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Tag: Allergies

Woman holding nasal spray towards nostrils.

Saline Nasal Spray Helps Control Nosebleeds

Epistaxis, popularly known as nosebleed, is a common problem affecting many people. While majority of cases can be easily treated, some can cause significant problems or can even be life-threatening if associated with serious disorders.

Nosebleeds usually occur during cold or dry months and are often associated with various types of cold, hay fever and allergic symptoms that may irritate the delicate nasal tissues.

In most instances, bleeding occurs when the lining of the nose or nasal mucosa becomes dry and irritated causing the blood vessels along the surface of the nasal lining to break or rupture.

Common medications used to control or prevent nosebleeds include decongestants and antihistamines. However, excessive, or prolonged use of these drugs may further aggravate the dryness and increase risk for more nosebleeds.  Keeping the nasal tissues hydrated or moist with the use of saline nasal spray is frequently offered as a simple intervention which may be as effective as drug therapy in controlling nosebleeds. Apart from addressing the underlying condition or factor that causes epistaxis, using saline nasal spray traditionally becomes a practical part of medical management to prevent recurrence of nosebleed. Saline nasal spray becomes handy in humidifying the nasal environment and in moisturizing the nasal mucosa thus preventing future episodes of bleeding.

The 2020 Clinical Practice Guidelines (CPG) for Nosebleed published in the American Academy of Otolaryngology- Head and Neck Surgery authored by Dr. David Tunkel and his team outlined some supportive measures such as nasal saline spray in keeping the nose humid to prevent dry crusts and to facilitate healing.

The authors underscored that nasal saline spray or gel which can help moisturize the tissues inside the nose can reduce or prevent nosebleeds together with the elimination of contributing factors such as digital trauma (nose picking), vigorous nose blowing and proper nasal hygiene.

To prevent additional nosebleeds in patients taking anticoagulants or antiplatelet drugs, who are at increased risk of recurrent epistaxis, the CPG recommended saline lubrication as well as control of comorbidities.

The result of a North American study which was published online in the Journal of American Medical Association (JAMA) in 2016, demonstrated that salt-based spray is as effective as medicated spray in controlling nosebleeds among patients with Hereditary Hemorrhagic Telangiectasia (HHT), also known as Osler-Weber-Rendu Disease). In Hereditary Hemorrhagic telangiectasia, a condition characterized by abnormal blood vessel formation, patients suffer from frequent episodes of nosebleeds that may occur once a week or several times a day in some patients.

This double-blind, placebo-controlled randomized clinical trial which included 121 patients afflicted with HHT used either a saline spray or sprayed one of three drugs, bevacizumab, a drug for cancer and macular degeneration, a hormone, Estriol and tranexamic acid, a drug that promotes clotting.

The US-based study lead by Dr. Kevin Whitehead, an Associate professor of Cardiovascular Medicine at the University of Utah School of Medicine, said in the news release that none of the drugs proved any better than the saline spray at preventing nosebleed. No drug treatment was significantly different from placebo for epistaxis duration. Participants in the US-based study who are afflicted with HHT revealed that they had significant improvement in Epistaxis Severity Score even if they were solely using the saline spray.

Resources:

1. Clinical Practice Guideline: Nosebleed (Epistaxis)

2. Effect of Topical Intranasal Therapy on Epistaxis Frequency in Patients With Hereditary Hemorrhagic Telangiectasia

FAQs on ALLERGIC RHINITIS

Allergic rhinitis is a common medical problem with bothersome symptoms that can significantly interfere with daily activities and affect performance at work or school. Here are some basic facts that can help in dealing better with allergic rhinitis and its impact on daily life.

     1. WHAT IS ALLERGIC RHINITIS?

Allergic rhinitis is an inflammatory condition of the nasal passages that develops in response to outdoor or indoor allergens, such as pollen, dust mites, or tiny flecks of skin and saliva shed by cats, dogs, and other animals with fur or feathers (dander) causing cold-like signs and symptoms, such as runny nose, congestion, sneezing, and pressure on the sinuses. It may also affect the throat and the eyes.

     2. IS ALLERGIC RHINITIS THE SAME AS THE COMMON COLD?

No. While allergic rhinitis may present with symptoms similar to the common cold, allergic rhinitis is not caused by a virus unlike the common cold.

     3. WHAT ARE THE CAUSES OF ALLERGIC RHINITIS?

Allergic rhinitis can be seasonal and may occur when certain plants come into bloom and release their pollen into the air.

Allergic rhinitis may also be triggered by dust mites, spores from fungi, mold, animal dander, or other indoor allergens and symptoms may occur all year round.

When there is allergy, the immune system produces antibodies to an allergen or substance. The next time the individual encounters the substance, the antibodies signal the release of chemicals such as histamine which causes the signs and symptoms of allergy.

Some factors may trigger or worsen allergic rhinitis, such as chemicals, pollutants, cigarette smoke, perfume and cold temperatures.

     4. WHAT ARE THE SIGNS AND SYMPTOMS OF ALLERGIC RHINITIS?

Signs and symptoms may include an itchy, stuffy, runny nose, and sneezing. Allergic rhinitis may also affect the eyes and throat causing red, itchy or watery eyes, itchy or sore throat, postnasal drip and cough and sometimes it may also cause fatigue.

     5HOW IS ALLERGIC RHINITIS TREATED?

The best way to prevent allergic rhinitis is avoidance of triggers. However, once symptoms develop, treatment is directed towards the control of the allergic response with the use of antihistamines, steroids, and supportive therapies such as nasal saline wash or irrigation.

     6. CAN PATIENTS WITH ALLERGIC RHINITIS BENEFIT FROM SALINE NASAL WASH?

Cleaning the inside of the nose with saline wash is a highly recognized measure widely prescribed by doctors worldwide. Nasal saline wash has been shown to relieve symptoms of allergic rhinitis and to improve the quality of life. As part of regular hygiene, nasal washing can also help in keeping the nasal passages clean and in preventing illness by flushing away irritants that cause allergy such as pollens, dirt, dust, and infectious agents like bacteria and viruses that may sometimes complicate allergy.

Nasal washing is commonly done either with a saline spray or large volume saline irrigation, each with its own set of benefits suited for the right condition.

When nasal washing is being considered, medical experts advise nasal washing devices prepared under stringent standards of manufacturing like nasal sprays and large-volume irrigating kits which are already available over the counter in neighborhood drugstores and pharmacies. This will help avoid the risk of using contaminated solutions prepared at home and eliminate the inconvenience of mixing one’s own salt solution.

It is always best to consult a doctor for prompt and adequate management of the recurring symptoms of allergic rhinitis.

References:

Mayo Clinic. Hay fever.

Nasal irrigation as an adjunctive treatment in allergic rhinitis