Nature of nasal discharge: dense, thick, frothy, liquid, mucous, bloody

The nature of nasal discharge is considered important diagnostic information.

Periodically appearing muco-nasal secretion cannot be considered a symptom of the disease, rather mucus performs its natural function - protection, moisturizing of tissues of the nasal passages. Runny nose, which differs from natural secretions, in volume, intensity, color and consistency of secretions can be a sign of the first stage of the disease. The nature of nasal secretions is the first signals of an unhealthy state of local and general immunity.

Types of muco-nasal mucus:

• Transparent, small amounts of discharge are a variant of a normal condition without signs of respiratory pathologies.
• A runny nose with discharge colored yellow or greenish. This type of mucus signals an acute form of a viral or bacterial disease.
• Mucous secretion with a clear green tint is a sign of the onset of purulent inflammation. Most often, the process is localized in the paranasal sinuses (sinus paranasales).
• A yellow runny nose is a sign of a developing purulent process; less often, it may indicate a reaction of the nasal excretory system to a certain type of antibacterial therapy.
• Mucus with blood inclusions, bleeding is a clear sign of vascular disorders and abnormal hemoglobin levels in the blood.
• A brown tint to nasal discharge may indicate a number of serious pathologies, smoking abuse, or an extremely polluted environment (dust, industrial emissions).

There are also several more typical signs when the nature of nasal discharge helps the doctor to quickly determine the etiology of the inflammatory process:

1. The liquid consistency of mucus indicates a low level of mucin content. This in turn is a clear sign of a viral or allergic disease (washing out of the virus, allergen). Also, abundant transparent mucus may indicate the first stage of a viral infection.
2. Thick muco-nasal secretion is a symptom of bacterial "invasion" when mucin production is activated to coat and remove bacterial agent molecules. In addition, thick runny nose with a decrease in the intensity of accompanying symptoms may indicate the final stage of inflammation and a quick recovery.

Purulent discharge from the nose

An acute inflammatory process accompanied by purulent discharge from the nose is called purulent rhinitis in the practice of otolaryngologists. The causes of this condition can be various diseases, but the leading one on this list is a bacterial infection.

Inflammation of bacterial etiology is divided into the following stages:

1. Phase of swelling of the nasal mucosa (dry phase). Breathing becomes difficult, itching in the nostrils appears, there may be a series of sneezing reflexes without noticeable muco-nasal discharge.
2. Bacterial phase, when the nose is literally "clogged up" and breathing is forced by inhaling and exhaling through the mouth. This is the stage of formation of mucus clots with a high mucin content.
3. Purulent nasal discharge. Phase of rejection of bacterial infection molecules. Swelling subsides, breathing becomes easier, but overall health may worsen, temperature rises, headache appears.

If you stop the inflammatory process at the first or second stage, you can significantly reduce the risk of developing sinusitis and its variety - sinusitis. The third phase, neglected and not treated in time, triggers the mechanism of inflammation in the nearby areas of the nasopharynx, pus accumulates in the sinuses. Such a condition is assessed by doctors as an acute, complicated form of bacterial inflammation.

Symptoms and signs that may accompany purulent nasal discharge:

• The runny nose does not go away within 10-14 days.
• The mucous discharge is accompanied by a severe headache, which can intensify when turning or tilting the head.
• Nasal mucus becomes thick and has a characteristic yellow color with green inclusions.
• It is very difficult for a patient to blow his nose; it requires considerable effort.
• The discharge has a specific unpleasant odor.

The following bacterial agents most often provoke purulent mucus:

• Staphylococcus.
• Mollicutes.
• Streptococcus (Streptococcus pneumoniae, Streptococcus pyogenes, Staphylococcus aureus).
• Haemophilus influenzae.
• Moraxella catarrhalis.
• Pseudomonas aeruginosa.
• Proteus mirabilis.
• Klebsiella pneumoniae.

In addition to bacteria, purulent discharge can be caused by viruses:

• Rhinovirus.
• Coronaviridae.
• Influenza viruses (flu).
• Parainfluenza (parainfluenza).
• Adenoviridae.
• Enterovirus.
• Human orthopneumovirus (HRSV).

Almost all of the listed pathogens are classified as opportunistic, so active immune defense is the main barrier to viruses and bacteria. By taking care of immunity, a person reduces the risk of attack by harmful agents by at least half, and also speeds up the recovery process without any negative complications.

Clear nasal discharge

Allergies are almost always accompanied by nasal discharge. Runny nose of allergic etiology is specific, it is detected quickly, as it has characteristic signs. Transparent nasal discharge in allergy sufferers can be as follows:

• Atypical lacrimation combined with eye irritation.
• Rhinorrhea, when the runny nose does not stop even after taking vasoconstrictor nasal medications.
• A feeling of itching, burning, and dryness in the nasal cavity.
• Difficulty breathing due to swelling of the mucous membrane of the nasopharynx.
• Cough, series of reflexive sneezing.

Allergic rhinitis is easily differentiated by the accompanying signs of autoaggression of the immune system. Much more dangerous is another type of persistent runny nose, in which transparent nasal discharge is a signal of the leakage of liquor cerebrospinalis (cerebrospinal fluid). Liquorrhea most often manifests itself as a symptom of severe craniocerebral trauma, and may also indicate a hidden violation of the integrity of the dura mater (dura mater) or damage to the spine. Liquor fluid should normally constantly circulate between the bone system of the spinal column and the spinal cord and in the cavities of the brain. A crack, fracture, complex injury, complications after surgery (neurosurgery) can provoke the leakage of liquor cerebrospinalis, including through the nose.

Symptoms of liquorrhea:

• Clear nasal discharge has an oily consistency.
• Unlike a standard runny nose, liquorrhea is characterized by discharge from only one nasal passage, which is especially noticeable if the head is tilted forward.
• Nasal discharge may be accompanied by cerebrospinal fluid leakage from the ears (head tilts).
• In case of TBI, blood clots are clearly visible in the cerebrospinal fluid secreted from the nose.
• Clear discharge is accompanied by a decrease in blood pressure and headache
• Liquorrhea may be combined with a cough if cerebrospinal fluid flows into the nasopharynx.

Signs of overt liquorrhea are simultaneous discharge from the nose and ears. The latent (nasal) form manifests itself only by nasal discharge and is often diagnosed at a late stage. Liquorrhea is detected based on anamnestic data, complaints, neurological examination, and tests. The so-called "handkerchief test" is important, when the discharge is collected on a cloth. Cerebrospinal fluid, when drying, leaves the handkerchief soft, unlike mucous rhinitis. Also, liquor discharge can be distinguished from ordinary rhinitis by specific oily streaks. Treatment of transparent nasal discharge of this etiology is prescribed after a comprehensive and comprehensive examination. Diagnostics should be comprehensive with computed tomography to exclude serious organic pathologies.

Mucous discharge from the nose

A runny nose as a physiological norm is not a disease if mucous discharge from the nose is produced in sufficient quantity and does not reduce the quality of life of a person. The purpose of normal mucous discharge is moisturizing and absorption of harmful substances, therefore, a certain amount of mucus is almost always present in the nasal passages.

As soon as viruses or bacterial agents enter the nasopharynx, the body begins to actively produce muconasal secretions. The secretions are thicker and more viscous, there is more of them in volume, they flow out more often than usual when performing standard functions. Mucous discharge from the nose can be considered a sign of illness if the following symptoms are observed:

• A runny nose is accompanied by a fever and headache.
• The mucous secretion has an unpleasant odor.
• The discharge is an atypical color - greenish, yellow, dark brown.
• Bloody inclusions are visible in the mucus.
• A persistent runny nose exhausts a person, as it prevents him from breathing normally during the day and especially at night.
• Turning and tilting the head provokes severe headaches.
• Muconasal discharge is accompanied by congestion and pain in the ears.
• The runny nose does not stop after instilling vasoconstrictor medications into the nasal passages.

Any change in the consistency, color, or frequency of mucus discharge should be a reason for more careful monitoring of symptoms. If nasal mucus reduces productivity, interferes with normal breathing, and is accompanied by discomfort, it is necessary to undergo examinations and begin treating the underlying disease that causes the runny nose.

Bloody discharge from the nose. Bloody discharge from the nose.

A runny nose, in which bloody inclusions are clearly visible in the mucus, should not always be considered a sign of a serious illness. It should be distinguished from real bleeding, which has its own characteristic "markers" and causes.

Nasal bleeding, causes:

1. Local factors:
   • extensive and minor injuries to the nose;
   • operations;
   • NGZ - nasogastric tube, diagnostic procedure;
   • NTI - nasotracheal intubation;
   • puncture of the maxillary sinuses;
   • nasal sinus irrigation with a catheter;
   • sinusitis (hemorrhagic form of sinusitis);
   • adenoids;
   • atrophic rhinitis (pathological curvature of the septum);
   • angioma, granuloma – oncological processes in the nasal cavity.
2. Common etiological factors:
   • hypertension;
   • atherosclerosis of blood vessels;
   • avitaminosis;
   • anemia;
   • condition after solar overheating or hyperthermia (high temperature);
   • hemorrhagic diathesis;
   • changes in barometric pressure, sudden decompression;
   • disruption of the hormonal system (age-related and pathological).

This is a list that differentiates simple, capillary bloody nasal discharge from true nosebleeds, which involve larger vessels.

The pathogenesis of the appearance of blood clots in mucus is quite simple. The mucous tissue is abundantly equipped with capillaries, which are vulnerable and susceptible to any, even minor, external and internal influence.

What can damage blood vessels and cause bloody discharge from the nose?

• Minor injuries, the habit of actively cleaning the nose with foreign objects (sticks, tampons, napkins) without being careful.
• Dryness of the surrounding air, low humidity (dry mucous membrane of the nostrils).
• Excessive use of vasoconstrictor nasal agents, which also dry out the mucous tissue.
• An innate property is the fragility of the walls of blood vessels and capillaries.
• Childhood. The mucous membrane of the nose of children is very sensitive, any nasal procedure can damage fragile vessels.
• Avitaminosis (lack of vitamins C, A, group B, rutin).
• Condition after a viral disease (thinning of capillary walls).
• Sinusitis.

If blood continues to appear in the mucus for several hours, profuse nasal discharge begins, bleeding becomes massive, dizziness, tinnitus and deterioration of general health are observed, you should consult a doctor or call emergency medical care.

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Thick nasal discharge

Viscous, thick mucus is a clear sign that the mucin level in the muconasal secretion has increased. Therefore, there is every reason to assume the presence of a bacterial infection in some area of the respiratory tract, including the ENT organs. Thick nasal discharge is rarely abundant, more often its volume is insignificant and it tends to accumulate in the nasopharynx. The mechanism of change in the consistency of discharge is as follows:

· The onset of a disease of viral or bacterial etiology is accompanied by a profuse runny nose, transparent, liquid mucus. It is secreted actively and in large quantities. This is how the body tries to "wash out" harmful infectious agents.

• Thick nasal discharge is a sign of the end of the inflammatory process in the nasal mucosa. Usually, such thickening is observed 2-3 days before recovery.

What can cause thick nasal discharge?

• Bacterial infection.
• Dryness of the nasopharyngeal mucosa.
• Inflammatory process in the lungs, bronchitis, pneumonia.
• General hypothermia of the body.

An experienced therapist can quickly differentiate the etiology of respiratory inflammation:

1. Viruses cause a runny nose with a liquid consistency, transparent, water-like mucus.
2. Thick nasal discharge is a compensatory function when the body tries to stop bacterial invasion by enriching mucus with a specific protein - mucin.

A clinical marker for accurate diagnosis is not only the consistency of nasal discharge, but also its color. For example, thick muco-nasal secretion, colored yellow or green, indicates a possible spread of infection to the bronchotracheal system, to the lungs.

If viscous, thickened discharge becomes white, brownish, yellow-green in color or is accompanied by persistent bleeding, has an unpleasant odor, you should immediately consult your physician or ENT doctor.

Nasal discharge with odor

A specific runny nose accompanied by an unpleasant odor is called ozena. Nasal discharge with an odor is a clear sign of an advanced atrophic process in the nasopharynx. This disease has characteristic signs that are visible and felt without special diagnostic examinations:

• Obvious atrophic changes in the nasal mucosa.
• Thick, scanty nasal discharge.
• The mucus has the property of drying out and forming crusts that have a foul odor.
• The crusts are greenish in color, often mixed with blood and pus. They come off easily and grow back again.
• Chronic atrophy leads to noticeable thinning of the lateral, lower and upper walls of the nose - osteomalacia, bone resorption. Due to pathological atrophy, the nose gradually widens.
• Respiratory function is impaired, leading to respiratory failure.
• A person gradually loses the ability to smell; the sense of smell is lost (hyposmia, anosmia).
• The general condition of the patient significantly worsens, as does his quality of life; social and family problems arise due to the foul odor emitted.

This form of rhinitis atrophica - atrophic rhinitis was encountered in ancient times. There are records of Hippocrates, Galen, Egyptian doctors, recording a fairly large number of diseases of "spoiled juice flowing from the head". Despite such an ancient "age", ozena as a nosology has been little studied and its etiology is still considered unspecified. There are several versions confirmed by objective scientific research, statistics:

• Ozena is caused by violation of sanitary and household standards and poor nutrition, malnutrition.
• Pathological atrophy of the nasal mucosa and foul-smelling discharge are a consequence of chronic anemia.
• Ozena has a genetic etiology. The disease is transmitted through generations.
• Nasal discharge with a smell is caused by enterobacteria (klebsiella ozaenae)
• Ozena most often affects female patients.
• The stench is explained by a chronic dystrophic process, protein destruction. Atrophy of the mucous membrane of the nasal cavity, metaplasia of the epithelial tissue leads to the production of hydrogen sulfide, 3-methylindole, indole, which have a characteristic odor of feces.

Treatment of ozena consists of deodorization and maximum elimination of symptoms.

Runny watery discharge from the nose

Transparent, water-like mucus is called rhinorrhea. Liquid discharge from the nose is the main symptom of upper respiratory tract disease, infectious infection. Activation of mucus production is associated with parasympathetic innervation of the nasal cavity. Elimination (removal) of harmful agents, washing out the irritating factor occurs due to the increased work of enterocytus caliciformis - goblet enterocytes and glandulae nasi - mucous glands. The discharge of water from the nose can be provoked by the following reasons:

• Allergic reaction (allergic rhinorrhea, allergic rhinoconjunctivitis).
• Hyperactivity of the glandulae nasi function due to a disorder of the autonomic nervous system.
• TBI - traumatic brain injury.
• Congenital displacement of the nasal septum.
• Foreign bodies entering the nasal passages.
• Diseases of viral etiology in the acute phase (catarrhal stage).
• Nasal liquorrhea, which has its own specific provoking factors.
• Initial stage of sinusitis, catarrhal sinusitis with serous discharge.
• Frontitis.
• Vasomotor rhinitis.

Runny nose, especially of an allergic nature, is often accompanied by increased lacrimation, sneezing, and shortness of breath due to the expanding swelling of the mucous tissue of the nasopharynx. It is important to stop the inflammatory process in time at the first stage, a clear marker of which is runny nose. Prolonged swelling of the mucous membrane not only disrupts the drainage function of the nose (paranasal sinuses), but in a matter of days can also become a favorable "base" for the development of a bacterial infection.

Serous nasal discharge

Acute rhinitis is conventionally divided into several forms, which in turn are directly caused by etiological factors and general characteristics of the inflammatory process. Serous nasal discharge or serous rhinitis has specific signs caused by the characteristics of the fluid. Inflammation accompanied by serosa - serous discharge, is a serum exudate containing protein fractions. Such fluid is normally produced to moisturize internal cavities, in the pathological process it more actively seeps through the capillaries, flowing out in large volumes. A sign of developing respiratory inflammation is serous nasal discharge. Rhinitis occurs in different forms, but one way or another, the acute form goes through three main stages:

1. Dry period, when nasal congestion and drying of the mucous membrane are observed.
2. Wet stage, accompanied by active secretion of serous mucus.
3. The purulent period, when mucus contains bacterial decay products.

Rhinitis acuta – an acute inflammatory process in stage II is characterized by the following symptoms:

• Activation of the inflammatory process and, as a consequence, nasal congestion.
• Serous transudate is secreted in large volumes.
• The serous secretions may contain NaCl and ammonia, which irritate the mucous tissue of the nose.
• As inflammation increases, the activity of enterocytus caliciformis (enterocytes) is activated, and nasal secretions acquire a mucous-serous consistency.
• Serous rhinitis is accompanied by lacrimation and inflammation of the conjunctiva of the eyes.
• A patient suffering from acute rhinitis may also develop otitis.

The serous discharge stage lasts for several days, during this period it is possible to stop the inflammation and prevent its development. The standard period, during which the runny nose gradually subsides, lasts no more than 10 days. If at the end of this period the symptoms persist and are accompanied by persistent headache, fever, you should consult an otolaryngologist, therapist to exclude sinusitis or sinusitis or to receive adequate treatment for the identified

Foamy nasal discharge

The norm is considered to be a transparent consistency of mucus, foamy discharge from the nose is a sign of the activity of a specific component - mucin. Mucoproteins are responsible for maintaining the level of moisture in the mucous tissues, and also provide protection of the cavity from pathogenic elements, capturing them and preventing hemagglutination - gluing of erythrocytes affected by the virus. An increase in the amount of mucin, increased viscosity of nasal secretion - a direct indication of the development of an inflammatory process in the nasal cavity.

The main clinical signs that determine the stages of nasopharyngeal infection:

• The secretion of clear mucus in large volumes is the initial phase of a runny nose.
• Foamy nasal discharge is the peak of inflammation development, especially if the mucus becomes thick and white.

In addition to a viral or bacterial infection, the viscosity and foaminess of mucus can be caused by the following reasons:

• Increased dryness of air indoors or outdoors.
• Abuse of nasal medications that constrict capillaries and dry out the nasal mucosa.
• Adenoids
• Nasal polyps (ethmoidal polyps).
• Fungal infection of the nasal passages in the initial stage.
• Sinusitis.

The following symptoms may accompany foamy discharge:

• Poor sleep due to difficulty breathing, snoring.
• Ear pain, otitis.
• Headache.
• Swelling of the nose, puffiness of the face.
• Cough in the morning - with adenoiditis.
• Loss of appetite, weight loss.

At the first suspicion of an inflammatory process, the appearance of white, foamy discharge from the nose, you should seek advice on treatment from a doctor. Self-medication without determining the nature of the disease is unacceptable.

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Curdy nasal discharge

The nasal cavity is a pathway for various infectious agents to enter the nasopharynx and respiratory system. ENT organs are most often exposed to viruses and bacteria, but are also vulnerable to mycoorganisms - fungal infections. Curdy nasal discharge is one of the symptoms of otomycosis, pharyngomycosis and other diseases from the mycosis category.

The main factors that cause the appearance of fungus in the nasal cavity:

• Decreased activity of the immune system.
• Avitaminosis.
• Chronic stress.
• Long-term course of hormonal therapy.
• A course of antibiotic treatment.
• Failure to comply with personal hygiene rules.
• Chronic diseases of internal organs.
• Metabolic disorders of various etiologies.
• Endocrine pathologies (diabetes mellitus).
• Nasal trauma.
• HIV, immunodeficiency pathologies.
• Tuberculosis.
• Dental intervention and infection of the nasal cavity.
• Dental caries of the upper jaw.

Curdy nasal discharge as a sign of fungal rhinitis may indicate the following diseases:

1. Mucorosis – mucormycosis, a disease of the respiratory organs, fraught with destruction of bone tissue of the paranasal sinuses. Most often it is a consequence of diabetes mellitus.
2. Nasal candidiasis accounts for 90% of cases of fungal infections of the nasal cavity.
3. Darling's disease ( histoplasmosis ), blastomycosis - diseases typical for countries of Asia, Africa, South America. Rarely diagnosed in European countries.

Clinical manifestations of fungal infection of the nose are:

• Itching, irritation of the nasal cavity.
• Sneezing reflex in series.
• Persistent headache.
• Chronic nasal congestion.
• Periodic bleeding of the nasal mucosa.
• A sensation of a foreign body in the nasal passages.
• Curdy nasal discharge of various shades and consistencies.
• A characteristic unpleasant odor from the nose.

Curdy, thick consistency of mucus is most often observed in candidal lesions of the nose; Treatment of mycoses of the ENT organs is always long-term and complex, including not only antimycotics, but also vitamins, microelements, and a special diet. After completion of therapy, a preventive examination is recommended, an examination within one year to avoid relapses and strict observance of personal hygiene.

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Thick nasal discharge

The function of the nasal mucosa is to protect and moisturize the nasopharynx by constantly producing secretions. Nasal secretions contain a specific protein called mucin. The higher its concentration, the thicker the mucus. Thick nasal discharge is a clear sign of mucin activity, which in turn indicates developing inflammation of the mucous tissue of the nasal cavity. What causes thick nasal discharge?

• Mucin performs a passive protective, buffering function – it lubricates, adsorbs, and dissolves any microparticles that are pathogenic to the mucous membrane.
• Mucins have their own specific gel-like consistency.
• The mucociliary system is a barrier to infectious agents and allergens.
• The higher the risk of infection, the greater the production of mucin and the viscosity and density of the secreted mucus.

Thick, dense mucus from the nose can be a sign of the following diseases:

• Viral infection in the acute stage.
• Bacterial inflammation of the nasal mucosa.
• Allergy to dust micro-substances, fluff, feathers.
• Advanced, undiagnosed disease of the bronchopulmonary system.
• Sinusitis of bacterial etiology and its types – maxillary sinusitis, frontal sinusitis, sphenoiditis.

A patient with thick nasal discharge should seek medical help if the symptoms do not disappear within 5-7 days and tend to worsen. It is also necessary to be attentive to the accompanying manifestations of the disease - headache, changes in body temperature, shortness of breath, dizziness, signs of general intoxication of the body.

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