Imagine living without being able to smell.
No more scents of aromatic coffee, fragrant flowers, stinky tofus or potent farts. Without the sense of smell, our ability to taste is also affected and food tastes different.
If you don’t have the capacity to detect odours, you wouldn’t smell a gas leak, smoke, or sour milk – in essence, you have nothing to protect you from dangerous stimuli.
This condition is known as anosmia, or a complete loss of the sense of smell. Fortunately, for most people, anosmia is a temporary nuisance caused by a severely stuffy nose from a cold or an allergy.
However, more people suffer from hyposmia, which is the partial loss of the ability to perceive smells.
If you have allergic rhinitis, a chronic nasal inflammatory state characterised by sneezing spells, a runny or blocked nose and itching of the nose, eyes and throat; or sinusitis, which refers to an inflammation of the sinus mucosa, then you may have experienced hyposmia at some point.
“Sinusitis lends additional symptoms such as headaches and facial pain to an inflamed nose. Sinusitis almost always happens as a result of inflammation starting in the nose. As both the conditions are closely related, doctors now use the term ‘rhinosinusitis’ to describe someone who has both an inflamed nose (rhinitis) and inflamed sinuses (sinusitis),” explained consultant otorhinolaryngologist, and head and neck surgeon, Dr Azida Zainal Anuar.
On a mission to increase public awareness about the olfactory function (smell organ or nose), allergic rhinitis and sinusitis, the Nuvaceutical division of Nuvanta Sdn Bhd recently hosted The Scent-sitive Nose Forum, an educational media get-together with a panel of experts.
‘Almost half of allergic rhinitis patients also suffer from asthma as the two conditions affect the same airway,’ said Dr Azida Zainal Anuar. Photos: The Star/Low Boon Tat
The team comprised Dr Azida, clinical psychologist Dr Priyadarshini Srinivasan Moharkonda and pharmacist Datin Swanee Teh.
According to Dr Azida, approximately 25-33% of the population have allergic rhinitis, and sometimes it may be difficult to distinguish the ailment as the common cold also has similar symptoms, although this tapers off over time.
“The cause of allergies can be genetic, and it may not come early in life but may be triggered much later. Similarly, non-allergic rhinitis, which doesn’t involve the immune system, can also manifest later in life due to other factors,” she said. “Uncontrollable allergic rhinitis can develop into asthma and enlarged adenoids or tonsils.”
Although most people believe that allergic rhinitis and sinusitis are caused by allergens present in the environment such as dust mites, pet dander, mould and pollen, the root cause is actually the person’s immune system, which has somehow been tuned to “hypersensitive mode”.
Every day, the mucosa of our nose and sinuses produce approximately one litre of mucous, which is moved to the back of the nose by cilia (hair-like structures that extend from the surface of the cell) and then swallowed subconsciously.
“When inflammation occurs in the nose and sinuses, the cilia stop beating and fail to transport the mucous, which then builds up in the nose and sinuses.
“At the same time, the mucosal lining swells up and blocks up the ostia (opening) of the sinuses. If an infection sets in, the mucous then changes from a colourless fluid to greenish pus in the affected sinuses,” added Dr Azida.
When the nose is blocked, the tendency is to breathe through the mouth, resulting in the blood not getting all the oxygen that is required. This then leads to a dry cough, bad breath, gum disease and mouth ulcer.
Clinial psychologist Dr Priyadarshini Srinivasan Moharkonda.(R) and pharmacist Datin Swanee Teh shedding light on the olfactory function.
There is plenty of clinical evidence that mouth-breathing has an adverse effect on the growth and development of a child’s face and jaw. Not only do children end up having a smaller jaw and longer face, they also tend to be more hyperactive.
Both allergic rhinitis and sinusitis can cause anosmia due to a blocked nose or an obstructive lesion like a polyp in the nose. In these cases, removal of the obstructive factor may lead to return of the sense of smell, but not always.
Having a chronically blocked nose can lead to sleeping disorders, snoring and sleep apnoea. Although snoring was previously thought to be no more than an irritant to sound-sleeping partners, the otorhinolaryngologist pointed out that it is now recognised as a serious health risk, especially if it involves apnoea (the cessation of breathing during sleep).
Dr Azida said, “Snoring coupled with sleepless nights can drive a deep wedge between couples as both parties find themselves tired, moody and not surprisingly lacking sexual desire and intimacy.”
As a pharmacist, Teh has seen countless customers giving the “allergic salute”, i.e. the habitual gesture of wiping and/or rubbing the nose in an upwards or transverse manner with the fingers, palm, or back of the hand. It may be off-putting but that is what sufferers have to contend with.
She said, “It’s easy to dismiss a runny nose or frequent sneezing spells as a minor nuisance. But if the public was more aware of this condition, of how it robs one’s ability to breathe and smell and function optimally, besides its role in increasing the risk of asthma, you’ll be on your way to recognising it as a legitimate medical problem and significant burden.
“Both these conditions tend to run in families, and can last for decades, and may lead to many days of missed school or work. It can also affect a person’s concentration and performance at school or at work, and how they feel about themselves.
“In fact, some countries consider it the most common chronic allergic disease in the world today.”
Psychologically, the annoying, leaky or blocked nose often translates into a sense of self-betrayal and shame. Patients with sensitive noses tend to keep to themselves.
“A blocked nose may not look like a serious condition, but patients who suffer from this have had a normal ability taken from them. A once happy child can turn grumpy and irritated; a former sociable spouse can turn into a couch potato; and a go-for-gold athlete can lose strength and the will to win,” offered Dr Priyadarshini.
It’s easy to tell a sufferer to avoid triggers and flush the nose with a salty solution after being in a polluted environment, but these may not offer a permanent solution.
The many options for treating allergic rhinitis and sinusitis can be confusing at first, but if you nose around, you’ll find a way to keep your nose unblocked and less drippy.
While conventional drugs such as antihistamines and decongestants sometimes help, they are not able to address the hypersensitive state of the immune system, which is the root cause of the problem.
Dr Azida noted that allergen immunotherapy may be the most effective long-term approach towards a cure as it gradually decreases your sensitivity and builds up your immunity to allergens.
It involves regular administration of gradually increasing doses of allergen extracts over a period of three to five years. Immunotherapy can be given to patients as an injection or as drops or tablets under the tongue. But, the long duration of treatment can be a deterrent.
For an alternative remedy, sufferers can try the natural, activated astragalus root extract, which has shown to be effective in alleviating nasal allergies.
Instead of blocking histamine, as what antihistamines do, the extract helps “calm” the immune system from acting angrily each time it encounters an allergen in the environment. Harmless allergens are then neutralised without the nose flaring up into inflammation.
Here are some quick tips to manage allergic rhinitis and avoid sinusitis:
• Minimise exposure to allergens by closing windows and running air conditioners.
• Reduce exposure to allergens such as dust mites and moulds, by covering pillows and mattresses with pillow protectors, and removing dust-collecting household items, such as carpets, heavy drapes and bedspreads.
• Although air purifiers and dust filters can be costly, they may help reduce the amount of allergens in the air.
• Saline nasal sprays and humidifiers can help clear congestion.
• Avoid strong “smell-influenced” triggers like perfumes or colognes, flowers and other powerful odours.
http://www.star2.com/health/wellness/2016/04/10/unblocking-hypersensitive-noses/