints of dry nose, sore throat, coughing. On examination, dryness and hyperemia of the mucous membrane, covered with scanty mucous discharge, drying up into crusts, is revealed. The mucous membrane becomes easily injured, resulting in increased bleeding. Minor bleeding may occur, especially nasal bleeding, and the resulting crusts acquire a mucous-bloody character.

Clinical picture of allergosis upper respiratory tract, allergic rhinitis, allergic rhinosinusitis, allergic rhinopharyngitis most often develops against the background of degenerative changes in the mucous membrane of the nasal cavity and pharynx. This determines the originality of the manifestation of the allergic process in the upper respiratory tract, as a result of which these nosological forms in the clinic of occupational pathology are designated as "allergosis of the upper respiratory tract." In occupational allergic diseases of the upper respiratory tract, a certain sequence of development of the allergic process through a number of stages of the disease is observed: vasomotor disorders, allergic changes in the mucous membrane of the upper respiratory tract, predastma. When contact with industrial allergens is interrupted, especially in the initial periods of the development of occupational allergic pathology, a reverse development of the disease can be observed, and vice versa, with continued exposure to industrial allergens, the progression of the pathological process is observed. Given this, each stage can be regarded as an independent disease.

In vasomotor disorders, the sensitizing agent acts in combination with irritating factors that cause primary vascular reactions in the mucous membrane of the upper respiratory tract. Therefore, the violation of vascular tone is an integral component of the allergic process of chemical genesis, its initial stage. The main signs in the clinical picture of such patients are vascular disorders in the mucous membrane of the nasal cavity, pharynx and larynx (rhinorrhea, sneezing, lacrimation). These changes, as a rule, disappear when the action of the allergen ceases, however, the mucous membrane of the lower turbinates, uvula, posterior pharyngeal wall remains pasty, there are Voyachek spots, indicating vascular dystonia. The clinical picture is similar to neurovegetative rhinitis. However, in vasomotor disorders associated with the action of an industrial allergen, hypereosinophilia in the peripheral blood, an increase in the level of neuraminic acid, are noted in rhinocytograms, there are eosinophils, macrophages with a metachromatic substance in the cytoplasm and hypersecreting ciliated epithelium.

The next, more pronounced stage is allergic diseases of the upper respiratory tract. With prolonged contact with industrial allergens, allergic changes in the mucous membrane of the upper respiratory tract develop, clinically different from similar diseases of general genesis. The nature of the complaints and the clinical picture depend on the degree of dystrophic changes, against which allergic diseases develop.

Clinically pronounced forms of URT allergosis are allergic manifestations against the background of hyperplastic, subatrophic and polyposis changes in the mucous membrane. The stage of the most pronounced allergic process in the upper respiratory tract is pre-asthma, it can be accompanied by degenerative or polypous changes in the mucous membrane. Such patients complain of a dry paroxysmal cough, a feeling of heaviness or discomfort in the chest, as well as a persistent or emerging after provocative tests change in respiration indicators, indicating a violation of bronchial patency.

Diagnostics of occupational diseases of the upper respiratory tract

Diagnostics of the dystrophic state of the mucous membrane of the upper respiratory tract does not cause difficulties. The criteria for classifying the disease as a professional are the prevalence of the pathological process throughout the entire segment of the upper respiratory tract (nasal cavity, pharynx and larynx) - a total process, work experience under conditions of exposure to industrial dust with a concentration in the air of industrial premises of more than 10 MPC, at least 10 years.

Diagnosis of URT allergosis should be based on the study of both local and general symptoms. For this purpose, methods of non-specific diagnostics of the state of sensitization of the body and methods of provocative specific testing with the industrial allergen under study are used.

Methods of non-specific diagnostics are aimed at identifying general sensitization of the body (allergic history, study of the number of eosinophils in the peripheral blood, the concentration of neuraminic acid and the level of histamine in the blood), as well as to identify local changes in the mucous membrane of the upper respiratory tract. The latter include X-ray examination of the paranasal sinuses, olfactometry, electrothermometry, a single rhinocytological examination, study of the transport function of the ciliated epithelium, determination of the concentration of hydrogen ions in the nasal mucus.

Anamnesis... When studying a professional allergic history, it is necessary to pay attention to the manifestation of allergies in other organs, the presence of a positive allergic history in the family, and the results of previous allergological testing. To establish a diagnosis of occupational allergy, it is necessary to take into account the occupational route (work experience in the profession), the patient's indication of a possible connection between the manifestation of allergy symptoms with the presence of a chemical substance in the air of industrial premises, the exposure of the chemical substance, the presence of symptoms of an allergic disease of other organs and systems, the manifestation of symptoms elimination and exposure.

Physical examination... X-ray examination of the paranasal sinuses is necessary to determine the prevalence, and in some cases and localization of the allergic process in the upper respiratory tract. More often, changes occur in the maxillary sinuses and cells of the ethmoid labyrinth. Parietal darkening of one of the maxillary sinuses is observed, sometimes with dynamic observation it is possible to note the migration of the process - the darkening of one or the other of the sinuses. Allergic sinusitis in 78% of cases is accompanied by allergic changes in the nasal cavity.

Electrothermometry of the nasal cavity is an additional objective method for determining the functional state of the mucous membrane. The temperature of the nasal mucosa in persons with clinical signs of URT allergosis ranges from 31.2 to 34.4 ° C.

An additional method of objective diagnosis of allergic diseases of the upper respiratory tract of chemical etiology is a single rhinocytological examination by the method of reprint smears. When assessing the rhinocytological picture, only the intensity of the eosinophilic reaction is assessed.

The specific diagnosis of allergic diseases of the upper respiratory tract is aimed at identifying the body's sensitization to a specific allergen. From methods of specific diagnostics, drip and scarification skin tests with household, pollen and bacterial allergens are used; drip and application skin testing with chemical allergens; endonasal provocative tests with chemical allergens. Skin drip and scarification tests with bacterial pollen and household allergens are carried out to identify signs of polyvalent sensitization.

The main method for identifying the etiological role of a professional factor in the development of an allergic disease of the upper respiratory tract is an endonasal provocative test with an industrial allergen. In response to the introduction of an allergen, specific reactions of the body develop, which are detected by assessing clinical symptoms and data from electrothermometric and rhinocytological methods.

The test is carried out in a hospital using the application method during the remission of the allergic process. The symptom complex of a positive reaction of the body to testing with an industrial allergen develops in the range of 20-60 minutes after exposure to the allergen and is manifested by an exacerbation of an allergic disease. The obligatory use of morphofunctional indicators during endonasal testing allows one to assess the local response of an organism sensitized to a given substance not only qualitatively, but also quantitatively. The cytological picture of imprint preparations after endonasal exposure is characterized by a 2-4 times increase in comparison with their initial level in the number of test cells of the allergic process (eosinophils, secreting epithelium, macrophages with metachromatic substance and mast cells in the cytoplasm). At the same time, the morphofunctional state of cells also changes - signs of hypersecretion and functional activity appear.

To determine the prevalence and severity of the process, as well as the prognosis of the URT disease, the examination complex includes the determination of indicators of the function of external respiration (vital capacity and minute ventilation of the lungs, bronchial resistance and some others). These studies are performed before and after the intranasal test with a chemical allergen. In occupational allergic diseases of the upper respiratory tract, as a rule, there is a decrease in these indicators, which indicates a violation of bronchial patency. Such persons need dynamic observation.

Examples of the formulation of diagnoses and their justification:

1. " Occupational chronic subatrophic rhinopharyngolaryngitis... Considering the long (more than 10 years) work experience in industrial dust, the concentration of which exceeded the MPC by more than 10 times, pronounced dystrophic changes in the state of the mucous membrane of the upper respiratory tract, the disease should be considered professional. Work in environments with irritants and dust is not recommended. Observation and treatment by an otorhinolaryngologist. "

2. " Occupational Allergosis of the Upper Respiratory Tract... Taking into account the typical clinical picture of changes in the mucous membrane of the upper respiratory tract, data of an allergic examination, industrial contact with substances of a sensitizing effect and positive indicators of an endonasal test with an industrial allergen, the disease should be considered professional. Work under conditions of exposure to sensitizing substances and potential allergens is contraindicated. "

Treatment of occupational diseases URT

In the treatment of occupational diseases of the upper respiratory tract, the same principles are used as in general otorhinolaryngology - hyposensitizing therapy, drugs of local anti-inflammatory and biostimulating action.

With significantly pronounced difficulty in nasal breathing, surgical treatment (conchotomy, polypotomy), cryotherapy, electrocoagulation, mucosal extinguishing with a 0.5-1% solution of silver nitrate or trichloroacetic acid are indicated. However, these methods should be performed with caution, since endonasal structures in chronic occupational diseases are characterized by poor resistance to invasive methods. Often, after such interventions, persistent atrophic changes develop in the nasal cavity.

In the stage of a pronounced allergic process, manifested by a pre-asthmatic state, in addition to the listed measures, the appointment of bronchodilators and expectorants is recommended. All patients with an allergic disease of the upper respiratory tract during the period of remission are shown sanatorium-resort treatment, stay in dispensaries.

Examination of working capacity

The ability to work in the initial stages of dystrophic processes of the URT is not significantly impaired, since in these cases it depends on the prevalence and severity of the disease, as well as on the nature of professional activity (constant or short-term contact with an allergen during the working day) and the presence of concomitant diseases.

Forecast with regard to recovery from continued contact with occupational hazards that caused one form or another of the URT disease, in most cases it is unfavorable. Timely elimination of contact with chemicals of irritating and sensitizing action is unambiguous for all forms and stages of occupational allergosis of VAR. Since full medical and labor rehabilitation is possible at the stage of vasomotor disorders, in the conclusion about the ability to work, it is necessary to take into account the possibility of recovery, and at a young age - the need for retraining.

In severe cases, as well as in combination with URT allergosis with any form of dystrophic condition, further work in contact with substances of irritating and sensitizing action is contraindicated. Such patients need to carry out all the necessary rehabilitation measures: transfer to work without contact with harmful production factors, rational employment, retraining and measures for medical rehabilitation, including treatment in sanatoriums.

Prophylaxis

The basis for the prevention of occupational diseases of the upper respiratory tract is sanitary and hygienic measures aimed at improving the working environment, as well as the use of personal protective equipment. No less important are preliminary and periodic medical examinations with the participation of an otorhinolaryngologist-occupational pathologist.

Medical contraindications for working in contact with substances of a sensitizing and irritating effect are signs of allergic inflammation of the upper respiratory tract, the presence of pronounced dystrophic changes in the mucous membrane of the upper respiratory tract of an atrophic or hypertrophic nature, causing a violation of its barrier functions. Persons with foci of chronic infection in the upper respiratory tract (chronic tonsillitis, chronic rhinitis, sinusitis), as well as with pronounced curvature of the nasal septum, disrupting nasal breathing, are subject to preliminary sanitation.

Based on the results of periodic medical examinations, it is recommended to form the following dispensary registration groups for conducting targeted therapeutic and prophylactic measures (Pankova V. B., 2009):

First group- healthy workers (risk group of exposure to industrial chemical allergens). These are persons without allergic complaints and without clinical signs of changes in the nasal cavity, pharynx and larynx, however, they have functional disorders in the nasal cavity (first of all, changes in excretory, bactericidal and calorific functions). Persons of this group should carry out preventive treatment: biostimulating agents (vitamins, injections of aloe or FIBS), moisturizing and cleansing the mucous membrane of inhalation with alkaline solutions or 1% sea salt solution (depending on the pH of the mucus in the nasal cavity).

Second group- practically healthy workers (or a risk group for the development of an occupational allergic disease of the upper respiratory tract). This group should include persons who, along with functional disorders, showed signs of sensitization of the mucous membrane of the upper respiratory tract (the presence of eosinophilia from ++ to +++ in the rhinocytogram in a single rhinocytological study, as well as other test cell forms indicating the processes of sensitization of the mucous membrane ). The same group should include persons with chronic diseases of the upper respiratory tract (chronic tonsillitis and chronic sinusitis). These diseases contribute to the development of allergic pathology. In addition, chemicals alter the course of chronic diseases of the nasal cavity and pharynx themselves. In the complex of therapy of this group, it is necessary to include inhalations that reduce the hypersensitivity of the mucous membrane.

Third group- patients with allergic diseases of the upper respiratory tract, who, depending on the identified form of the disease, receive appropriate treatment.

For each of these groups, an algorithm for medical supervision is developed, and for each person included in these groups, an individual plan of rehabilitation and preventive measures is developed.

Otorhinolaryngology. IN AND. Babiyak, M.I. Govorun, Ya.A. Nakatis, A.N. Pashchinin

The upper respiratory tract (URT) is represented by the nasal cavity and the pharynx. The initial sections of the respiratory tract are the first to encounter viruses and bacteria that cause a significant proportion of infectious diseases. Pathological processes also often develop as a result of injuries and systemic diseases. Some of the conditions are prone to spontaneous healing, a number of other disorders require the involvement of specialized medical care.

Diseases of the upper respiratory tract

It is rational to divide the structure of pathological disorders from the URT according to several criteria.

Regarding the level of the inflammatory process, they are classified:

  • Rhinitis is a disease of the nasal cavity.
  • Sinusitis is a pathology of the paranasal sinuses.
  • Private variants of inflammation of the paranasal sinuses: sinusitis (maxillary sinus), frontal sinusitis (frontal), ethmoiditis (ethmoid).
  • Pharyngitis - diseases of the pharynx.
  • Combined lesions: rhinosinusitis, rhinopharyngitis.
  • Tonsillitis and tonsillitis are an inflammatory reaction of the tonsils.
  • Adenoiditis is a hypertrophy and inflammation of large pharyngeal lymphoid structures.

Upper respiratory tract pathologies develop under the influence of heterogeneous factors. The main causes of damage to the upper respiratory tract are:

  • mechanical damage, injury;
  • ingress of foreign bodies;
  • allergy;
  • infections;
  • congenital features and developmental anomalies.

Symptoms and treatment

The most significant proportion of diseases are inflammatory processes in the upper respiratory tract caused by viruses and bacteria. All respiratory infections are characterized by the presence of catarrhal syndrome and general intoxication of the body.

Typical manifestations of local inflammation include:

  • soreness;
  • edema;
  • redness;
  • temperature increase;
  • organ dysfunction.

When the upper respiratory tract is damaged, there is a change in mucociliary clearance. The formation of mucus by the cells of the respiratory epithelium is disrupted. At the initial stage, rhinitis is characterized by the abundant appearance of a liquid secretion. Subsequently, the composition of the discharge changes to mucous and viscous mucopurulent. Pain syndrome is most inherent in inflammatory processes of other localization.

The manifestations of diseases are directly related to the level of damage and the etiological factor. Data from the patient's story about what worries him, a typical clinic and the results of a special examination allow the doctor to make an accurate diagnosis.

Rhinitis

The condition develops as a result of exposure to infectious agents or upon contact with an allergen against the background of existing sensitization. An adult suffers up to 3-4 viral rhinitis per year. Bacterial inflammation of the nasal mucosa develops mainly against the background of an untreated rhinitis.

Isolated rhinitis occurs in several phases:

Babies with a runny nose are capricious and cannot fully suckle.

The total duration of uncomplicated rhinitis is up to 7, sometimes up to 10 days. If a person promptly resorts to rinsing the nose with saline solutions and general methods of treatment (hot foot baths, warming tea with raspberries, adequate sleep), the duration of the onset of a cold is reduced by 2 times.

The adaptive mechanisms of pathogens cause the emergence of resistance to non-specific types of protection. In debilitated people, rhinitis can last up to 2-4 weeks and develop into a chronic form.

During an influenza epidemic, with the development of typical symptoms of this ARVI, a patient with a mild course of the disease is shown bed rest. Then, as the condition improves, the activity expands. An important component in treatment is the use of drugs that block neuraminidase (Oseltamivir, Zanamivir). The use of adamantanes (Remantadine) does not always reduce the viral load on the body.

Uncomplicated rhinitis with ARVI, as a rule, can be cured with simple means. With a cold, vasoconstrictor drugs are used with concomitant irrigation of the nasal cavity with sea water solutions. There are combined sprays and drops that combine a decongestant and a saline component (for example, Rinomaris). The addition of bacterial inflammation requires instillation of antibiotic agents. An enhanced drinking regime (teas, fruit drinks, warm water) is recommended for all patients. With poor tolerance of elevated temperature, they resort to paracetamol or Ibuprofen. The basis for the treatment of allergic rhinitis is the elimination of contact with the allergen, the use of antihistamines and subsequent hyposensitization therapy.

Sinusitis and rhinosinusitis

Inflammation of the paranasal sinuses is usually a complication of the common cold. The basis of the disease is edema of the mucous membrane of the accessory sinuses, increased production of mucus in the latter and impaired outflow of secretions. In such conditions, a favorable environment is created for the reproduction of bacterial flora. Pus gradually builds up in the sinuses.


In addition to nasal congestion, the appearance of mucopurulent discharge, patients are worried about headaches. The body temperature usually rises significantly. Lethargy, irritability develops. The diagnosis is confirmed by x-ray examination of the sinuses. The images show areas of reduced aeration and areas of darkening of the sinuses.

Treatment is aimed at eliminating the infectious agent. With bacterial inflammation, antibiotics are prescribed in tablet form (less often in injectable form). Shows the use of vasoconstrictor drugs, nasal lavage and drainage of the focus of infection. Mucolytics (Rinofluimucil) promote thinning of viscous secretion and improve its excretion from areas of "stagnation" of mucopurulent contents. In some cases, a medical sinus puncture with evacuation of pus is indicated.

There is a method of treatment with YAMIK, which is carried out without a puncture. In this case, the contents of the sinuses are literally "sucked" by a special device. The otolaryngologist may prescribe complex drops (Markova, etc.).

Sinusitis often occurs against a background of rhinitis. In such patients, a combination of pathology symptoms is observed. The condition is classified as rhinosinusitis.

Pharyngitis and tonsillitis


Acute inflammation of the pharynx is considered mainly as ARVI or ARI, depending on the viral or bacterial origin. Patients are worried about coughing, feeling of a lump and sore throat. The unpleasant sensations are aggravated by swallowing. The general condition may worsen: there is a rise in temperature, weakness, lethargy.

On examination, the granularity of the posterior pharyngeal wall is noted, the appearance of pustules and raids is possible. The mucous membrane is loose, red. Often this condition is accompanied by an increase in the palatine tonsils. Tonsillitis is also manifested by the friability of lymphoid tissue, hyperemia, with bacterial lesions, the appearance of purulent plugs or translucent follicles with pus is observed. The patient's anterior cervical lymph nodes enlarge and become painful.

Pharyngitis and tonsillitis can be combined and isolated, but with a persisting local picture.


Treatment of viral diseases is carried out by irrigating the throat with antiseptic solutions (Chlorhexidine, Miramistin, Jox). Effective results are obtained using infusions and decoctions of chamomile, rinsing with soda-salt water. The patient is shown frequent warm drinks. Food must be mechanically processed (grated, boiled). Antipyretics are used symptomatically if necessary. With a bacterial etiology of the disease, appropriate antibiotic therapy is prescribed.

Curvature of the nasal septum

This condition is represented by persistent deviation of the bone and / or cartilaginous structures of the septum from the median plane and is quite common. Curvature is formed as a result of trauma, long-term improper treatment of chronic rhinitis, individual developmental characteristics. Various forms of deformation are distinguished, including ridges and spines of the septum. The condition is often asymptomatic and does not require medical attention.

In some patients, the pathology manifests itself in the form of:


Due to the difficulty in aeration of the paranasal sinuses, pronounced curvature can be complicated by sinusitis and otitis media. If, against the background of the existing symptoms, another ENT pathology develops, they resort to surgical alignment of the septum.

Bleeding from the nose

The condition develops after trauma, with systemic and respiratory diseases. There are three degrees of nosebleeds:

  • insignificant, in which the blood stops on its own, blood loss is minimal (a few milliliters);
  • moderate, up to 300 ml of blood is lost, hemodynamics is stable;
  • strong or severe - loss of more than 300 ml, there are disturbances in the work of the heart and even the brain (with blood loss of up to 1 liter).

As a self-help at home, you need to apply cold to the bridge of the nose, press the nostril from the side of the bleeding. The head is tilted forward (it cannot be thrown back). The optimal would be the introduction of turunda soaked in hydrogen peroxide. In the absence of stopping bleeding, a specialized tamponade of the nose or cauterization of the bleeding vessel is required. In the case of profuse blood loss, the infusion of solutions and the administration of drugs (aminocaproic acid, Dicinona, etc.) are connected.

Also, the pathology of the upper respiratory tract includes other diseases of the nasal cavity and pharynx, which are diagnosed by an otolaryngologist (hematomas, perforations with a whistling sensation through the pathological opening in the septum, adhesions and bridges between the mucous membranes, tumors). In such cases, only a specialist is able to conduct a comprehensive examination, according to the results of which the volume and tactics of treatment are determined.

Winter is not only New Year's, long weekends and skiing are also colds. Respiratory diseases, like love, are submissive to all ages, but babies, whose immunity is not yet working in full force, are especially defenseless against such diseases. Respiratory diseases in children are often difficult and require special attention, since the risk of complications in children is higher than in adults.

Respiratory diseases in children and adults are the most common infectious diseases in the world. They account for more than 90% of all diseases that are caused by bacteria, viruses or fungi. Every year in our country, about 30 million cases of acute respiratory infections are registered - that is, they affect every fifth inhabitant of Russia.

2-3 times a year adults get sick with acute respiratory infections
6-10 times a year children get sick with acute respiratory infections
38% of cases of acute respiratory infections are children under 4 years old
34% of people who died from complications of acute respiratory infections and acute respiratory viral infections - children under 2 years old

Polls show that almost two-thirds of Russians, at the first symptoms of a respiratory infection, go not to a polyclinic, but to a pharmacy to buy "something for a cold." Many do not trust medicine at all and prefer to be treated with home remedies. Such carelessness very often ends in complications and the spread of infection.

Respiratory diseases are especially dangerous for the elderly and for preschool children, since in the former the body's defenses have already weakened, and in the latter, immunity is in the process of formation and cannot always repel bacteria and viruses.

What are the causes of respiratory diseases in children?

Of course, walking in the cold in an unbuttoned jacket and without a hat does not add health, but this is not the main reason for the development of respiratory diseases in children. Hypothermia only leads to narrowing of the capillaries and a decrease in immunity. Respiratory diseases in children are infectious in nature, and infections are much easier to enter the body if its defense has weakened, even if only for an hour.

Respiratory diseases are mainly transmitted by airborne droplets or through dirty hands. They can affect the upper respiratory tract and lead to otitis media, sinusitis, or sore throat. If the infection spreads to the lower respiratory tract, pneumonia and bronchitis develop.

Bacteria, in particular streptococci, staphylococci, and Haemophilus influenzae, are often the culprit. But no less often doctors deal with viruses, first of all, with the influenza virus. Very often, against the background of a viral respiratory disease, a complication occurs in the form of a bacterial infection. The mucous membrane is the first line of defense against bacteria, but with inflammation and irritation, which are companions of viral diseases of the respiratory tract, it loses its protective properties.

What symptoms should you watch out for?

Doctors divide respiratory diseases in children and adults into two groups - diseases of the lower and upper respiratory tract. Actually, there is no generally accepted border between the upper and lower respiratory tract. The upper ones include: the nose and its paranasal sinuses, the pharynx and the upper larynx. The area of ​​the lower respiratory tract is the lungs, trachea, larynx and bronchi.

The following signs indicate respiratory diseases in children:

  • Stuffy nose, mucous or mucopurulent nasal discharge;
  • Sneezing;
  • Cough, both dry and with expectoration;
  • Sore throat, plaque on the surface of the tonsils;
  • Enlargement of the cervical lymph nodes;
  • Increase in body temperature (in young children, it can rise quickly and very significantly, up to 40 ° C);
  • Nausea and vomiting caused by intoxication of the body.

If you notice these symptoms in a child, do not try to diagnose yourself. It is very difficult to distinguish a viral infection from a bacterial one based on symptoms alone. It is possible to identify the causative agent of the disease and prescribe an effective treatment only after laboratory diagnostics. An accurate diagnosis is extremely important because viral, bacterial, and mixed infections are treated differently.

Diseases of the upper and lower respiratory tract can occur in both acute and chronic forms. At the same time, the erased form of the course of the disease with subtle symptoms can correspond to both acute and chronic processes.

If in the acute course of respiratory diseases in children, the symptoms are pronounced and cause concern for parents, then in the chronic course of the disease, the signs of respiratory diseases are often ignored. And this is very dangerous, since it is the chronic course of the infection that is fraught with the most serious complications.

Self-medication also leads to the development of complications. Most often, home "therapy" includes drugs that relieve symptoms, fever, inflammation of the mucous membranes and cough, but do not affect the cause of the disease - viruses and bacteria. As a result, the disease in some cases can become chronic.

Often, parents, seeing that "folk remedies" do not help, still take the child to the doctor. But in such cases, the treatment lasts longer, since the disease is already running.

How to properly treat respiratory diseases in children?

The main remedy in the fight against bacterial respiratory tract infections in children and adults is antibiotics. However, parents are usually suspicious of them. There are a lot of myths and misconceptions around antibiotics. And all because people sometimes have very little idea of ​​how these tools work. Let's try to figure out what antibiotics are, why they are prescribed and whether they can help cure respiratory diseases in children.

Myth number 1. Antibiotics cause allergies This is not entirely a myth - an allergic reaction is indeed possible. But medicine has a lot of different types of antibiotics in its arsenal. And if one drug conflicts with the patient's immune system, the doctor will immediately select another.

Myth number 2. Antibiotics destroy the immune system This myth has no foundation at all. There is no study that proves that antibiotics weaken the body's defenses. But neglected respiratory diseases in children can indeed lead to suppression of the immune system and frequent recurrent colds.

Myth number 3. Antibiotics kill all living things This is also not true. Moreover, antibiotics do not kill absolutely all harmful bacteria at once. Antibiotics are not mass destruction; they are very selective. Each remedy is designed to target a specific type of bacteria, and what works for streptococcal infections will not work for another. The confusion stems from the fact that most antibacterial agents are called “broad spectrum antibiotics,” and to the uninitiated, it seems to the uninitiated that such drugs should kill many types of bacteria. In fact, this term means that the antibiotic is effective against several dozen bacteria, but nothing more.

Antibiotics are constantly being improved, modern, even safer drugs are being developed, new convenient dosage forms are being produced - for example, dispersible tablets that dissolve in water, which greatly facilitates their intake.
There is no reason to fear antibiotics - of course, if they are prescribed by a doctor, medications are taken under his control and all recommendations are strictly followed.

Antibiotics are the only effective medicine known to fight bacterial infections, and no tea with raspberries can replace them.

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Upper respiratory tract infections (URTI) are the most common diseases, especially during the cold season. They are most commonly diagnosed in people with weakened immune systems, children, and the elderly. The form of URTI can be acute or chronic.

What indicates how an upper respiratory tract infection manifests itself, and how is it treated? It is on this topic that our today's conversation will go. Let's briefly dwell on the main diseases, find out the methods of drug treatment and consider one effective folk recipe for each ailment.

Upper respiratory tract infections

Here are some of the most common ones:

- Rhinitis (runny nose)- inflammation of the nasal mucosa. May have an acute or chronic course.

The main symptoms are: swelling of the mucous membrane, dryness, itching, difficulty in breathing. At the initial stage, there is a liquid, transparent discharge from the nasal cavity. In the future, the discharge becomes thick, mucopurulent, and then gradually disappears. Everything is accompanied by a general malaise.

Treatment

They use vasoconstrictor, anti-inflammatory and decongestant drugs: Naphthyzin, Ephedrine hydrochloride, Galazolin (instructions for use of each drug must be studied personally before using it from the official annotation enclosed in the package!). For children - Nazivin. Treatment with antibiotics is possible, but only in the case of the bacterial nature of rhinitis and in the presence of complications.

Folk recipe:

Mix freshly squeezed carrot juice 1 tsp and unrefined olive oil of the same volume. Add 3 drops. fresh garlic juice. Drop 2-3 drops on each nostril. Use the mixture only freshly prepared.

- Sinusitis, rhinosinusitis- infectious and inflammatory process of the paranasal sinuses, with an acute or chronic course. It can be of a viral, bacterial, fungal or allergic nature. It can develop in isolation, but more often it is a complication of other pathologies: measles, rhinitis, flu or scarlet fever.

The main symptoms are: general malaise, weakness and headaches, a person's body temperature rises, there is abundant mucous discharge from the nose.

Treatment

Bacterial sinusitis is treated with antibiotics. They are prescribed by a doctor, depending on the type of bacteria and their sensitivity to a particular drug. With a viral nature, antiviral drugs are prescribed - Neovir, Isoprinosine. Additionally, decongestant drops and sprays are used: Naphtizin, Sanorin, Galazolin.

If sinusitis is a complication of another disease, measures are taken to treat the pathology that caused it.

Folk recipe:

Prepare freshly squeezed black radish juice. Place 2 drops on each nostril into the nasal passages. If it burns very much, you can dilute with water.

- Angina (acute tonsillitis)- can be catarrhal, follicular, phlegmous and lacunae. Moreover, one variety rarely develops in its pure form. Most often, the patient has signs of at least two varieties.

Characteristic common symptoms are: pain, redness of the throat, tonsils enlarge, catarrhal phenomena are present. There is general malaise, weakness, the temperature rises, chills appear, the lymph nodes are enlarged.

Treatment

Depending on the variety, antimicrobial, antifungal, anti-inflammatory drugs, local antiseptics, symptomatic drugs are prescribed. Use disinfectant solutions to gargle the throat. If the disease is caused by a bacterial infection, antibiotics of a certain group are prescribed.

Folk remedy:

Mix equal amounts of elderberry, clover and linden blossoms. Add the same amount of crushed rowan berries, viburnum, peppermint leaves and black currant leaves. Mix well. Insist 2 hours in a thermos 4 tablespoons of the mixture, pouring it with a liter of boiling water. It is recommended to take half a glass several times a day.

- Pharyngitis- inflammatory disease of the mucous membrane of the upper pharynx, tonsils and uvula. Most often it is viral in nature. It can be an independent ailment, or it manifests itself as a complication of other infections, in particular ARVI, rhinitis, sinusitis, etc. It can occur as a result of alcohol and smoking abuse.
It is characterized by an acute or chronic course.

The main symptoms: dryness, redness in the throat, pain when swallowing. The pharynx may become covered with a purulent bloom, follicular grains may appear. It is accompanied by weakness, malaise, possibly a slight increase in temperature.

Treatment

In the presence of a viral infection, drugs are prescribed: Faringosept, Falimint and Laripront. Anaferon, Tamiflu and others are used to reduce painful symptoms in the throat. Antibiotics are prescribed for the bacterial nature of the process.

Folk remedy:

Several times a day, inhale with a soda solution: 1 tsp per glass of boiling water. Breathe in hot steam with a towel over your head.

- Bronchitis- inflammatory disease of the bronchial mucosa. It usually develops against the background of other respiratory tract infections.

The main symptoms: cough (dry or wet), weakness, malaise, other symptoms of general intoxication of the body are observed.

Treatment

An acute bacterial infection is eliminated with antibiotics of a certain group. If necessary, sulfanilamide group preparations are prescribed: Etazol, sulfadimethoxin. In the presence of fever, antipyretic drugs are used: Aspirin, Paracetamol, etc. Steam inhalation is used to treat cough. For better sputum discharge, prescribe: ACC, Libeksin, Mukaltin, etc.

Folk remedy:

Grind 0.5 cups of beeswax to powder. Place in a saucepan. Add 0.5 cups of sunflower oil, bee honey and resin (pine resin). Melt the mixture in a water bath until very hot, but do not boil. Cool, pour into a jar. Treat with beeswax, resin and honey by taking 1 tsp of the composition in the morning, with warm milk or weak tea. Strong black tea will weaken the effect of the medicine, and therefore it is undesirable, however, like coffee. Keep the jar in the cold.

- Tracheitis- inflammatory process of the tracheal mucosa. It can manifest itself as an acute or chronic form.

The main symptoms: violent dry cough, worse at night and in the morning, after sleep. Also, coughing fits occur when talking loudly, laughing, crying, or taking a deep breath. Very often, coughing begins with changes in air temperature.

After an attack, a sore nature is felt that occurs behind the sternum and pharynx. If phlegm is present, it can be scanty, viscous. Or plentiful, with mucopurulent discharge.

Treatment

If there are signs of intoxication, sulfa drugs are prescribed. For bacterial infections, antibiotics are used. For the treatment of cough, drugs are prescribed: Codeine, Libeksin, etc. To warm up the chest, put mustard plasters (instructions, application is on the website in the "Preparations" section).

Folk remedy:

Put 60 g of crushed propolis in a small saucepan, add 40 g of wax. Melt in a water bath. Use the hot mixture for inhalation, which is carried out for 10 minutes in the morning and at bedtime.

In conclusion of our conversation, we note that any upper respiratory tract infection is tolerated rather hard by most patients.

These diseases deliver a maximum of unpleasant, painful sensations, knock out of the usual rhythm of life.

Therefore, it is important to consult a doctor in a timely manner for help, to start the treatment prescribed by a specialist. The sooner this is done, the less likely it is to develop complications and the higher the chance of getting rid of the infection quickly, effectively. Be healthy!

Diseases of the upper respiratory tract are common throughout the world and occur in every fourth inhabitant. These include sore throat, laryngitis, pharyngitis, adenoiditis, sinusitis, and rhinitis. The peak of diseases occurs in the off-season, then the cases of inflamed processes take on a massive nature. The reason for this is acute respiratory illness or the flu virus. According to statistics, an adult suffers up to three cases of the disease; in a child, inflammation of the upper respiratory tract occurs up to 10 times a year.

There are three main reasons for the development of various kinds of inflammation.

  1. Virus. Influenza strains, rotaviruses, adenoviruses, mumps and measles, when ingested, trigger an inflammatory response.
  2. Bacteria. The bacterial infection can be caused by pneumococcus, staphylococcus, mycoplasma, meningococcus, mycobacterium and diphtheria, as well as whooping cough.
  3. Fungus. Candida, aspergillus, actinomycetes cause local inflammation.

Most of the listed pathogens are transmitted from humans. Bacteria, viruses are unstable to the environment and practically do not live there. Some strains of the virus or fungi can live in the body, but only manifest themselves when the body's defenses are reduced. Infection occurs during the activation of dormant pathogenic microbes.

Among the main methods of infection should be highlighted:

  • transmission by airborne droplets;
  • household way.

Virus particles, as well as microbes, penetrate through close contact with an infected person. Transmission is possible by talking, coughing, sneezing. All this is natural in case of diseases of the respiratory tract, because the respiratory tract is the first barrier for pathogenic microorganisms.

Tuberculosis, diphtheria and Escherichia coli often enters the host's body in a household way. Household and personal hygiene items become the link between a healthy and an infected person. Anyone can get sick, regardless of age, gender, material condition and social status.

Symptoms

The symptoms of upper respiratory tract inflammation are quite similar, with the exception of discomfort and pain, which are localized in the affected area. It is possible to determine the place of inflammation and the nature of the disease based on the symptoms of the disease, but it is possible to confirm the disease and identify the pathogen only after a thorough examination.

All diseases are characterized by an incubation period that lasts from 2 to 10 days, depending on the pathogen.

Rhinitis

Known to everyone as a runny nose, it is an inflammatory process of the nasal mucosa. Typical for rhinitis is an exudate in the form of a runny nose, which, when microbes multiply, abundantly leaves. Both sinuses are affected as the infection spreads quickly.
Sometimes rhinitis may not cause a runny nose, but, on the contrary, manifest itself as severe congestion. If, nevertheless, discharge is present, then their nature directly depends on the pathogen. The exudate can be represented by a clear liquid, and sometimes purulent discharge and green color.

Sinusitis

Sinus inflammation goes away as a secondary infection and is manifested by difficulty breathing and a feeling of blockage.
Sinus swelling causes headaches, has a negative effect on the optic nerves, and impairs the sense of smell. Discomfort and pain in the bridge of the nose indicates a running inflammatory process. The discharge of pus is usually accompanied by fever and fever, as well as general malaise.

Angina

The inflammatory process in the area of ​​the palatine tonsils in the pharynx causes a number of characteristic symptoms:

  • pain when swallowing;
  • Difficulty eating and drinking;
  • high temperature;
  • muscle weakness.

Angina can occur due to the ingestion of both a virus and bacteria. In this case, the tonsils swell, a characteristic plaque appears on them. With purulent tonsillitis, yellow and greenish overlays envelop the palate and mucous membrane of the throat. With fungal etiology, a plaque of white curdled consistency.

Pharyngitis

Sore throat is manifested by sore throat and dry cough. Breathing may be difficult from time to time. General malaise and low-grade fever are variable. Pharyngitis usually occurs with influenza and an acute respiratory infection.

Laryngitis

Inflammation of the larynx and vocal cords also develops against the background of influenza, measles, whooping cough and parainfluenza. Laryngitis is characterized by hoarseness and cough. The mucous membrane of the larynx swells so much that it interferes with breathing. Without treatment, in the form of stenosis of the laryngeal walls or muscle spasm. Symptoms get worse without treatment.

Bronchitis

Inflammation of the bronchi (this is the lower respiratory tract) is characterized by sputum waste or severe dry cough. In addition, general intoxication and malaise.
At the initial stage, symptoms may not appear until the inflammation reaches the nerve processes.

Pneumonia

Inflammation of the lung tissue in the lower and upper parts of the lung, which usually cause pneumococci, always general intoxication, fever and chills. As the cough progresses, pneumonia increases, but sputum may appear much later. With a non-infectious nature, symptoms may not appear. Symptoms are similar to a running cold and diseases are not always diagnosed on time.

Therapies

After clarifying the diagnosis, treatment is started in accordance with the general condition of the patient, the cause that caused the inflammation. Three main types of treatment are considered:

  • pathogenetic;
  • symptomatic;
  • etiotropic.

Pathogenetic treatment

It is based on stopping the development of the inflammatory process. For this, immunostimulating drugs are used so that the body itself can fight the infection, as well as auxiliary treatment that suppresses the inflammatory process.

To strengthen the body take:

  • Anaferon;
  • Ameksin;
  • Neovir;
  • Levomax.

They are suitable for both child and adult. It is pointless to treat diseases of the upper respiratory tract without immune support. If a bacterium has become the causative agent of inflammation of the respiratory system, treatment is carried out with Immudon or Bronchomunal. For individual indications, non-steroidal anti-inflammatory drugs can be used. They relieve general symptoms and inhibit pain syndrome, this is important, especially if you treat a child who
is difficult to tolerate the disease.

Etiotropic method

Based on suppression of the pathogen. It is important to stop the multiplication of the virus and bacteria in the upper sections, as well as to prevent their spread. The main thing is to accurately establish the strain of the virus and the etiology of pathogenic microbes in order to choose the right regimen and start treatment. Antiviral drugs include:

  • Remantadine;
  • Relenz;
  • Arbidol;
  • Kagocel;
  • Isoprinosine.

They only help when a virus has caused the disease. If it cannot be killed, as with herpes, you can simply suppress the symptoms.

Bacterial inflammation of the airways can only be treated with antibacterial drugs, the dosage must be prescribed by a doctor. These medicines are very dangerous if used rashly and can cause irreparable harm to the body.

For a child, such treatment can lead to complications in the future. Therefore, when choosing a drug, special attention is paid to the age of the patient, his physiological characteristics, and also a test for the presence of allergic reactions is carried out. Modern pharmacology offers effective drugs for the treatment of macrolides, beta-lactams and fluoroquinolones.

Symptomatic treatment

Since antibacterial or antifungal treatment has a gradual effect in most cases, it is important to suppress the symptoms that cause discomfort to the person. For this, there is symptomatic treatment.

  1. Nasal drops are used to suppress the common cold.
  2. Broad-spectrum anti-inflammatory drugs or topical herbal sprays are used to relieve sore throat and swelling.
  3. Symptoms such as a cough or a sore throat are suppressed with expectorant drugs.

With severe edema of the upper as well as lower parts of the lungs, symptomatic treatment does not always have the desired result. It is important not to use all known treatment methods, but to choose the correct regimen based on the complex elimination of symptoms and the causative agent of inflammation.

Inhalation will help relieve puffiness, suppress cough and sore throat, and also stop a runny nose. And traditional methods of treatment can improve breathing and prevent oxygen starvation.

The main thing is not to self-medicate, but to undergo it under the supervision of a specialist and follow all his recommendations.

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