Get your Health question answered in 3 easy steps
A Doctor will be with you shortly
Ask a Doctor Now
186 Doctors are Online

Sneezing in the morning, blocked nose, headache, watery eyes. Used Nasivion. Want non steroid medicine

User rating for this question
Very Good
Answered by

ENT Specialist
Practicing since : 1991
Answered : 2511 Questions
Question
Hi, I am here in Bangalore for last 6 and half year. I am getting sneezing early morning, nose block, stuffiness, headache, watery eyes, some times at midnight i get sudden sneezing and it continues for the day, no fixed frequency. I used nasivion for last 1 month to get relief. once i stop it, again my nose get blocked and sneezing starts. Kindly help me in giving me right advice on the medication ( non steroid based) to be used,which can give a permanent solution my constant problem.
Posted Thu, 27 Sep 2012 in Ear, Nose and Throat Problems
 
 
Answered by Dr. Sumit Bhatti 3 hours later
Hi,

Thank you for your query.

1. You have developed a condition known as Rhinitis Medicamentosa due to continuous use of decongestant nasal drops (Nasivion). The nasal mucosa (lining) becomes dependent upon continuous use, failing which the nose gets blocked.

2. Get an AEC (Absolute Eosinophil Count) done. a course of Heterazan may help lower your eosinophil count.Do you have any Sinuses) done? I would like to review the images if you have nasal obstruction.

3. In such a situation Intrinsic or Vasomotor Rhintis may also exist. Have you had a nasal endoscopy and if yes, what were the exact clinical findings? The color and appearance of the nasal lining (mucosa) givesa fairly accurate idea of the type of rhinitis. For example, in allergy it is reddish purple, in vasomotor rhinitis it is red and in long standing allergy, it is pale white. Bogginess indicates an active inflammatory process. Discuss this with your physicians.

4. New technologies such as Radio-Frequency and Co-ablation coagulate tissue at under 100 degrees C and in more controlled fashion. These would be of use if you have significant nasal obstruction.

5. I would recommend the use an anti histamine, an anti leukotriene, a steroid nasal spray such a mometasone, fluticasone or ciclesonide (not a decongestant, which cause rhinitis medicmentosa) and steam inhalation with saline nasal washes for at least two weeks under medical supervision and then reassess.

6. The steroid sprays and saline nasal washes are necessary along with discontinuation of nasal decongestants to get over the Rhinitis Medicamentosa.

7. There is no need to avoid the steroid nasal spray as the steroid content is very low and in 50 - 65 micro grams. Our bodies also produce 5000 to 7000 micro grams of steroid every day and it is essential for life. Most steroid complications occur only after intake of this amount is exceeded for a long time. Newer sprays such as mometasone and ciclesonide are absorbed only up to 0.1% of the dose which is negligible. hence these sparys can be used for many months.

8. Another interesting point is that the above treatment will require at least 7-10 days to show it's effect fully.

Hope I have answered your query. You may need to fill in some information. If you have any follow up queries I will be available to answer them.

Regards.
Above answer was peer-reviewed by
 
Follow-up: Sneezing in the morning, blocked nose, headache, watery eyes. Used Nasivion. Want non steroid medicine 11 hours later
Hi

For Sl. no.
1) i will stop using nasvion

2) why eshonophil count has to be reduced ? do i have to take Heterazan, if yes and what is the dosage and time ? i do not have Acid re-flux. I have not done CT PNS till date, no one has advised me to do it.

3) How will i get it tested, i do not have any symptoms now due to medication. How many hours after medication can i get it tested so that the test is accurate.

5) Is Steroid based nasal spray only recommended and for how many days, is it enough to cure completely? does it cause dry cough after regular usage ?

My mucus discharge is white in color. In cold weather / AC room in temperature of 18 to 22 degree my nose get blocked & have dry mouth.

Regards


AAA



 
 
Answered by Dr. Sumit Bhatti 3 hours later
Hi,

Thank you for writing back.

1. I would suggest that you start using the above course of medication (under medical supervision) for at least 15 days along with the nasivion drops an then discontinue the nasivion.

2. A raised eosinophil count is not normal. Among its many effects are increased allergic symptoms (they play an important part in allergy), feeling ill and dry cough (Tropical Eosinophilia). The dose of Tab Hetrazan is 100 mg thrice a day for one to two weeks. However this should be decided only after the AEC (Absolute Eosinophil Count) and again under strict medical supervision.

3. The effect of these medications will not last longer than a day or two. You may get checked after this time period.

4. I have recommended a full course of treatment under medical supervision and not steroid spray alone. Each drug in the combination acts on a different point of the allergy cycle. Together, their effect is more than each used separately.

5. There is no cure for allergy, It may only be controlled. Newer steroid sprays neither cause a bad taste in the throat nor any cough.

6. Nasal blockage in cold air is a non specific allergy and is very common. If this does not respond to medical treatment after 15 days trial, get the plain CT PNS (Para Nasal Sinuses) done with 1 mm coronal , axial and saggital cuts. This scan may be done pre and post decongestion with Otrivin nasal drops. You may share the images here.

I hope that I have answered your queries. If you have any further questions, I will be available to answer them.

Regards.
Above answer was peer-reviewed by
 
Follow-up: Sneezing in the morning, blocked nose, headache, watery eyes. Used Nasivion. Want non steroid medicine 16 hours later
Hi,

Thanks for your response

for Sl.No. 2 & 3 - do i have to take a course of Hetrazan now, as you have said the effect of these medications will not last longer than a day or two. Will it help ?

Regards


AAAAA
 
 
Answered by Dr. Sumit Bhatti 3 hours later
Hi,

Thank you for writing back.

You should use Hetrazan only if your AEC is more than 440.

I hope that I have answered your queries.

If you have any further questions, I will be available to answer them.

Regards.
Above answer was peer-reviewed by
 
Share on Facebook
Share on Twitter
Share on Google+
Question is related to
Diseases and Conditions
Medical Topics

The user accepted the expert's answer

Ask an ENT Specialist

© Ebix, Inc. All Rights Reserved.
All the information, content and live chat provided on the site is intended to be for informational purposes only, and not a substitute for professional or medical advice. You should always speak with your doctor before you follow anything that you read on this website. Any health question asked on this site will be visible to the people who browse this site. Hence, the user assumes the responsibility not to divulge any personally identifiable information in the question. Use of this site is subject to our Terms & Conditions
Already Rated.
Your rating:

Ask a Doctor