Moms commonly turn to doctors with a question: If my kids have problems with the upper respiratory tract, can I take them to the pool? The answer of Dr. Luca Malvezzi, Otolaryngologist and Specialist in Head and Neck Surgery at Humanitas, is yes.

Going to the pool, in fact, is important because it helps the musculoskeletal development of children and for adults, it is an aerobic sport, non traumatic to the joints, which helps us stay fit. However, it is good to use some precautions and this applies to all age groups. It is trivial, when you leave the pool, especially during the winter, to dry your hair and wear appropriate clothes, so you avoid catching a cold and stressing your body. Therefore, reducing the chances of developing diseases typical of this season.

“Children have a sensitive respiratory system. With the immune system under development and the lymphatic tissue hypertrophy in the nasopharynx, the adenoids, oropharynx and palatine tonsils can be activated, preventing the normal flow of the mucus produced by the nose and the paranasal sinuses outward, enabling the viralization of the bacteria found there” explains Dr. Malvezzi .

Another common issue may affect the ears. Staying in the water for a long time, causes the skin of the external auditory canal to macerate (as also happens to the skin of the fingers that “shrivels”) and becomes favorable ground for bacterial proliferation, with a consequent risk of local infections. The most common is external otitis. It can be particularly inconvenient for those who have skin problems such as psoriasis, but should not be an obstacle for you to continue your activity in the water. In fact, if you “maintain”, prevent and protect your ears appropriately with waterproof strips, you will not need to give up on the pleasure of swimming.

Even the nose may be at risk. If chlorine is considered a good disinfectant, for those who suffer from diseases of the upper respiratory tract and present a nasal mucosa with small fissures, it can irritate the nose, resulting in a nasal congestion and deterioration of a set of symptoms that include the lower respiratory tract. In this case, the treatment for the nose is to wash it with fresh water or saline solution in the bath after exercising and use emollient creams to minimize the problem.

“I believe the fear of getting a cold or ear infection should not limit our sports activity or that of our kids”, explains Dr. Malvezzi.


Cold and rhinosinusitis

People face a seasonal cold or viral rhinosinusitis during climate change. The symptoms are temporary, lasting a maximum of 10 days, and is characterized by nasal congestion with respiratory obstruction, production of light or viscous mucus, reduction of the perception of odors and facial pain mostly at the infra and supraorbital levels

Under such conditions, it is important not to abuse medicines. Instead, rely on natural products and leave our immune system to work against the “crisis” condition. However, do not underestimate the duration of the symptoms or their recurrence.

In fact, the other side of a typical cold is bacterial rhinosinusitis. It has the same symptoms, but more intense. For example, the secretions are typically yellowish and present for a longer time. In this case, a specialized assessment and a correct drug therapy are necessary, especially for the groups who are mostly at risk. As always, children and elderly people may present some complications in the course of “trivial” infection. In this case, it is important to pay attention to individuals presenting recurrent rhinosinusitis with symptoms lasting beyond 12 weeks, which is considered chronic. These individuals may hide a more serious problem and need to be watched closely as well as those who already have a known issue, such as an allergy or a problem in the lower respiratory tract, like asthma.


Diseases that should not be underestimated

“Often those diseases are the ones of the upper respiratory tract (such as Rhinitis) that are superficially treated by doctors and the patients tend to give little importance to or adapt themselves to the illness condition. This is the wrong approach, as these conditions may represent the tip of the iceberg of a much more complex and delicate situation. A frequent cold must be watched carefully and we must turn to those presenting a chronic symptomatology with even more attention. A chronic inflammation of the nose and/or the paranasal sinuses can be a sign of a systemic problem involving the high and lower respiratory tracts and can heavily affect the patient’s health” says Dr. Malvezzi.

“The typical chronic inflammatory conditions that affect the upper and lower respiratory tracts can affect our quality of life negatively, as they affect our performance at school or at work and our social life. In terms of social cost, these conditions also affect us as they can cause our absence in the workplace, and in terms of health expenses, these diseases have contributed prospectively to improving the living conditions of these potential patients, by raising the level of care and giving people the opportunity to better manage them under an analytical and therapeutic point of view” said Dr. Malvezzi.


Personalized medicine and multidisciplinary approach

“On the threshold of the second decade of the third millennium, the doctor’s role should increasingly move towards the so-called personalized medicine and precision medicine; a concept that applies not only to Oncology. Patients with upper respiratory tract disorders should enjoy a multidisciplinary diagnostic and therapeutic pathway, which offers a view of the lower respiratory tract and the immunological aspects of these diseases. It is clear that this concept applies in both cases, that is, patients who first connect to the Allergology and Pulmonology department should benefit from an ENT evaluation. Don’t forget that in its natural history of evolution, Rhinitis develops into a chronic rhinosinusitis, without polyps or nasal polyposis. These diseases are often connected with the lower respiratory tract being strongly related to bronchial hyper reactivity or asthma” concluded Dr. Malvezzi.