question: Why does the body eliminate nose congestion with moderate to extreme exercise?
comment: I'm not a scientist, but I think the body has a want to survive, so under pressure it adjusts to maximize performance for survivability to a point. Physical activity puts a strain on the equilibrium so it adjusts, opening up your sinuses to allow more oxygen through, overriding the immune systems response to the inconvineince of a virus.
passages: Exercise can trigger bronchoconstriction both in people with or without asthma. It occurs in most people with asthma and up to 20% of people without asthma. Exercise-induced bronchoconstriction is common in professional athletes. The highest rates are among cyclists (up to 45%), swimmers, and cross-country skiers. While it may occur with any weather conditions, it is more common when it is dry and cold. Inhaled beta2-agonists do not appear to improve athletic performance among those without asthma, however, oral doses may improve endurance and strength.
  
  Section::::Diagnosis.:Classification.:Occupational.
   It is possible that the nasal cycle may exacerbate the nasal congestion caused by the common cold, as the lack of motility of the cilia in one half of the nose may lead to an uncomfortable sensation of not being able to shift mucus by blowing the nose.
  
  Section::::Benefits in breathing.
   While the potential triggering events for E.I.B. are well recognized, the underlying pathogenesis is poorly understood. It usually occurs after at least several minutes of vigorous, aerobic activity, which increases oxygen demand to the point where breathing through the nose (nasal breathing) must be supplemented by mouth breathing. The resultant inhalation of air that has not been warmed and humidified by the nasal passages seems to generate increased blood flow to the linings of the bronchial tree, resulting in edema. Constriction of these small airways then follows, worsening the degree of obstruction to airflow. There is increasing evidence that the smooth muscle that lines the airways becomes progressively more sensitive to changes that occur as a result of injury to the airways from dehydration. The chemical mediators that provoke the muscle spasm appear to arise from mast cells.
   Avoidance of triggers is a key component of improving control and preventing attacks. The most common triggers include allergens, smoke (from tobacco or other sources), air pollution, non selective beta-blockers, and sulfite-containing foods. Cigarette smoking and second-hand smoke (passive smoke) may reduce the effectiveness of medications such as corticosteroids. Laws that limit smoking decrease the number of people hospitalized for asthma. Dust mite control measures, including air filtration, chemicals to kill mites, vacuuming, mattress covers and others methods had no effect on asthma symptoms. Overall, exercise is beneficial in people with stable asthma. Yoga could provide small improvements in quality of life and symptoms in people with asthma.
   The underlying cause of this type of bronchoconstriction appear to be the large volume of cool, dry air inhaled during strenuous exercise. The condition appears to improve when the air inhaled is more fully humidified and closer to body temperature.
  
  This specific condition, in the general population, can vary between 7 and 20 percent. This increases to around 80 percent in those with symptomatic asthma. In many cases, however, the constriction, even during or after strenuous exercise, is not clinically significant except in cases of severe to moderate emphysema.
   To give an example, in the exercise called "flying" the practitioner extends their arms slowly out from the side up to stretching above the head and then slowly back down again. One cycle can take anywhere between 2 and 10 minutes. The practice of breathing in and out of both nose and mouth at the same time is recommended while doing the exercises. The key is to pay close attention to the subtleties of sensations and the quality of experience while doing the exercises, thus linking body and mind in the presence of awareness given to the sensations.
   As evidenced by many professional athletes who have overcome EIB using some combination of accepted treatments, the prognosis is usually very good. Olympic swimmers Tom Dolan, Amy Van Dyken, and Nancy Hogshead, Olympic track star Jackie Joyner-Kersee, baseball Hall of Famer Catfish Hunter, and American football player Jerome Bettis are among the many who have done so. Tour de France winner Chris Froome admitted to suffer from the condition after being spotted using a nasal inhaler during race. Other sportspeople with EIB include racing cyclist Simon Yates, distance runner Paula Radcliffe and cross-country skier Marit Bjørgen. Research by sports scientist John Dickinson found that 70 percent of UK-based members of the British swimming team had some form of asthma, as did a third of cyclists, compared to a national asthma rate of eight to ten percent, whilst a study by the United States Olympic Committee in 2000 found that half of cross-country skiers had EIB.
   Some odor chemicals bind with olfactory receptors easily, even under conditions of high airflow, and other odors need more time, under low airflow conditions, to bind with receptors. With high airflow on one side and low airflow on the other side, the olfactory center detects a greater range of smells.
  
  Section::::Distinction.
  
  The nasal cycle should not be confused with pathological nasal congestion: individuals with normal nasal breathing usually do not realize their breathing is asymmetric unless there is underlying nasal obstruction. In pathological conditions, however, the nasal cycle may influence the symptoms.
  
  Section::::Research on the effects.
   A non-pharmacological nasal strip, applied prophylactically, variably reduces EIPH, depending on the severity of EIPH in an individual horse, and the duration and intensity of the exercise bout. The strip minimizes the increase in resistance to breathing, and the work of breathing as exercise intensity increases. There is synergy with the nasal strip in combination with furosemide. The strip has a spring-like action that mechanically supports and maintains the size of the nasal passage at its narrowest part, the nasal valve. Resistance to breathing doubles during intense or long-duration endurance exercise, with 50% of the total resistance originating at the nasal passages. Decreased resistance reduces the airway forces across the pulmonary capillary membrane, reducing the EIPH. Use of the strip is permitted by the FEI, and in U.S. horse racing.
   BULLET::::- symptom improvement
  
  BULLET::::- decline in number of rhinosinusitis episodes requiring medication in year after treatment
  
  BULLET::::- improvements in work productivity and activity level
  
  Patients who had balloon sinus dilation experienced a much quicker recovery, less bleeding, and less need for prescription pain medication.
  
  Overall, data from these studies address key clinical questions, and affirm sinus dilation’s role as an alternative to traditional surgery.
  
  Section::::Benefits.
   Other supportive evidence includes: a ≥20% difference in peak expiratory flow rate on at least three days in a week for at least two weeks, a ≥20% improvement of peak flow following treatment with either salbutamol, inhaled corticosteroids or prednisone, or a ≥20% decrease in peak flow following exposure to a trigger. Testing peak expiratory flow is more variable than spirometry, however, and thus not recommended for routine diagnosis. It may be useful for daily self-monitoring in those with moderate to severe disease and for checking the effectiveness of new medications. It may also be helpful in guiding treatment in those with acute exacerbations.
   There appears to be a connection between pulmonary edema and increased pulmonary blood flow and pressure which results in capillary engorgement. This may occur during higher intensity exercise while immersed or submersed.
  
  Facial immersion at the time of initiating breath-hold is a necessary factor for maximising the mammalian diving reflex in humans.
  
  Section::::Physiological response.:Thermal balance responses.
   Section::::Management.:Medications.:Adverse effects.
  
  Long-term use of inhaled corticosteroids at conventional doses carries a minor risk of adverse effects. Risks include thrush, the development of cataracts, and a slightly slowed rate of growth. Higher doses of inhaled steroids may result in lower bone mineral density.
  
  Section::::Management.:Others.
  
  When asthma is unresponsive to usual medications, other options are available for both emergency management and prevention of flareups. Additional options include:
  
  BULLET::::- Oxygen to alleviate hypoxia if saturations fall below 92%.
   Intranasal (i.n.) immunization or vaccination is effective way how to stimulate respiratory immune system. This way of immunization can provoke both cell-mediated and humoral immune response and is capable of stimulating both mucosal and systemic immune system. Dose of i.n. administered antigen can be much smaller than of oral administered antigen, because antigens are not exposed to digestive enzymes. Thus, it would be suitable way of vaccination against airborne viruses and bacteria. In 1997, nasal-spray vaccine containing inactivated form of influenza virus with nLT (heat-labile enterotoxin) as adjuvants was used in Switzerland, but it had to be withdrawn from the market, because it caused Bell's palsy to some patients. Thus, scientists are looking for more suitable and safe adjuvants, for expamle, Masafumi Yamamoto et al. in 1998 on mice model proved safe and efficient i.n. vaccination against "Streptococcus pneumoniae" and in 2002 also against influenza virus.
   The Buteyko method emphasizes the importance of nasal breathing, which protects the airways by humidifying, warming, and cleaning the air entering the lungs. A majority of asthmatics have problems sleeping at night, and this is thought by Buteyko practitioners to be linked with poor posture or unconscious mouth-breathing. By keeping the nose clear and encouraging nasal breathing during the day, night-time symptoms can also improve. Strictly nasal breathing during physical exercise is another key element of the Buteyko method.
  
  Section::::Method.:Reduced breathing exercises.
   The best treatment is avoidance of conditions predisposing to attacks, when possible. In athletes who wish to continue their sport or do so in adverse conditions, preventive measures include altered training techniques and medications.
  
  Some take advantage of the refractory period by precipitating an attack by "warming up," and then timing competition such that it occurs during the refractory period. Step-wise training works in a similar fashion. Warm up occurs in stages of increasing intensity, using the refractory period generated by each stage to reach a full workload.
  
  Section::::Treatment.:Medication.
   In response, many bacterial pathogens have evolved mechanisms for nitric oxide resistance. Because nitric oxide might have proinflammatory actions in conditions like asthma, there has been increasing interest in the use of exhaled nitric oxide as a breath test in diseases with airway inflammation. Reduced levels of exhaled NO have been associated with exposure to air pollution in cyclists and smokers, but, in general, increased levels of exhaled NO are associated with exposure to air pollution.
   It was initially thought that exhaled NO derived mostly from the sinuses, which contain high levels of NO. It has subsequently been shown that the lower airways contribute most of the exhaled NO, and that contamination from the sinuses is minimal.
  
  Section::::Medical use.
  
  Section::::Medical use.:Asthma.
   Regular exercise makes these systems more efficient by enlarging the heart muscle, enabling more blood to be pumped with each stroke, and increasing the number of small arteries in trained skeletal muscles, which supply more blood to working muscles. Exercise improves not just the respiratory system but the heart by increasing the amount of oxygen that is inhaled and distributed to body tissue. A 2005 Cochrane review demonstrated that physical activity interventions are effective for increasing cardiovascular fitness.
   Several researchers have reported that pranayama techniques are beneficial in treating a range of stress-related disorders. A Cochrane systematic review on the symptomatic relief of asthma by breathing exercises did not find a statistically significant improvement but did find that there was a statistically significant increase in the dose of histamine needed to provoke a 20% reduction in FEV1 (PD20) during pranayama breathing but not with the placebo device.
  
  Section::::Medical.:Risks.
   The conchae comprise most of the mucosal tissue of the nose and are required for functional respiration. They are enriched with airflow pressure and temperature-sensing nerve receptors (linked to the trigeminal nerve route, the fifth cranial nerve), allowing for tremendous erectile capabilities of nasal congestion and decongestion, in response to the weather conditions and changing needs of the body. In addition, the erectile tissue undergoes an often unnoticed cycle of partial congestion and decongestion called the nasal cycle. The flow of blood to the nasal mucosa in particular the venous plexus of the conchae is regulated by the pterygopalatine ganglion and heats or cools the air in the nose.
   The characteristic presentation of RM involves nasal congestion without rhinorrhea, postnasal drip, or sneezing following several days of decongestant use. This condition typically occurs after 5–7 days of use of topical decongestants. Patients often try increasing both the dose and the frequency of nasal sprays upon the onset of RM, worsening the condition. The swelling of the nasal passages caused by rebound congestion may eventually result in permanent turbinate hypertrophy, which may block nasal breathing until surgically removed.
  
  Section::::Causes.
  
  Common issues that lead to overuse of topical decongestants:
  
  BULLET::::- Deviated septum
  
  BULLET::::- Upper respiratory tract infection
  
  BULLET::::- Vasomotor rhinitis
   Exercise is the cornerstone of pulmonary rehabilitation programs. Although, exercise training does not directly improve lung function, it causes several physiological adaptations to exercise which can improve physical condition. There are three basic types of exercises to be considered. Aerobic exercise tends to improve the body's ability to use oxygen by decreasing the heart rate and blood pressure. Strengthening or resistance exercises can help build strength in the respiratory muscles. Stretching and flexibility exercises like yoga and Pilates can enhance breathing coordination. As exercise can trigger shortness of breath, it is important to build up the level of exercise gradually under the supervision of health care professionals (e.g., respiratory therapist, physiotherapist, exercise physiologist). Additionally pursed lip breathing can be used to increase oxygen level in patient's body. Breathing games can be used to motivate patients to learn pursed lip breathing technique.
   Medication challenge tests, such as the methacholine challenge test, have a lower sensitivity for detection of exercise-induced bronchoconstriction in athletes and are also not a recommended first-line approach in the evaluation of exercise-induced asthma.
  
  Mannitol inhalation has been recently approved for use in the United States.
  
  A relatively recent review of the literature has concluded that there is currently insufficient available evidence to conclude that either mannitol inhalation or eucapnic voluntary hyperventilation are suitable alternatives to exercise challenge testing to detect exercise-induced bronchoconstriction and that additional research is required.
  
  Section::::Treatment.
  
  Section::::Treatment.:Lifestyle.
   For people with COPD, the use of cardioselective (heart-specific) beta-blocker therapy does not appear to impair respiratory function. Cardioselective beta-blocker therapy should not be contraindicated for people with COPD.
  
  Section::::Management.:Oxygen.
  