Proper Nasal Care May Help Reduce the Risk of Common Colds

Common colds are inevitable—they are caused by various pathogens that are abundant in our environment, and those who are ill spread them further by infecting others. Daily attention and proper care of the nasal cavity are essential for the treatment and prevention of colds. We discuss this with Assoc. Prof. Jūratė Staikūnienė from the Department of Pulmonology and Immunology at LSMU MA.

The cold season is changeable—upper respiratory tract infections are increasingly bothering the population. What should the doctor remind patients about primary and secondary prevention?

It should be understood that colds are inevitable—they are caused by viruses, which are abundant in our environment, and those who are ill spread them further by infecting others. Usually, having a cold four times a year for adults and up to eight times a year for young children is considered a normal frequency.

A cold is usually mild, typically manifesting as a runny nose, sore throat, and general malaise. Fever may occur, accompanied by weakness and sweating. Influenza is a more severe disease that threatens complications such as bronchitis, pneumonia, inflammation of the heart and blood vessels (e.g., myocarditis), joint inflammation, arthritis, and nerve damage.

Colds are caused by many viruses that often "open the door" to bacteria, which can cause serious complications of colds: purulent ear inflammation, tonsillitis, sinusitis, and pneumonia.

How can these diseases be avoided? First of all, it is necessary to strengthen the body, exercise, eat properly, get enough sleep, avoid chronic stress and contact with sick people, and avoid crowded places during a cold outbreak—shopping centers, theaters, and concert halls.

Until now, it seems that we have not learned the lesson that nasal mucosa care is equally important for prevention and treatment. Why is it talked about more now?

Today it is known that chronic inflammation of the respiratory tract develops in cases of allergic rhinitis, rhinosinusitis, and asthma. Then the body's cells are ready to receive viruses. Therefore, daily care is really important. If the virus is quickly eliminated before it enters the cell and establishes itself, even by washing the nasal cavity and hands or blowing the nose, the number of cases of illness can be significantly reduced.

Of course, in such cases, comprehensive treatment is necessary. What groups of drugs and what is the recommended duration of treatment for these patients? It should be known that the temperature should only be reduced if it is higher than 38 degrees. When the patient feels weakness or so-called bone pain, pain-relieving and anti-inflammatory drugs are taken to alleviate the condition.

Over-the-counter cold remedies should not be overused. It is recommended to take them for no longer than 5 days, as medicamentous rhinitis may develop, and then we will not get rid of it without special medication. Local and oral nasal decongestants are often used to treat rhinitis.

It is necessary to follow a rest regimen, drink plenty of warm fluids, and eat a balanced diet. High doses of vitamin C and preparations of echinacea help to recover faster and alleviate symptoms. However, in recent scientific discussions, there is a widespread opinion that doses of vitamin C higher than 500 mg are only a burden on the kidneys, not beneficial.

Are there clinical studies supporting the effectiveness of seawater in treating various types of rhinosinusitis or other diseases?

It has already been proven that rinsing the nasal cavity is effective for those with rhinosinusitis. Analysis of Cochrane data shows that using only seawater significantly reduces the symptoms of chronic rhinosinusitis.

Most cold-causing viruses enter the human body through airborne transmission, i.e., they are inhaled with the air. The nasal mucosa is a superficial immunity or protective barrier where inflammatory mediators such as histamine and others are secreted.

In case of inflammation of the nasal mucosa, it is important to push the mucus into the nasopharynx because there are lingering pathogens in the nasal mucus that cause local inflammation, further disrupting mucociliary clearance—the cleansing function of the nasal mucosa. This is one of the theories why nasal lavage is effective in treating acute or chronic nasal and sinus diseases.

It should become a habit to rinse the nose as usual as brushing your teeth. Hypertonic waters not only moisturize but also act osmotically (improve the removal of secretions, bacteria, viruses, and allergens). It is also believed to have an antiseptic effect, increase the resistance of the mucosa to physical and infectious irritants and allergens, strengthen mucosal capillaries, and reduce secretion and bleeding.

Does the Hypertonic Salt Solution Made at Home Have the Same Effectiveness as Medical Nasal Sprays?

It is necessary to handle the homemade solution carefully because it is difficult to prepare the required concentration, although essentially a hypertonic solution may be suitable. It is important to remember that in some cases, it can harm the mucous membrane, so it is more reliable to use the products that can be purchased at pharmacies.

Clinical studies have shown that the most effective hypertonic buffered salt solutions, such as preservative-free and stabilizer-free ocean water, are suitable for use. Salt solutions used with certain devices (sprayers) are suitable and effective for adults and children, pregnant and lactating women. Pregnant and lactating women should always consult a doctor before use.

It is also important that ocean water does not cause systemic vasoconstriction of the nasal mucosa, so it does not worsen mucosal blood flow, does not exacerbate inflammation, and there is no likelihood of medicamentous rhinitis.

How Long Should Nasal Cavity Care Last?

When suffering from cold-related illnesses, the nasal cavity should be rinsed with seawater constantly. This therapy is applied several times a day until improvement is achieved. It may be suitable for all patients with rhinosinusitis. Long-term use requires consultation with specialists.

Do Sinus Infections Tend to Recur When the Cold Season Strikes Again? How Can This Be Avoided?

Viruses cause sinusitis, which is treated like a cold. Viral sinusitis does not require special treatment. The most dangerous situation is when bacterial sinusitis complications develop, then antibiotics may be needed.

To avoid complications of the disease, it is necessary to treat accordingly, dress warmly, and avoid contact with sick people. It is especially important to ventilate rooms (bacteria accumulate in poorly ventilated rooms) and wash hands frequently.

R. Pečeliūnienė interviewed

LT/QUI/2014/16