This is a question that many mothers in particular commonly ask their doctor: can children be taken to the pool if there are problems in the upper respiratory tract? The answer of Dr. Luca Malvezzi, Otorhinolaryngologist and specialist in Cervical Facial Surgery in Humanitas, is yes.

Going to the pool is in fact important because it helps musculoskeletal development and it is also considered an aerobic sport for adults, not traumatic for the joints, thus helping us keep fit. It’s good to use some precautions and this applies to all age groups; it’s trivial, but going out of the pool, especially in cold periods, without drying your hair and without having adequate clothing, represents a stress for our body and encourages the development of diseases affecting the airways.

Children have particularly delicate respiratory tract, with an immune system still in development and hypertrophy of lymphatic tissue in nasopharynx, adenoids, or in oropharynx, palatine tonsils, which can be activated by preventing the normal flow of mucus produced by nose and sinuses and therefore the proliferation of bacteria present there,” explains Dr. Malvezzi.

Another very common problem may be the ears. Remaining in water for a long time, the skin of the external auditory duct macerates (as it also happens to the skin of the fingers) and thus becomes a favorable environment for bacterial proliferation, with the consequent risk of local infections, the most common of which is the external otitis. This problem can be particularly uncomfortable for those with skin problems such as psoriasis, but should not be an obstacle to water activity. In fact, a careful “maintenance” of our ears, prevention and protection with waterproof earplugs allow us not to give up the pleasure of swimming.

The nose may also be at risk. If chlorine, in fact, is considered a good disinfectant, for those who suffer from pathologies of the upper respiratory tract and who have a nasal mucosa with small fissurations, it can be a nasal irritant with consequent nasal congestion and worsening of a symptomatological picture, which often includes participation of the lower airways. Moreover, in this case, the care of our nose and washing with fresh water or saline after bathing in the pool and the use of emollient creams minimizes the problem.

I believe that the fear of having a cold or otitis should not limit our sporting activity and the sports activities of young people growing up,” explains Dr. Malvezzi.


Cold and rhinosinusitis

Seasonal cold, or viral Rhinosinusitis, is an event that often occurs in times of climate change. The symptomatology is temporary, lasting a maximum of ten days, and is characterized by nasal congestion with respiratory obstruction, production of clear mucus, reduction of odor perception and facial pain predominantly below and above orbital level.

Under such conditions it is best not to abuse drugs, but to rely on natural products and leave our immune system to work to counteract the “crisis” condition. However, be careful not to underestimate both the duration of the symptoms and their recurrence.

In fact, the other side of the common cold is bacterial rhinosinusitis. Same symptomatology, but there are more intense secretions, typically yellowish and present for a longer period. In this case, specialist evaluation and proper pharmacological therapy are necessary, especially for the most at-risk groups. As always, children and the elderly may present some complications of “trivial” infections. In this case, however, particular attention must also be paid to subjects who have recurring rhinosinusitis forms or in which the symptoms continue beyond 12 weeks, or are chronic. These subjects could conceal a more serious problem and deserve closer attention, as well as those who have a known problem, for example allergic or low respiratory problems, such as asthma.


These diseases should not to be underestimated

“Doctors and patients, who tend to give little importance or adapt to the state of malaise in the presence of rhinitis, frequently treat diseases of the upper respiratory tract superficially. This is wrong because these diseases can be the tip of the iceberg of a much more complex and delicate situation. A cold that occurs with a certain frequency should be looked at carefully and even more carefully for those with chronic symptoms. The chronic inflammation of the nasal and paranasal sinuses can, in fact, be an expression of a systemic problem that involves both the upper and lower respiratory tract and that can have a serious impact on the patient’s health,” says Dr. Malvezzi.

“The infrequent chronic inflammatory conditions affecting the high and low respiratory tract can have a negative impact on our quality of life, affecting school or work performance, social life and also in terms of social costs due to absence at work and, of course, in terms of health care costs. Raising the level of attention and managing these diseases in the best way, both from a diagnostic and therapeutic point of view, means contributing prospectively to improving the living conditions of these potential patients,” says Dr. Malvezzi.


Customized medicine and multidisciplinary approach

At the threshold of the second decade of the third millennium, the role of the doctor must increasingly be directed towards so-called personalized medicine and towards precision medicine, a concept that does not only apply in the field of oncology. Patients with disorders of the upper respiratory tract must have a multidisciplinary diagnostic and therapeutic plan, with a glance at the lower respiratory tract and the immunological aspects of these diseases. Of course, this is true in both directions, i.e. those patients who first visit the allergology and pulmonology service could also benefit from an otorhinolaryngology evaluation. It should not be forgotten that in its natural evolutionary history, rhinitis evolves towards chronic rhinosinusitis without polyps or with nasal polyps. Moreover, these pathologies frequently have low respiratory tract co-participation because they are strongly correlated to bronchial hyperreactivity or asthma,” concludes Dr. Malvezzi.