Purulent rhinitis ICD code 10. Acute rhinitis: treatment in children and adults. Features of the neurovegetative form of vasomotor rhinitis

This is the body's reaction to something that it should not react to under normal conditions. One of the symptoms of the disease is an allergic rhinitis, due to which the meeting with the allergen ends at the level of the nose and is manifested by the development of an inflammatory process of non-infectious origin. This disease is considered by medicine as a separate pathology, therefore, in ICD 10, allergic rhinitis has its own code, or rather there are several of them, depending on its type.

What is allergic rhinitis MBC 10

The causes of this pathology are not yet fully understood, but the mechanisms are known. It has been established that acute allergic rhinitis develops as an immediate hypersensitivity reaction, which means that a runny nose appears within minutes after meeting with an allergen.

An important role in the occurrence of such reactions is played by hereditary and constitutional predisposition.

Triggers for allergic rhinitis:

• flowering plants, and their pollen;
• mold in residential areas;
• particles of house dust from carpets, upholstered furniture, toys;
• traces of saliva, urine and animal hair;
• down, feathers from pillows and blankets;
• bed and dust mites;
• synthetic detergents;
• medicines and certain foods.

In response to the entry of an allergic molecule into the nasal mucosa, many inflammatory inductors are released, which increase the production of mucus in order to wash away foreign particles. This mucus is swallowed and enters the intestines along with allergens (for the immune system, these are antigens), in response, the body produces protective antibodies. A large number of antigen-antibody complexes circulate in the blood, sufficient to develop acute non-infectious rhinitis. The pathological process over time can go further to other organs, for example: bronchi, lungs, kidneys.

Classification

The International Classification of Diseases is used by healthcare professionals to systematize different diseases, with data updated every 10 years. According to the latest version, acute and chronic allergic rhinitis is singled out as an independent pathology in the J30-J39 group. The following types of nosology under consideration fall under the exact definition according to ICD 10:

• J0 Vasomotor rhinitis - is considered as an inadequate response of the vascular plexuses of the nose to various stimuli. It is associated with a violation of autonomic innervation in general neuroses or systemic diseases.
• J1 Allergic rhinitis (pollinosis, hay fever) - causes pollen of plants (ragweed, poplar fluff, lilac flowers, etc.). Its peak is in spring and late summer.
• J2 Other seasonal allergic rhinitis is an acute inflammatory process of an intermittent nature.
• J3 Other allergic rhinitis is a year-round form of persistent rhinitis that occurs under the constant influence of allergens inside the house (dust, mold, fluff, wool, etc.). This also includes occupational rhinitis associated with the inhalation of allergens in the workplace (flour, paint, drugs, etc.).
• J4 Allergic rhinitis of unspecified origin - when the diagnosis is still in question after examination and differential diagnosis with other diseases.

Each of these rhinitis can proceed as acute and chronic. Symptoms for all types of the disease are similar - sneezing, nasal congestion, profuse watery discharge, itching.

How to help

Treatment of allergic diseases will be effective only if contact with the guilty allergen is completely eliminated, otherwise medications will bring only temporary relief. Due to the lack of the possibility of its detection, in practice it is very difficult to rid the patient of this pathology. Treatment in this case is reduced to symptomatic measures necessary to alleviate the patient's condition, restore his working capacity and improve the quality of life. Preparations for internal use with antihistamine and anti-inflammatory effects, local remedies (nasal drops and sprays of a similar effect) are prescribed. In severe cases resort to the use of corticosteroid therapy.

A prerequisite for the treatment of allergic rhinitis is a change in the usual environment and the nature of nutrition as an addition to taking medication.

Housing should be as free from dust collectors as possible (carpets, upholstered furniture, open bookcases), it is advisable to purchase an air purifier and humidifier, avoid contact with pets, adhere to a strict hypoallergenic diet. With an unidentified allergen, therapy can be long and serious, bringing temporary relief.

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Vasomotor and allergic rhinitis (J30)

Includes: spasmodic coryza

Excludes: allergic rhinitis with asthma (J45.0) rhinitis NOS (J31.0)

In Russia, the International Classification of Diseases of the 10th revision (ICD-10) is adopted as a single regulatory document for accounting for morbidity, reasons for the population to apply to medical institutions of all departments, and causes of death.

ICD-10 was introduced into healthcare practice throughout the Russian Federation in 1999 by order of the Russian Ministry of Health dated May 27, 1997. №170

The publication of a new revision (ICD-11) is planned by WHO in 2017 2018.

With amendments and additions by WHO.

Processing and translation of changes © mkb-10.com

Rhinitis acute

Acute rhinitis: Brief description

Acute rhinitis: Causes

Etiology

Classification

Clinical picture

The duration of symptoms is 7-8 days, in some cases, with a good immune status, acute catarrhal rhinitis proceeds abortively for 2-3 days, with a weakened state of protective forces, it can drag on up to 3-4 weeks with a tendency to become chronic.

Acute rhinitis: Treatment methods

Treatment

Tactics of conducting

Drug therapy

In bacterial etiology - antibiotics, 20% r - r sulfacetamide (topically) Vasoconstrictors (topically), such as phenylephrine (0.25% r - r) every 3-4 hours, no more than 7 days. Prolonged (more than a week) use of vasoconstrictors can lead to the development of drug rhinitis. Simanovsky's ointment and a complex ointment (protargol - 0.4; menthol - 0.4; diphenhydramine - 0.1; vaseline oil - 4.0; vaseline - 16.0) are prescribed in the nose on a cotton ball for 15 minutes 2–3 r / day Cameton, Ingacamf Ascorbic acid 1 g / day in stages I and II of the disease To accelerate the period of convalescence - 20% splenin ointment.

Forecast

Prevention

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Acute rhinitis - description, causes, treatment.

Short description

Acute rhinitis is an acute inflammation of the nasal mucosa.

The reasons

Etiology. Bacteria (staphylococci, streptococci, gonococci, corynebacteria), viruses (influenza, parainfluenza, measles, adenoviruses).

Classification Acute catarrhal rhinitis Acute traumatic rhinitis (nose injury, burns, frostbite, other factors of physical impact) Acute allergic rhinitis (seasonal form - immediate reaction).

Stage I - dry, characterized by a feeling of dryness and tension in the nose, nasal congestion, swelling of the mucous membrane II - wet. There is a growing feeling of nasal congestion, nasal breathing is sharply difficult (often absent), abundant mucous discharge from the nose III - suppuration. Reducing the swelling of the mucous membrane, improving nasal breathing, the discharge becomes mucopurulent (at first - in large quantities, then gradually decreases). Recovery is coming.

clinical picture. The course of acute catarrhal rhinitis depends on the state of the nasal mucosa before the disease: if it is atrophied, the reactive phenomena will be less pronounced, and the acute period will be shorter. With hypertrophy of the mucous membrane, on the contrary, acute phenomena and the severity of symptoms will be much more pronounced, the course will be longer.

Features in infections Influenza rhinitis is characterized by hemorrhages, up to profuse epistaxis, rejection of the epithelium of the mucous membrane of the nasal cavity in layers. All this is so characteristic that it allows diagnosing the influenza-like nature of the common cold before obtaining the results of a serological study and serves as an indication of the need to use IFN for instillation into the nose. ; such patients become bacillus carriers and infect others. This form of rhinitis is characterized by mucosal discharge from the nose, severe dermatitis in the vestibule of the nose, lack of effect from conventional treatment. Runny nose with measles is a common occurrence in the prodromal period; it is characterized by abundant mucous discharge from the nose; anterior rhinoscopy reveals individual red spots in the region of the inferior nasal concha, which stand out against the background of a hyperemic mucous membrane. These spots are observed for a short time and only in the prodromal period. Scarlet fever is not specific and proceeds like ordinary catarrhal rhinitis. A runny nose with gonorrhea can occur in a child if it has become infected during childbirth. Therefore, a runny nose that arose during the first days of life is always suspicious of gonorrhea.

The duration of symptoms is 7-8 days, in some cases, with a good immune status, acute catarrhal rhinitis proceeds abortively within 2-3 days, with a weakened state of protective forces, it can drag on up to 3-4 weeks with a tendency to become chronic.

Diagnosis - instrumental methods for the study of ENT - organs, in particular the nasal cavity (anterior rhinoscopy).

Treatment

Tactics of conducting The mode in most cases is outpatient. With acute catarrhal rhinitis, with rhinitis accompanying infectious diseases - treatment in an infectious diseases hospital Patients with acute rhinitis should be recognized as temporarily disabled Thermal, distracting procedures, such as foot, hand, lumbar baths, mustard plasters on the calf muscles nose area.

In bacterial etiology - antibiotics, 20% r - r sulfacetamide (topically) Vasoconstrictors (topically), for example phenylephrine (0.25% r - r) every 3-4 hours, no more than 7 days. Prolonged (more than a week) use of vasoconstrictors can lead to the development of drug rhinitis. Simanovsky's ointment and a complex ointment (protargol - 0.4; menthol - 0.4; diphenhydramine - 0.1; vaseline oil - 4.0; vaseline - 16.0) are prescribed in the nose on a cotton ball for 15 minutes 2–3 r / day Cameton, Ingacamf Ascorbic acid 1 g / day in stages I and II of the disease To accelerate the period of convalescence - 20% splenin ointment.

The prognosis in adults is favorable, although transmission of infection to the paranasal sinuses and lower respiratory tract is possible, especially in individuals prone to lung disease. In infancy, acute rhinitis is always dangerous, especially for debilitated children who are prone to various pulmonary, allergic complications.

Prevention. Hardening of the body to cooling, overheating, humidity and dryness of the air. The struggle for clean air in working and residential premises, maintaining the optimum temperature and humidity in them.

ICD-10 J00 Acute nasopharyngitis [runny nose]

Allergic rhinitis according to ICD 10

Allergic rhinitis does not affect life expectancy, does not change mortality rates, but is chronic and significantly disrupts the normal functioning of a person.

Predisposing factors

The following factors contribute to the development of acute rhinitis:

• chronic fatigue;
• Constant stress at work
• sleep deprivation;
• Hypovitaminosis and constitutional features of the organism;
• Contaminated air;
• hereditary predisposition.

Prevalence

Pollinosis is a very common disease. The number of patients in Russia ranges from 18 to 38%, in the USA 40% of children suffer from it, more often boys. Children under 5 years of age rarely get sick, the rise in incidence is observed at the age of 7–10 years, the peak incidence occurs at the age of 18–24 years.

The prevalence of pollinosis over the past 10 years has increased more than five times.

Classification

Allergic rhinitis can be year-round - a persistent course, and seasonal - an intermittent course.

• Perennial rhinitis (persistent). The attack becomes chronic. A runny nose bothers at least 2 hours a day and more than 9 months a year. It is observed upon contact with household allergens (wool, saliva, dander and feathers of pets, cockroaches, mushrooms and house plants). This chronic runny nose is characterized by a mild course without disturbing sleep and performance.
• Seasonal rhinitis. An attack of a runny nose occurs after contact with an allergen for several hours during the flowering period of plants. Acute rhinitis lasts less than 4 days a week and less than 1 month a year. It proceeds in more severe forms, disrupting night sleep and human performance.
• Episodic. It rarely appears, only after contact with allergens (cat saliva, ticks, rat urine). Allergy symptoms are pronounced.
• Since 2000, another form has been distinguished - professional runny nose, which affects confectioners, livestock specialists, flour millers, pharmacists (pharmacists), employees of medical institutions and woodworking enterprises.

Severity

Allocate mild, moderate and severe course of the disease.

1. With a slight runny nose, sleep is not disturbed, normal professional and daily activities are maintained, and severe painful symptoms are not disturbed.
2. In severe and moderate rhinitis, at least one of the following symptoms is observed:
   • sleep disturbance;
   • distressing symptoms;
   • disruption of daily/professional activity;
   • a person cannot play sports.

With a progressive course of the disease for more than 3 years, bronchial asthma appears.

ICD 10

ICD 10 is a unified classification of diseases for all countries and continents, in which each disease received its own code, consisting of a letter and a number.

According to ICD 10, hay fever is a disease of the respiratory system and is part of other diseases of the upper respiratory tract. The code J30 is assigned to vasomotor, allergic and spasmodic rhinitis, but it does not apply to allergic rhinitis with asthma (J45.0)

ICD 10 classification:

• J30.0 - vasomotor rhinitis (chronic vasomotor neurovegetative rhinitis).
• J30.1 - Allergic rhinitis caused by pollen of flowering plants. Otherwise called pollinosis or hay fever.
• J30.2 - other seasonal allergic rhinitis.
• J30.3 Other allergic rhinitis, eg perennial allergic rhinitis.
• J30.4 - allergic rhinitis of unspecified etiology.

Clinic and diagnostics

Acute allergic rhinitis is manifested by periodic disruption of normal breathing through the nose, clear liquid watery discharge, itching and redness of the nose, and repeated sneezing. The basis of all symptoms is contact with the allergen, i.e. a sick person feels much better in the absence of a substance that provokes an attack of an allergic disease.

A distinctive feature of acute pollinosis from the usual infectious (cold) rhinitis is the preservation of the symptoms of the disease unchanged throughout its entire period. In the absence of an allergen, a runny nose goes away on its own without the use of drugs.

The diagnosis is established on the basis of the symptoms of the disease, history and laboratory tests. To confirm the diagnosis, skin tests and a contact examination using modern sensors are carried out. The most reliable method is recognized as a blood test for specific antibodies from the immunoglobulin E (IgE) class.

Treatment

The main point in treatment is the exclusion of allergens. Therefore, in a house where there is an allergic person, there should be no pets and items that collect dust (soft toys, carpets, fleecy bedding, old books and furniture). During the flowering period, it is better for a child to be in the city, away from fields, parks and flower beds, it is better to hang wet diapers and gauze on the windows at this time to prevent the allergen from entering the apartment.

An acute attack is relieved with antihistamines (Allergodil, Azelastine), cromones (Cromoglycate, Necromil), corticosteroids (Fluticasone, Nazarel), isotonic saline solutions (Quicks, Aquamaris), vasoconstrictors (Oxymetazoline, Xylometazoline) and antiallergic drops (Vibrocil) are successfully used . Allergen-specific immunotherapy has proven itself well.

Timely, properly performed treatment can completely stop the existing acute attack, prevent the development of a new exacerbation, complications, and the transition to a chronic process.

Prevention

First of all, preventive measures should be taken in relation to children with aggravated heredity, i.e. whose closest relatives, parents suffer from allergic diseases. The probability of morbidity in children increases to 50% if one parent has allergies, and up to 80% if both have allergies.

1. Restriction in the diet of a pregnant woman of products that are highly allergenic.
2. Elimination of occupational hazards in pregnant women.
3. To give up smoking.
4. Continue breastfeeding for at least 6 months, introduce complementary foods no earlier than five months of age.
5. With an existing allergy, it is necessary to be treated with courses of antihistamines, to avoid contact with allergens.

Allergic rhinitis, whether acute or chronic, has a negative impact on the patient's social life, study and work, and reduces his performance. Examination and treatment is far from an easy task. Therefore, only close contact between the patient and the doctor, compliance with all medical prescriptions will help to achieve success.

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Acute rhinitis - a familiar disease like a runny nose

Acute rhinitis is an inflammation of the nasal mucosa. This stage of the disease is characterized by the rate of development of symptoms and their intensity. Inflammation can be caused by a specific allergen, bacterial or viral infection entering the paranasal sinuses.

Common symptoms of rhinitis include aching and pressure in the nose, cheeks, mucus (most often clear), and fever. In more than 70% of cases, acute rhinitis is manifested against the background of a cold.

Therefore, for ordinary people without medical education, this condition is better known as a runny nose. Professional doctors in communicating with patients can also use a colloquial name, but most often they make a diagnosis according to the approved classifier of diseases. Rhinitis according to ICD 10 is encrypted under the code J00.

What subtypes of acute rhinitis can be distinguished?

In official medical sources, the classification of the disease is rarely given. Since acute rhinitis itself is only a stage. However, starting from the trigger, we can conditionally distinguish the following types of rhinitis at the acute stage:

It is provoked by a certain allergen, usually lasts for several days, but can pass without treatment, after contact with the trigger is eliminated.

It is divided into bacterial and viral. It is dangerous because the patient can be contagious to others, lasts up to two weeks.

It is provoked by a trauma of the nose, it can last until the anatomical shape of the septum is restored.

Appears under the influence of dust, smoke, irritating gas; may take several minutes/hours. Such a runny nose goes away without treatment, immediately after going out into the fresh air.

Sometimes, the term acute catarrhal rhinitis is also used. There is no mention of this type of disease in ICD-10. Moreover, the term "catarrhal" is most often used to describe the chronic form of the disease, and means inflammation of the mucous membranes.

Given that coryza itself indicates inflammation of the nasal mucosa, the use of the term "catarrhal" is redundant (but not erroneous).

What are the symptoms of acute rhinitis?

And although a runny nose in an adult lasts (in an acute form) no more than two weeks, and does not seem to be a serious problem, the absence of treatment can lead to serious consequences. You need to think about therapy immediately after the following signs of rhinitis appear:

• Nasal congestion;
• Secretion of mucus;
• sneezing;
• Feeling of pressure in the ears;
• Headache;
• Loss of smell and sense of taste.

Due to the fact that the symptoms of rhinitis in adults can interfere with daily work, the disease is the basis for issuing a sick leave (but not more than 6 days).

Of course, with a normal flow from the nose, the ENT is unlikely to go to a meeting and issue a certificate. It is worth consulting a doctor if acute rhinitis is accompanied by fever, does not disappear even after taking medication.

Methods of treatment of infectious rhinitis

Knowing the types of rhinitis and their symptoms, you can determine how to treat the disease. Since it is infectious rhinitis that is most often diagnosed (and the viral one appears much more often than the bacterial one), most pharmaceutical preparations are aimed precisely at eliminating this problem.

If washing the nose does not help get rid of a runny nose, then it is allowed to use vasoconstrictor drops (Afrin, Rinonorm).

However, the period of use of drugs of this type should not exceed 5 days. To facilitate breathing, you can smear the skin under the nose with ointments such as Asterisk, Dr. Mom Phyto.

Treatment of acute rhinitis on an outpatient basis is supplemented by ultraviolet irradiation (popularly quartzization). In order to completely get rid of an unpleasant symptom, you need only procedures.

Quartzing is usually done once a day in the morning. Under the influence of a special lamp, not only bacteria die, but also viruses, fungi, spores. In modern clinics, laser therapy can be offered. The advantage of the procedure is that it allows you to completely get rid of the common cold in 3 procedures.

The well-known doctor Komarovsky offers to treat rhinitis in children without the use of medications. The pediatrician recommends installing a humidifier in the room and regularly rinsing the baby's nose with saline.

But if rhinitis prevents the baby from eating normally, then you need to additionally use a nasal aspirator, which helps to physically remove mucus from the nose. Some pharmacy saline solutions (for example, Otrivin baby) are sold complete with a special tube.

How to deal with other types of rhinitis?

If it is not possible to contact a therapist and determine what type of disease is developing, it is recommended to monitor how long the runny nose lasts.

With a viral infection (especially if the patient regularly flushes the nose, consumes a large amount of fluid), the nasal passages are cleared in about 7 days. If a person ignored the primary treatment, and the body "fought" the viruses itself, then relief can be expected in two weeks.

If the symptomatic treatment of acute rhinitis did not help, and after two weeks the runny nose worsened, or green or dirty yellow discharge appeared from the nose, then this means that the disease is progressing. In this case, you will have to treat acute rhinitis with antibiotics.

In the event of a runny nose caused by an allergy, it is necessary to drink an antihistamine drug selected by a doctor. However, in most cases, allergic rhinitis is chronic, which means that it is possible to take preventive measures.

Occupational and traumatic rhinitis requires elimination of the trigger of the problem, but for momentary relief of breathing, you can rinse the nose with saline or saline.

How to make breathing easier when you have a cold?

To prevent the complication of rhinitis at home is quite simple. The main thing is to follow three simple rules:

Drink enough liquid.

Plain clean water will help activate drainage in the nasal passages. But drinks containing caffeine or alcohol are best avoided during a runny nose. Even 2-3 glasses of a strong liquid will provoke swelling of the nose.

You can alleviate your condition by simply inhaling steam from a pot of hot water, and if you add a few drops of essential oils there, the procedure will become many times more effective.

It is also worth monitoring the humidity in the room, dry warm air does not contribute to a speedy recovery, but rather the opposite. It is best to install a humidifier in the apartment that will maintain an ideal environment.

Treat nasal passages regularly.

You can use ready-made pharmaceutical preparations (Sialor, Aquamaris, etc.), or prepare your own nasal solution. You just need to mix a teaspoon of fine pure salt (without a slide) with a liter of purified water.

By adhering to such simple rules, you can not be afraid that a runny nose will ever develop into a chronic one.

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Acute rhinitis: types and forms of the disease, signs, treatment, prevention

Acute rhinitis is a respiratory disease that manifests itself in the form of copious discharge from the nose of various consistency and color. At the same time, there are various types of this pathology, in which various symptoms are manifested. It is an acute inflammation of the nasal mucosa.

Classification according to the ICD-10 code

The etiology of acute rhinitis is manifested in an intense form by copious discharge from the nasal passages. Sometimes the process affects only the passages themselves, and sometimes the paranasal sinuses are also involved.

As a rule, the latter is already referred to as a complicated or advanced form. ICD of acute rhinitis - J00.

Types of acute rhinitis

Acute rhinitis is divided into several types, including:

• Allergic, manifested both seasonally and year-round in the form of clear discharge, sneezing, tearing, dry throat, perspiration, and so on.
• Vasomotor also manifests itself, like allergic, but always has a time-limited manifestation, for example, during the flowering period of a plant or as a reaction to a specific stimulus - cold, dryness, and so on.
• Viral rhinitis is provoked by viruses and manifests itself like allergic. At the same time, the symptoms of a cold, flu or other acute respiratory infections often develop in parallel. There is catarrhal inflammation of the mucous membranes.
• Hypertrophic is manifested to a greater extent by growth with subsequent thickening of the mucous tissue in the nasal passages, which leads to difficulty breathing through the nose;
• Atrophic is the opposite of the previous one and leads to thinning of the mucous membranes, as well as to degeneration of bone tissues. It manifests itself in the dry type without discharge, and in the lake - with purulent discharge and a characteristic odor;
• Infectious bacterial or fungal is manifested by the release of a secret with purulent contents.

Features of acute rhinitis:

Symptoms in adults and children

Symptoms are generally the same for all ages:

• Discharge from the nose of various consistency and color;
• sneezing;
• Swelling of the mucosa;
• Nasal congestion and inability to breathe through the nose;
• Headache;
• Dry mouth.

The photo shows the symptoms of acute rhinitis

Clinical stages

The disease goes through three stages:

• Dry irritation;
• Serous discharge (clear);
• Purulent discharge (yellow-green).

Diagnostic studies

Basically, a visual examination and listening to the patient's complaints is enough for the doctor. In the case of bacterial rhinitis, mucus can be taken for bacteriological culture.

Nasal sinuses with different types of rhinitis

How to treat

It is not advisable to treat rhinitis on your own, especially when it comes to children and pregnant women, since this pathology often not only causes complications, but also becomes chronic.

Self-selection of the drug is also impossible without an examination by a doctor and a diagnosis, since the same bacterial rhinitis has similar symptoms with atrophic purulent rhinitis (ozena), and the viral one is often confused with allergic.

Nasal lavage is mandatory. Adults do this with the help of a special teapot with a long nose. In the case of children, either a special aspirator pear is used, or a small syringe no more than 2 cubes, or a pipette.

Flushing is done with various formulations depending on the type of disease, but saline or saline is most commonly used. Especially for children, there are preparations based on sea water, which take into account the dosage of the composition, as well as the method of administration in the form of special nozzles.

Principles of treatment of acute rhinitis in our video:

Principles of complex treatment

Treatment of any rhinitis is carried out in a complex manner, depending on which type is detected. Most often used:

• Antibiotics for bacterial rhinitis or ozen (the latter is incurable, but it stops well if the treatment process is properly approached);
• Antiviral drugs for viral rhinitis;
• Antihistamines of a general systemic or local type (depending on the patient's condition);
• Inhalations and nasal lavages: with bacterial types - with a solution of furacilin, with the rest - with saline or saline.

Prevention

• With allergies - timely intake of antihistamines, elimination of the allergen as far as possible;
• With vasomotor, it is important to eliminate the influence of the irritating factor;
• For viral and bacterial infections, prophylactic treatment is carried out after contact with an infected person or before the period of epidemics;
• Daily ventilation of the room;
• Air humidification;
• Timely examination and treatment of pathologies of ENT organs;
• Strengthening immunity;
• Rejection of bad habits.

Forecast

The prognosis is generally positive in almost all types of rhinitis, if therapy is carried out on time and in full, prescribed by the doctor. Hypertrophic and atrophic can not be completely cured, but you can stop and stop the progression.

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Allergic rhinitis: classification, ICD code 10

Allergic rhinitis is better known as hay fever or hay fever. This is an inflammation of the nasal mucosa, which is caused by exposure to a causally significant allergen. The disease is accompanied by profuse discharge, nasal congestion and sneezing. In accordance with the information provided in the "International Classification of Diseases (ICD 10)", there are several types of this disease.

Allergic rhinitis does not affect life expectancy, does not change mortality rates, but is chronic and significantly disrupts the normal functioning of a person.

Predisposing factors

The following factors contribute to the development of acute rhinitis:

• chronic fatigue;
• Constant stress at work
• sleep deprivation;
• Hypovitaminosis and constitutional features of the organism;
• Contaminated air;
• hereditary predisposition.

Prevalence

Pollinosis is a very common disease. The number of patients in Russia ranges from 18 to 38%, in the USA 40% of children suffer from it, more often boys. Children under 5 years of age rarely get sick, the rise in incidence is observed at the age of 7–10 years, the peak incidence occurs at the age of 18–24 years.

The prevalence of pollinosis over the past 10 years has increased more than five times.

Classification

Allergic rhinitis can be year-round - a persistent course, and seasonal - an intermittent course.

• Perennial rhinitis (persistent). The attack becomes chronic. A runny nose bothers at least 2 hours a day and more than 9 months a year. It is observed upon contact with household allergens (wool, saliva, dander and feathers of pets, cockroaches, mushrooms and house plants). This chronic runny nose is characterized by a mild course without disturbing sleep and performance.
• Seasonal rhinitis. An attack of a runny nose occurs after contact with an allergen for several hours during the flowering period of plants. Acute rhinitis lasts less than 4 days a week and less than 1 month a year. It proceeds in more severe forms, disrupting night sleep and human performance.
• Episodic. It rarely appears, only after contact with allergens (cat saliva, ticks, rat urine). Allergy symptoms are pronounced.
• Since 2000, another form has been distinguished - professional runny nose, which affects confectioners, livestock specialists, flour millers, pharmacists (pharmacists), employees of medical institutions and woodworking enterprises.

Severity

Allocate mild, moderate and severe course of the disease.

Why should a doctor prescribe the treatment of chronic vasomotor rhinitis? What are the causes of the development of the disease and its main symptoms? What prevention methods can be used?

In recent years, a significant increase in the prevalence of chronic rhinitis has been noted among diseases of the upper respiratory tract. Among the chronic forms of rhinitis, vasomotor rhinitis occupies a large place. What it is?

Chronic vasomotor rhinitis is a disease affecting the nasal mucosa due to dysregulation of general or local vascular tone.

ICD-10 code (International Classification of Diseases 10th revision) - J30.0.

According to the etiological factor, an allergic or neurovegetative form of the disease is distinguished.

The disease can be caused by physical, chemical or toxic factors. Other types of vasomotor rhinitis:

• psychogenic, in which vascular imbalance develops due to the lability of the autonomic nervous system;
• idiopathic;
• mixed.

Reasons for the development of the disease

The basis of the pathogenesis of the neurovegetative form of vasomotor rhinitis is dysfunction of the autonomic nervous system, both the autonomic nervous system of the nasal cavity, and general vegetative-vascular dystonia.

An imbalance between the sections of the autonomic nervous system in vasomotor rhinitis occurs due to an increase in the tone of one or a decrease in the tone of its other section. This pathological process can be initiated by many external and internal factors.

The consequence of an imbalance in the autonomic nervous system may be gastroesophageal or laryngopharyngeal reflux, which is also a trigger factor for the disease.

The trigger factor is often a respiratory viral infection. Non-specific causes can be: tobacco smoke, pungent odors, ozone, pollutants, alcohol intake, a sharp change in the temperature of the inhaled air.

Cold air is the main nonspecific triggering factor for the chronic form of the disease. The increased content of ozone in the inhaled air damages the epithelium, increases vascular permeability. Leukocytes and mast cells begin to migrate into the mucous membrane, stimulating the production of neuropeptides - mediators that are involved in the formation of nasal hyperreactivity in vasomotor rhinitis.

Mechanical factors that can cause pathological symptoms in the presence of nasal hyperreactivity:

• nose trauma, including surgical;
• deformities of the nasal septum, the presence of sharp ridges and spikes that are in contact with the side wall of the nasal cavity;
• forced exhalation through the nose;
• increased flashing.

The consequence of an imbalance in the autonomic nervous system may be gastroesophageal or laryngopharyngeal reflux, which is also a trigger factor for the disease.

The allergic form of vasomotor rhinitis occurs as a result of exposure to various allergens:

• pollen of plants during their flowering;
• book and house dust;
• bird feather;
• hair, pet dander;
• daphnia (dry fish food);
• food products: citrus fruits, honey, strawberries, milk, fish;
• perfumery.

In the pathogenesis of allergic rhinitis lies a specific IgE-dependent reaction between the allergen and tissue antibodies, which results in the release of mediators of the allergic reaction (histamine, serotonin, tryptase), which are involved in the formation of nasal hyperreactivity and the development of clinical signs.

Symptoms of chronic vasomotor rhinitis

The main symptoms of the disease are:

• prolonged difficult nasal breathing;
• nasal congestion;
• persistent or intermittent clear discharge from the nose;
• sensation of mucus running down the back of the throat;
• headache and decreased sense of smell, lacrimation.

As a result of an increase in the permeability of blood vessels, an increase in the volume of the inferior turbinates occurs, which leads to the appearance of nasal congestion. This symptom occurs in the form of attacks and is characterized by the appearance of profuse mucous or watery discharge from the nose and paroxysmal sneezing.

When turning and changing the position of the head, nasal congestion can alternately change from one half to the other. Persistent obstruction of nasal breathing appears as a result of hypertrophy of the turbinates, which develops in chronic rhinitis. Also, patients may have signs of vegetovascular dystonia:

• acrocyanosis;
• low blood pressure;
• drowsiness;

Diagnostics

Basic and additional diagnostic measures aimed at identifying the disease:

• detailed collection of complaints and anamnesis;
• anterior, posterior rhinoscopy;
• x-ray examination of the nose and paranasal sinuses;
• functional examination of the nose;
• endoscopic examination of the nasal cavity;
• bacterioscopic and bacteriological examination of discharge from the nasal cavity, determination of sensitivity to antibiotics;
• cytological examination of the nasal mucosa;
• computed tomography according to indications;
• determination of IgE;
• conducting allergy tests.

During rhinoscopy, depending on the form of vasomotor rhinitis, the following signs can be visualized:

• hyperemia and swelling of the mucous membrane of the nasal cavity, its pallor or cyanosis, polyposis changes;
• pathological discharge, mucus;
• crusts;
• thinning of the bone structures of the nasal cavity;
• false hypertrophy of shells;
• vitreous edema.

To detect changes in the nasal mucosa, a test with anemization with adrenomimetics is performed. After lubrication of the mucous membrane of the turbinates with a 0.1% solution of adrenaline, they decrease to normal sizes with edema. If the turbinates are enlarged due to hyperplasia of the bone skeleton, their size does not change significantly.

The cause of nasal hyperreactivity needs to be established. In cases where it is not possible to establish a relationship between symptoms and a specific trigger factor, vasomotor rhinitis is defined as idiopathic.

In a clinical blood test with an allergic form of vasomotor rhinitis, eosinophilia is detected, leukocytosis is possible when a secondary infection is attached.

To exclude concomitant acute and chronic pathologies of the ENT organs (presence of sinusitis, adenoids, curvature of the nasal septum, etc.), an x-ray examination of the nose and paranasal sinuses is performed.

The cause of nasal hyperreactivity needs to be established. In cases where it is not possible to establish a relationship between symptoms and a specific trigger factor, vasomotor rhinitis is defined as idiopathic.

According to the indications, the patient is referred for a consultation with an allergist, pulmonologist, neurologist.

Vasomotor rhinitis should be differentiated from hypertrophic rhinitis.

Treatment of chronic vasomotor rhinitis

The approach to the treatment of the disease should be comprehensive, taking into account concomitant diseases and the general condition of the body. The goal of therapy is to restore nasal breathing and improve the quality of life.

Medical treatment includes:

• systemic antihistamines (Zirtek, Loratadin);
• local antiallergic drugs in the form of drops, spray or gel (Azelastine, Levocabastin);
• decongestants (vasoconstrictor drugs - Tizin, Oxymetazoline) in a short course, no more than 7-8 days;
• endonasal blockade with procaine;
• intramucosal administration of glucocorticoids (Nasobek, Avamys, Flixonase).

A rational approach to the use of vasoconstrictor drops is very important, since their long-term use makes it necessary to increase their dose in order to achieve a greater effect. This, in turn, can lead to the following undesirable phenomena:

• headache;
• increased blood pressure;
• reactive hyperplasia of the nasal mucosa, especially the inferior turbinates;
• hyperplasia of the bone skeleton;
• aggravation of the imbalance of the autonomic nervous system;
• obstruction of the lumen of the nasal cavity, which can no longer be eliminated by decongestants.

To restore the state of the epithelium of the nasal mucosa, it is recommended to use special immunomodulatory drugs (IRS 19).

Irrigation of the nasal cavity with saline, sea water or antiseptic solutions (Miramistin, Octenisept) has a positive effect.

Physiotherapeutic methods have a normalizing effect on microcirculation in the mucous membrane in chronic rhinitis:

• exposure to UHF currents (ultra-high-frequency therapy) or microwaves endonasally;
• endonasal ultraviolet irradiation through a tube;
• exposure to helium-neon laser;
• endonasal electrophoresis 0.25–0.5% zinc sulfate solution, 2% calcium chloride solution;
• ultraphonophoresis with hydrocortisone ointment, Splenin;
• insufflation (blowing) of Rinofluimucil, Octenisept (at a dilution of 1: 6) into the nose;
• acupuncture.

In a clinical blood test with an allergic form of vasomotor rhinitis, eosinophilia is detected, leukocytosis is possible when a secondary infection is attached.

How to cure chronic vasomotor rhinitis with the ineffectiveness of conservative therapy? Surgery may be the solution. According to indications, the following is performed:

• submucosal vagotomy of the inferior turbinates;
• ultrasonic or microwave disintegration of the inferior turbinates;
• submucosal laser destruction of the inferior turbinates;
• sparing lower conchotomy.

Laser technologies make it possible to optimize surgical aids in the treatment of vasomotor rhinitis and reduce the time of rehabilitation of patients. A high-energy, low-power laser is used. Upon contact, it does not cause extensive tissue necrosis, which has a positive effect on the healing time of the laser wound.

In the chronic course of vasomotor rhinitis, a periodic examination by an otorhinolaryngologist is necessary. This is associated with a high risk of developing chronic inflammatory diseases of the paranasal sinuses, middle ear, pharynx, and larynx.

Patients are advised to follow a diet with a restriction of spicy foods, sweet, excessively hot food. Non-drug treatment also includes breathing exercises, which is aimed at preventing the common cold and diseases of the upper respiratory tract. Judging by the positive reviews, regular exercise helps to improve the overall physical and psychological state.

It is necessary to treat common diseases (neurosis, endocrine dysfunction, diseases of internal organs). Eliminate provoking factors, active and passive smoking.

Prevention

The main preventive measures:

• elimination of exogenous and endogenous factors that support the disease;
• sanitation of purulent-inflammatory diseases of the oral cavity, nasopharynx, paranasal sinuses;
• therapy of somatic diseases: pathologies of the cardiovascular system, kidneys, diabetes mellitus, obesity, etc.;
• improvement of hygienic living conditions;
• spa treatment;
• maintaining a healthy lifestyle;
• hardening procedures, impact on reflex zones (contrast shower, short-term dousing of cold water on the soles of the feet);
• vitamin therapy and washing the nasal cavity with saline or antiseptic solutions at home in the autumn-spring period;
• breathing exercises.

Video

We offer you to watch a video on the topic of the article.

allergic rhinitis- an inflammatory disease, manifested by a complex of symptoms in the form of a runny nose with nasal congestion, sneezing, itching, rhinorrhea, swelling of the nasal mucosa.

Code according to the international classification of diseases ICD-10:

Frequency- 8-12% of the general population. The predominant age of onset is under 20 years of age.
Risk factors. Family predisposition to atopic diseases (for example, allergic dermatitis, bronchial asthma). Early contact of the newborn (especially in the first 6 months) with animal allergens, food allergens. Smoking (including mothers during pregnancy, the presence of a smoker in the family).
Classification. Seasonal allergic rhinitis occurs during the flowering of a plant that releases causative allergens. Together with allergic conjunctivitis, it forms the clinical picture of hay fever. Perennial allergic rhinitis with persistent or intermittent symptoms throughout the year.

The reasons

Etiology. A variety of aeroallergens: house dust mites (Dermatophagoideus pteronissimus et farinae), wool and saliva of domestic animals (primarily cats and dogs), cockroaches, spores of certain types of mold fungi, plant pollen.
. General properties of aeroallergens .. The particle size is usually less than 50 microns .. They have a small mass, so they stay in the air for a long time in a suspended state and spread with the wind (pollen of wind-pollinated plants). Heavier pollen of plants pollinated by insects does not cause allergic rhinitis. Allergens enter the environment in large quantities. In composition, these are usually proteins with Mr = 10,000-40,000.
. Allergens with a seasonal pattern of distribution .. Allergens of tree pollen (birch, hazel, maple, elm, alder, etc.) in the middle lane cause symptoms in the second half of April and May .. Allergens of grass pollen (bluegrass, foxtail, timothy, fescue and etc.) and cultivated cereals (rye, oats, wheat) cause the onset of symptoms in June and July. Since poplar fluffs abundantly during this period, grass pollen sensitization is often mistakenly called an allergy to poplar fluff. of each type of pollen is constant, but the amount of pollen varies depending on environmental conditions ... The beginning of the season of exacerbation of allergic rhinitis can be shifted by 1.5-2 weeks due to the climatic features of the spring - summer period .. Fungal spores appear in early spring, reach peaks in July and August, disappear after the first frost. Clinically the most significant are Alternaria, Cladosporium, Aspergillus. The maximum concentration of spores is observed in strong winds after several days of wet and rainy weather.
. Allergens with year-round distribution. House dust. The main antigenic component is the waste products of the mite Dermatophagoides pteronyssinus and D. farinae. enzymes in laundry detergents.

Pathogenesis. The interaction of IgE and the allergen includes a cascade of processes in the mast cell, leading to the following effects. Release of mediators contained in the granules (histamine, proteases) .. Formation of new pro-inflammatory mediators (leukotrienes, Pg and platelet activating factor) . An immediate (15-30 minutes after contact with the allergen) symptomatic reaction turns into a persistent (4-8 hours or more) delayed reaction associated with tissue infiltration by activated eosinophils, neutrophils and mononuclear cells, as well as the damaging effects of their products. Mediators of immediate and delayed reactions affect the surrounding tissues, causing clinical symptoms: nasal congestion, itching, sneezing, etc.
Clinical picture. Attacks of sneezing (15-20 times in a row), which occur more often in the early morning, as well as upon contact with the guilty allergen. Itching of the nose, palate, and pharynx is common and can lead to an "allergic salute" (repetitive upward scratching of the tip of the nose), often causing a transverse crease across the bridge of the nose. Watery discharge from the nasal cavity is combined with nasal congestion and difficulty in nasal breathing, so breathing is often mouth. Excessive watering, itching, and soreness in the eyes often accompany allergic rhinitis. Loss of smell and taste can be the result of severe chronic congestive processes in the nasal mucosa. Sometimes otitis media and sinusitis develop due to impaired drainage of the auditory tube and paranasal sinuses.

Diagnostics

Treatment

TREATMENT
Diet. Patients allergic to plant pollen are shown a diet with the exclusion of cross-reacting plant products (hazelnuts and hazelnuts - for allergies to hazel, apples - for 50% of patients allergic to birch pollen, halva and sunflower seeds - for allergies to sunflower pollen, etc. .d.).
specific therapy. Elimination. Elimination or limitation of contact with the causative allergen is mandatory. Elimination is most effective in case of allergy to pets. In case of sensitization to house dust allergens, maintaining a dust-free regimen. Non-specific irritants (lime dust, strong odors, tobacco smoke) can also provoke clinical manifestations. Air conditioners reduce the concentration of pollen and fungal spores indoors, but they must be properly maintained to prevent fungal contamination. Immunotherapy (in the absence of contraindications) .. If the elimination of possible allergens and the use of drugs are ineffective .. Specific hyposensitization - extracts of causative allergens, usually determined during skin tests, are administered s / c in increasing doses.

Drug therapy.
. Antihistamines.. Oral drugs (see Urticaria).. Topical drugs, such as levocabastin (Histimet) in the form of nasal sprays.
. Vasoconstrictor drugs. Oral  - adrenomimetic drugs. Effective for reducing the severity of nasal congestion, but not rhinorrhea. Perhaps the excitation of the central nervous system, for prevention, a combination with H1 antagonists - receptors of the first generation is necessary. Preferably short courses (less than 10 days) .. Locally - phenylephrine or xylometazoline reduces nasal congestion, but with regular use for 4-5 days or more leads to severe difficulty in nasal breathing (rebound syndrome, drug-induced rhinitis) .. Combined agents: phenylpropanolamine + chlorphenamine, etc.
. Cromoglycic acid spray.. HA (topically), eg beclomethasone, fluticasone.
Surgery- nasal septal plasty, when its curvature is significant enough to affect the results of drug therapy.
Complications. Sinusitis. secondary infection. Nosebleeds. Otitis media. Nasopharyngeal lymphoid hyperplasia. Side effects drug therapy.
Concomitant pathology- other IgE - dependent conditions, most often - conjunctivitis, as well as bronchial asthma and allergic dermatitis.
Prevention. Elimination - Most patients with allergies to aeroallergens recover completely after contact with the allergen is eliminated. Air conditioning and limited outdoor exposure during the flowering period is highly effective in patients with pollen allergies. Educate patients sensitized to house dust mite allergens on best practices for maintaining a clean home and eliminating the allergen. Limit contact with animals. Avoid exposure to environmental irritants, such as smoking cessation (both active and passive). The use of special anti-allergic coatings, especially on mattresses and pillows.
Reduction. RAST - radioallergosorbent test.

ICD-10. J30 Vasomotor and allergic rhinitis

Vasomotor rhinitis has several types, is characterized by characteristic symptoms and, unlike other diseases of an otolaryngological nature, is not always treated by an ENT practitioner.

The disease has a number of characteristic symptoms, is often diagnosed in children and adolescents and, if left untreated, leads to serious complications. But how the laser treatment of rhinitis occurs is described in great detail in this

What is vasomotor rhinitis?

This is an otolaryngological disease, predominantly of a chronic or seasonal type of course, diagnosed in patients of various ages.

The peculiarity of the disease is that it does not have an infectious or viral pathogen. Occurs due to various reasons. But at the same time, it is not observed with colds, flu or other diseases, the cause of which is considered to be an infection and pathogenic microflora.

But chronic rhinitis can, under certain circumstances, develop into vasomotor. This happens if an inflammatory process in a latent (hidden) form flows in the respiratory organs for a long period of time. But what it can look like and how vasomotor rhinitis in a teenager is treated can be seen

On the video - a description of the disease:

The causes of the disease are as follows:

1. Systematic or regular contact with allergens that irritate the mucous membrane and lead to a runny nose.
2. Disorders in the functioning of the nervous system, diseases such as VVD, osteochondrosis of the cervical spine, neurovascular dystonia, etc.
3. Hormonal disruptions - changes during pregnancy or adolescence, also lead to chronic runny nose, nasal congestion.
4. Violations of metabolic processes in the body - this includes people with diseases of the endocrine system.

At risk are:

• people with diseases of a neurological and cardiovascular nature;
• children and teenagers;
• people with a tendency to allergic reactions of various kinds;
• pregnant women;
• people often arriving in the cold.

And also the disease can manifest itself in the presence of an infectious agent in the body, against the background of a weakened immune system.

If you give an accurate definition of vasomotor rhinitis, then you can characterize it as a seasonal or chronic disease, with specific symptoms, more often diagnosed in children and adolescents.

The disease proceeds with attacks, during this period, its signs intensify, there is an abundant flow from the nose. To stop the attack, you will need to contact an otolaryngologist.

What doctor treats?

Doctors work in tandem, thus, it is possible to influence the root cause of the pathological process and at the same time “extinguish” unpleasant symptoms. This therapy is the most effective.

signs

The disease has several characteristic symptoms, these include:

• copious flow from the nose with mucous secretions;
• congestion in 1 nostril, smoothly passing to another when changing position;
• an increase in the volume of secretions when taking hot food or drinks.

Nonspecific signs of vasomotor rhinitis:

1. Regular headaches.
2. An increase in blood pressure (jumps).
3. Vertigo.
4. Problems with the perception of information.
5. Insomnia, frequent mood swings.

Nonspecific symptoms are directly related to the root cause of the pathology.

You may also be interested in information on how to treat

Signs can disturb a person from time to time, while they occur only in the morning or evening hours.

Depending on the position in which a person sleeps in the morning, 1 nostril can be blocked in him, when he changes position, the other nostril is blocked.

In children, a runny nose often appears before bedtime, in the evening, when it is time for the baby to go to bed.

With a change in temperature, going outside, eating hot food or drinks, the amount of discharge increases.

In the allergic type of the course of the disease, signs appear when a person comes into contact with allergens. If contact has taken place, then characteristic signs appear, they may be accompanied by other allergy symptoms: itching of the skin, redness of the eyes, etc.

Symptoms largely depend on the underlying cause of the disease, but have common features. Vasomotor rhinitis is always a runny nose of a chronic nature, with nasal congestion and copious secretions of a mucous nature. At the same time, the secret is transparent or slightly cloudy, without impurities of pus or blood.

You may also be interested in information about which drugs should be used.

Code according to the international classification of diseases (according to ICD-10)

Classification

There are several types of the disease, they have a different cause and form of the course.

Vasomotor rhinitis has the following types:

• Allergic- provided that the cause of the disease was an allergy or systematic contact with allergens. This type of rhinitis is seasonal.
• Neurovegetative- this form of the disease is due to the occurrence of not only a runny nose and nasal congestion, but also the appearance of characteristic signs of disturbances in the work of the central nervous system. This is the main cause of rhinitis.
• Hormone- develops against the background of instability of the hormonal level, which leads to the appearance of specific symptoms.

It is also worth learning more about what types of vasomotor rhinitis exist.

On the video - a description of the types of rhinitis and their treatment:

Nominally, there are only 2 types of vasomotor rhinitis, hormonal is not on this list. But there is rhinitis of pregnant women - it occurs against the background of hormonal additions and is often temporary.

They also distinguish vasomotor chronic rhinitis. A similar term complements the type of course of the disease. Rhinitis can be seasonal or permanent (chronic), depending on the cause of the disease.

There is also vasomotor rhinitis:

1. atrophic.
2. Or hypertrophic type of flow.

The transition of the disease to these 2 forms indicates the development of complications. Atrophic or hypertrophic changes in the nasal mucosa.

With an atrophic type of flow, drying out, thinning of the mucosa is observed. In the hypertrophic form of the flow - an excessive increase in mucosal tissue.

You may also be interested in information about how it looks and how it is treated

Methods and means of treatment

There are several methods used to treat vasomotor rhinitis of any type of course.

In most cases, apply:

• drug therapy, it is called the traditional type of treatment;
• physiotherapy procedures complement conservative therapy;
• surgery, is used in the event that complications have arisen or it has not been possible to get rid of the disease with the help of drugs.

Traditional treatment

This is the use of various drugs that are prescribed by a doctor, are used to eliminate the root cause of the disease and unpleasant symptoms. Physio.

Surgery

The operation is advisable if conservative therapy has not brought any result. If necessary, a laser is used or an abdominal operation is performed using a scalpel.

Surgical manipulations are aimed at eliminating changes in the mucosa, if there are growths in the nasal cavity, foci of hypertrophied tissue, then they are removed. And also excised tissues that have undergone a significant change.

The main task of the surgeon is to restore the mucosa, return it to its former state. So that the respiratory organs can function normally.

Physiotherapy

This therapy is carried out after or during medication, it affects not only the respiratory mucosa, but also the root cause of the pathology.

In most cases, apply:

Physiotherapy is justified if no special effect is observed when prescribing drugs. In such a case, therapy is enhanced by various procedures. This will help a person quickly get rid of discomfort, runny nose and nasal congestion.

Vasomotor rhinitis is a disease that can lead to severe complications. His treatment takes place in several stages, with a low effectiveness of drug therapy, an operation is prescribed.