Difference between rhinitis, sinusitis and bronchitis?

= It is very common in the coldest months of the year to see people scratching their nose, having difficulty breathing and a runny nose. This happens because there is a significant increase in cases of rhinitis, sinusitis and bronchitis in the months of June, July and August, as the cold and dry climate in these months irritates the nasal mucosa, generating the symptoms mentioned above.

What is the difference between rhinitis, sinusitis and bronchitis?

Rhinitis

It is an inflammation accompanied by edema (swelling) of the nasal mucosa, whose most common symptoms are:

  • Runny nose;
  • Recurrent sneezing;
  • Itch;
  • Nasal congestion.

Rhinitis can be acute or chronic and its most common causes are:

  • Viral infections;
  • Rhinitis triggered by allergens (allergic rhinitis);
  • Vasomotor rhinitis (caused by irritants of the nasal mucosa such as pollution, cold air and dry air).

Sinusitis

Acute sinusitis corresponds to inflammation of the sinuses. The most common causes are: viral, bacterial infection or allergic crises. Sinusitis can occur in one or more sinuses and usually occurs consecutively to rhinitis, and may also be called rhinosinusitis.

Inflammation of the nasal mucosa obstructs the passage of the sinuses, causing secretion retention in them, which causes facial pain, headache, nasal congestion with discharge of clear or purulent secretion, in addition to coughing. Diagnosis is clinical and imaging tests are required only in specific cases.

Bronchitis

Acute bronchitis is characterized by inflammation of the lower airways (trachea and bronchi) caused mostly by infections by viruses (most common) and bacteria. Viral bronchitis can occur due to infection by several common respiratory viruses such as influenza, adenovirus, rhinovirus, cornavirus, among others, triggering inflammation and irritation of the airways that can persist for weeks even after the viral infection has already resolved.

Bacteria cause less than 5% of bronchitis cases. The symptoms are initially a runny nose, fatigue and body aches and digestive symptoms (less common), progressing to a dry and later wet cough with expectoration of clear or purulent secretion. In more severe cases, affected patients may experience transient wheezing and shortness of breath, and some cases may progress to pneumonia. The diagnosis is clinical and imaging exams are rarely necessary.

What care helps to improve the above conditions during the cold? Is there treatment for these conditions?

Rhinitis

Avoiding exposure to known irritants or allergens is the best way to prevent symptoms, but it’s not always possible. Treatments with topical nasal medication associated with frequent washing of the nostrils with saline solution help to control the symptoms as well as the use of antiallergic drugs in some specific situations. Specifically in the cold, in environments with heating or in very dry places, the use of room humidifiers can help to control nasal discomfort.

Sinusitis

The treatment is aimed at improving the drainage of the sinuses, reducing the inflammation of the nasal mucosa. Keeping the environment humidified, inhalation of water vapor and warm moist compresses on the face, frequent washing of the nostrils with saline solution associated with the use of topical anti-inflammatory nasal medication are the most common measures for the treatment of sinusitis. In more severe cases, antibiotics are recommended.

Bronchitis 

The recommended treatment is aimed at controlling the symptoms. Analgesics for general discomfort and fever and good hydration associated with humidification of the environment are the basic recommendations. In patients with persistent cough, wheezing and shortness of breath, nebulized medications are used with good results.

The use of cough syrups should be done with restrictions in cases of extreme coughing or that interfere with the patient’s sleep, always bearing in mind their medical history. Antibiotics are not routinely recommended as they do not treat viral infections. They should only be prescribed in case of bacterial bronchitis (which are rare) or in exceptional cases that have progressed to bacterial infection.