RESPIRATORY DISORDERS – Sneezing – Bad fortune?
Sneezing is a very common complaint that everyone often faces. Sneeze is a natural reflux expulsive defence mechanism of the body, like cough, for clearing irritants or toxins or foreign substances from the nose. It is an involuntary, sudden, violent, audible expulsion of air through the nose and mouth. During sneezing, secretions of the nose are being expelled as droplets (more than 6,000) up to 10 feet. It spreads infection through out the area of droplets sprayed as it contains bacteria and leucocytes. It is not contagious if it is not caused by bacteria or viruses.
Most of the time, sneezing is caused by an allergic reaction. Allergy symptoms are the result of too much immunity or hypersensitiveness. Our immune system protects us by producing antibodies that fight against bacteria and disease. Immunoglobulin (IgE) antibody is responsible for this antibody reaction. In allergic patients, these antibodies will be found in high titre for fighting against disease. It induces the secretion of histamine which triggers the feeling of itch and sneezing. It also increases the blood circulation to the nose and increases the secretions as running nose, for natural washing of bacteria or foreign substances. Sometimes the reaction is immediate and sometimes late. Some people will have allergic tendency to one substance, but many people often have an allergic response to more than one substance.
Occurrence and incidence – Incidence is more in people having inflammation associated with asthma or dermatitis. It occurs irrespective of age, race, sex, and attacks everyone.
Mechanism of sneezing – Normally, sneezing is an involuntary reflex, which is controlled by a complex interaction of nerve fibres. A variety of receptor sites, situated in the nose, reports about the irritation or foreign substance to the brain for inducing sneezing by releasing histamine, for clearing the nose. Receptors are sensitive to infection, touch, smells of dust, chemical gases, fumes, temperature and exposure to extreme cold air and water (the main offender). Usually, sneeze begins with a deep inspiration and closed glottis, which suddenly opens after gaining pressure from contraction of the diaphragm, abdomen muscles and other muscles which compress the lungs to let out the trapped air with force through nose and mouth. So with an explosive sound, throw of air occurs as a sneeze. Sneezing also involves contraction of the muscles of face, neck and eyes. Sometimes, sneezing air speed is measured more than 120 km/per hour. Normally, people sneeze once or twice during early morning or daytime to clear the nose.
Types of sneezing – sneezing can be classified as:
Paroxysmal sneezing -This type of sneezing is mostly acute in nature and often caused by bacterial or viral or fungal infection. This occurs during the start of the disease.
Continuous or allergic sneezing – Mostly these types are chronic in nature and caused by allergic tendencies of the body. It occurs due to constant exposure to dust, pets, etc.
Seasonal sneezing – Mostly in seasons, when pollens are more in wind. Seasonal allergic rhinitis usually results due to pollens of tree, grass or weed.
Perennial sneezing – Persists throughout the year, due to persistent pollution or allergen.
Causes of sneezing
A) InfectionIn the majority of cases, causative factors are due to bacteria, virus (common cold or influenza), and fungus (aspergillus’s infection). Children are easily affected while playing with infected children or infected objects.
B) External factors
- Mechanically plucking hair in the nose will cause sneezing
- Irritants – smoke, strong smells, pollution, pollens, pesticides, insecticides, wood dust, cotton dust, and other dusts, etc.
- Environment – Cold weather, rain water, smell of sand, especially during rain, dampness & temperature variations
- Contact with animals products – dander and mites of cats, dogs, furry animals and birds
- Household items – carpets, pillows, mattresses, furred and stuffed toys
- Foods can also cause sneezing immediately due to preservatives and food colours. Chillies, cucumber, watermelon and non-vegetarian foods such as fish, meat, and egg can also induce sneezing. This is often noticed in children.
- Herbs – plants, grass, trees, pollens. Pollen-allergic sneeze usually occur in spring and at the end of summer. Here weather plays the major role.
- Drugs can also cause allergic sneezing when the patients are hypersensitive
C) Internal factors – form from the progress of diseases.
- Nasal – deviated nasal septum, nasal polyp and sinusitis
- Ear- Otitis media, CSOM, impacted cerumen
D) Familial – In the tendency of allergic dermatitis or asthma, sneezing is found to run in families.
Even though these are all the triggers of sneezing and allergy, the ultimate reason or exact cause is obscure, since bacteria or dust are normally well tolerated.
Symptoms of sneezing Sneezing, itself a symptom – usually associated with watery and itching nose, burning or sensitive eyes to light, nose block, nasal speech, loss of smell, sore throat, hoarseness breathlessness, dizziness, ringing in ears, hardness in hearing, sleepy but disturbed sleep, restlessness, bursting type of headache especially over frontal with eye pain, general body aches, lack of concentration, nausea, vomiting and poor appetite.
Effects of sneezing Generally, excessive sneezing spreads infection. It causes fatigue, drowsiness, sleepy, red eyes, leading to disturbance in sleep, nuisance and lack of concentration at work. It usually aggravates the condition of tonsillitis, sinusitis, asthma, and CSOM – otitis media. Pressure in abdomen increases during sneezing – so, if it occurs continuously and violently, hernia may occur in diaphragm or muscle of abdomen (umbilical hernia, incision hernia, etc.) or into scrotal sac.
Snuffing habit (drawing the nose up with hand and inhaling air or phlegm into the nose) often develop, while watery nose occurs which leads to sinusitis and headache. Also some people develop the habit of snuffing tobacco. These snuffers usually inhale tobacco through the nose and this induces sneezing initially to clear the nose. Later on, the places which comes in contact with the snuff material will become numb and will not send any impulse to the brain, so they feel comfortable without any irritation in the nose or sneezing. This may also induce the habit of nose picking.
Diagnosis – Sneezing due to pollen allergies usually occurs in spring or in the end of summer. Occurrence of the sneeze after any activities or foods or any exposures should be correlated. Clinical examination of nose, throat and ear for any infection or foreign substance or deformity is a must. If sneezing persists, the following tests are necessary.
- X-rays – Para nasal sinuses – to rule out sinusitis
- Microscopic examination of nasal discharge – can reveal bacteria and eosinophils
- CT or MRI examination and rhinoscopy for diagnosing and evaluating of the sinuses, adenoids and also structural abnormalities
- Nasal smear – for the presence of eosinophils
- Blood tests- for total serum IgE & eosinophils count
- Allergy skin testing
- Dust or wear mask for protection
- Working in areas of noxious fumes or polluted air
- Cold things and cold winds
- Avoid pets and pollens
- Exercising or working in pollens-rich places and timings (in early morning)
- Contact with infected persons
- Drugs which cause allergy
- Smoking and smokes
- Rest in closed and warm room
- Nutritious diet for healthy life
- Plenty of fluids – water, juices to disperse mucous as less viscous for expulsion
- Air filters often
- Damp places to reduce molds and dust mites
- Bedspreads, pillows, blankets, mattress, rugs, every week
- Carpets frequently with vacuum cleaner
- Houses with vacuum cleaner rather than sweeping or dusting
Treatment must start with diagnosing the cause and its elimination. For patients with underlying diseases, treatment should be based first on it. In Allopathy, For an acute infection – Antibiotics, anti-inflammatory, anti-viral drugs are used. For nasal irritation – Nasal drops of anti-inflammatory and anti-histamine drugs are used. For irritation of eyes – Anti-inflammatory eye drops are used.
Anti-histamine drugs are commonly used in Allopathy. It arrests the release of histamine secretion for providing relief like Cetrizine, Avil, etc. As adverse reaction, these drugs can cause drowsiness, dizziness, sleeplessness and tremors
Nasal decongestants can give very temporary relief from nasal congestion. These decongestants should not be used continuously since rebound of complaints will occur with much intensity in due course
Steroids therapy – Steroidal injections and nasal spray will help much in reducing inflammation and watery nose and sneezing, by suppressing our reaction force to bacteria or disease force. But in due course, blood pressure, diabetes and renal damage may result as complications
Desensitisation or immune therapy – This will take months together and regular follow-up with physician should be there. Here, allergic substances are injected in increasing doses to de-sensitise the allergic reaction of the body. Sometimes it may cause severe allergic responses
In Homeopathy, we treat patients (symptoms of the patients) and not the disease. Sneeze is a symptom. It comes to expel the irritant substance from the nose. If you are switching it off with heavy doses of anti-histamines or steroids, then you are violating natural protection and elimination. Hence, there will be chances of constant infection which resemble continuous or repeated attack of the cold and sneezing. These patients can be cured permanently with Homeopathy. Patients and doctors need patience in treating sneeze.
Since ultimate cause is obscure and remains as an unknown science, we should aim in strengthening our protection force. Homeopathy raises immunity and prevents further recurrences. Some people are allergic to foods, medicines, smells, irritants, dusts, A/C room, cold winds, etc. And some may get aggravated at night or morning, during change of temperature, humidity, altitude, smoking, fumes and irritants, i.e. allergic reaction differs from person to person, so Homeopathy works well since it concentrates more on the patient’s individuality.
An elevated level of total blood eosinophil count and serum-Immunoglobulin IgE, in the blood are effects of the allergic reactions and they are not the cause for sneezing. People think that eosinophilia as the ultimate cause of sneezing, but it is not so. Also, most of the allergic reactions are like false alarm, i.e. they are due to our hypersensitiveness and not due to disease force.
Some common medicines often used in complaints of sneezing are Aconite, Allium cepa, Ars Alb, Baryta carb, Belladonna, Calc carb, Rhus tox, Pulsatilla, Hepar sulph, Kali bich, Sabadilla, Phosphorus, Silicea, Thuja, Nux vom, Ammon Carb, Agraphis Nutans, Lemna minor, Lycopodium, etc. These Medicines should be taken under the advice and diagnosis of a qualified Homeopath.
Dr. S. Chidambaranathan, BHMS, MD (Homeo)
24 E. New Mahalipatti Road
Tel: +91-452-233-8833 | +91-984-319-1011 (Mob)
(Disclaimer - The contents of this column are for informational purpose only. The content is not intended to be a substitute for professional healthcare advice, diagnosis, or treatment. Always seek the advice of healthcare professional for any health problem or medical condition.)