Geriatric Rhinitis - Causes, Symptoms, Treatment, and Prevention

Introduction

Rhinitis is the chronic inflammation of the nasal mucosa lining or membrane. Rhinitis mainly comprises allergic, non-allergic, mixed, and atrophic rhinitis. Atrophic rhinitis is most prevalent among the older or senior population. Geriatric or atrophic rhinitis is a subtype of non-allergic rhinitis. People often ignore the condition as it is not life-threatening. However, a person experiences chronic nasal congestion or obstruction due to this condition.

What Are the Various Types of Rhinitis?

1. Allergic Rhinitis

• Seasonal: These are seasonal allergies that occur in spring and summer. Some of the common allergens include cyclic airborne plant pollens.

• Perennial: These allergies occur throughout the year due to exposure to dust mites, cigarette smoke, cockroaches, pet dander, and mold spores.

2. Non-allergic Rhinitis

• Gustatory Rhinitis - This occurs due to eating spicy and hot food.

• Drug-Induced Rhinitis - It occurs due to excess use of nasal sprays, causing rebound nasal congestion.

• Hormonal-Induced Rhinitis - Hormone-induced rhinitis, a condition caused by hormones, can include congestion and other nasal symptoms.

• Atrophic Rhinitis - It is the chronic inflammation of the nasal mucosa. It usually occurs in elderly people. This condition is also known as dry nose syndrome or senile rhinitis.

• Vasomotor Rhinitis - It occurs due to changes in temperature, cold air, humidity, alcohol intake, barometric pressure, and strong emotions.

• Infectious Rhinitis

• Occupational Rhinitis - It occurs due to some irritants or allergens at the workplace that trigger rhinitis.

What Are the Symptoms of Geriatric Rhinitis?

• Nasal congestion occurs due to irritation and inflammation of the nasal mucosa, causing breathing difficulties.

• Chronic inflammation of the nasal mucosa also causes sinus infections, which further lead to headaches and facial pain.

• Breathing difficulties and irritation are also caused by the drying and thinning of nasal crusts in the breathing passage.

• Loss of sense of smell also occurs due to chronic inflammation, thus decreasing the ability to detect odor.

• Frequent nosebleeds may also occur due to thinning and drying the nasal mucosa.

• A dripping sensation of the nasal mucosa at the back of the throat can also be experienced by geriatric patients due to excessive nasal mucosa production.

These symptoms of geriatric rhinitis should be treated promptly, as they can be troublesome and affect the person’s quality of life. Also, the condition can lead to complications in severe cases, such as nasal polyps or sinusitis.

What Are the Causes of Geriatric Rhinitis?

• Geriatric rhinitis usually occurs due to age-related changes, such as thinning or drying nasal mucosa, causing irritation and inflammation.

• The condition can also occur due to age-related hormonal changes in the body, which affect the nasal mucosa.

• Geriatric rhinitis can also occur due to exposure to certain irritants, such as cigarette smoke, pollution, and allergens.

How Is Geriatric Rhinitis Diagnosed?

The otolaryngologist diagnoses rhinitis in older people by physically examining the initial symptoms.

They may also advise the following:

• Computed tomography (CT) scan to get a detailed picture of the nasal cavity.

• Allergy tests to rule out allergies.

• The nasal inflammatory flow test measures airflow when a person breathes.

• Nasal endoscopy is also performed to rule out the presence of nasal polyps and other conditions causing rhinitis. Nasal endoscopy involves a tube with an endoscopy camera attached to view inside the nostrils.

How Is Geriatric Rhinitis Treated?

The treatment is mainly based on the type of rhinitis, but most importantly, the patient’s medical history, the potential to develop side effects, and a slower metabolism.

Treatment options include:

• Home Remedies: A person can use saline nasal gels or sprays to prevent the formation of nasal crusts and keep the nasal passage moist. They can also rinse the nasal passage with a saltwater solution. In addition, they can also use humidifiers to add moisture to the air they breathe, which keeps the nasal passage moist. However, medical assistance is needed if the condition is very severe, and a doctor should be consulted.

• Medications: Antihistamines, intranasal corticosteroids, immunotherapy, and anticholinergic sprays. These drugs can be given in the form of oral and topical medications. However, these medications often cause adverse drug reactions in patients; therefore, elderly people should be asked to consult an otolaryngologist or ENT doctor before prescribing these medications.

• Surgery: The doctor opts for this option to ensure the removal of damaged nasal tissue to improve breathing problems. An otolaryngologist should be consulted if a person has congenital or structural abnormalities, such as nasal valve collapse or nasal septum deviation. For elderly people, the doctor usually recommends sinus or nasal surgery.

Aim:

• To moisten the nasal mucosa.

• To make the nasal cavities smaller.

• Increase blood flow in the nasal cavity.

• Encourage the regeneration of the nasal tissues.

How Can Geriatric Rhinitis Be Prevented?

Prevention of geriatric rhinitis is impossible; however, certain measures can be taken to reduce the risk of development in the elderly population.

These include:

• Exposure to nasal irritants like smoke, pollution, and dust should be avoided.

• Hygiene maintenance of nasal passage, such as regular washing and cleaning with saline solution.

• Limited use of nasal sprays and decongestants.

• Using humidifiers to add moisture to the air.

• Indulging in a healthy lifestyle, such as avoiding smoking, regular exercises (breathing exercises), and healthy eating.

• Regular follow-ups with the doctor are needed to help diagnose any underlying nasal condition and get timely treatment.

What Are the Complications Associated With Geriatric Rhinitis?

• Anosmia - Loss of sense of smell.

• Empty Nose Syndrome - It occurs when the turbinates of the nose that humidify and cleanse the air passing through the nasal cavity are cut off during any invasive surgical procedure. It makes a person feel short of breath due to nasal blockage.

Conclusion

Geriatric rhinitis is a chronic inflammation of the nasal lining that mainly affects geriatric people over the age of 60. The person usually complains about the constant need to clear the throat, nasal crusting, nasal obstruction, and a decreased sense of smell. The condition cannot be prevented, but taking preventive measures and managing the symptoms can help improve a person’s quality of life. Therefore, if a person experiences any symptoms of geriatric rhinitis, they must consult the doctor immediately.