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What Is The Cause And Treatment For Nasal Congestion?

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Posted on Thu, 3 Apr 2014
Question: Hello Dr. XXXXXXX Bhatti, I had a severe cold with nasal congestion and right ear blockage two months back. My ENT diagnosed an ear infection and prescribed Clavam 375 tablets for a week and suggested using Xylomist drops for few weeks. After three weeks, the ear infection got cured but I still had a nasal congestion and mild headache without a running nose. My ENT prescribed Otrivin for another two weeks. Taking Otrivin provided quick relief, but the nasal congestion re-occurred every 6-8 hours. I consulted another ENT and he suggested discontinuing Otrivin. Though there was nasal congestion and mild headache after discontinuing Otrivin, the extent of congestion was slightly lesser than the recurring congestion that I had every 6-8 hours while using Otrivin. On taking a CT scan of PNS, it was found that I had bilateral inferior turbinate hypertrophy. My ENT suggested that long term use of nasal decongestant sprays can be harmful and advised laser turbinectomy to be done. As I have no previous history of such nasal congestion before these two months, I'm wondering if a second opinion on the CTPNS scan should be taken to determine if the turbinate hypertrophy is large enough to require a surgery. Is there any non-surgical alternative to control the nasal congestion? Do the use of nasal saline irrigation devices, nasal corticosteriod sprays or oral medications help in controlling congestion without long term side effects? Thanks in Advance.
doctor
Answered by Dr. Rajkishori Godhi (1 hour later)
Brief Answer: allergy should be ruled out Detailed Answer: Hello sir, Welcome to healthcaremagic. I have looked at your scans. In your history you have mentioned that you suffer from frequent colds - 4-5 times per year. Frequent colds can occur in patients with allergies of the nose - allergic rhinitis. Inferior turbinate hypertrophy is also caused by allergies of the nose. Please see your ENT to confirm the presence of allergic rhinitis. If indeed you have allergic rhinitis then the treatnment is rather simple. You will need local steroid sprays , anti histamine tablets. But many times in long standing allergic rhinitis, inferior turbinate hypertrophy may fail to respond to the treatment. So it may require surgery, But surgery is considered only when the medical management has failed to give you relief. Decongestant nose drops should never be used continuously for more than 6 days at a time. They are known to cause reflex congestion and worsen nasal congestion. My advise to you will be to try local steroid sprays and anitistamines before you consider surgery. Talk to your doctor about it. Although CT scans do help us to diagnose enlarged turbinates but we rely on symptoms of the patient to determine whether surgery is indicated rather than on CT findings. Feel free to follow up , Regards, Dr Rajkishori Godhi.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Rajkishori Godhi (2 days later)
Hello Doctor, Thanks for your valuable feedback. I was able to consult an ENT who has presently given me medication to treat allergy, headache and wax blockage in the ears. Below is the list of medication I'm currently on: 1. Allegra-M 2. Solspre nasal spray 3. Calpol 4. Soliwax ear drops I've taken a blood test and have uploaded the report here. Please let me know any views you may have on the medication or the blood test report. Thanks in Advance.
doctor
Answered by Dr. Rajkishori Godhi (3 hours later)
Brief Answer: blood tests normal Detailed Answer: Hi, Your doctor has tried to look for evidence of allergy in the blood tests. Your blood tests are normal. Allergy can be present even when blood tests are normal. About the medicines - Allegra is an antihistamine It will help with the allergy. Solspre is nothing but saline nose drops. Calpol is a pain killer. Soliwax will liquefy the wax. Your doctor does not think you have allergy so he/ she has not given you steroid nasal spray. Probably after examination of your nose he has not found any evidence of allergy. Trust your doctor and go ahead with the treatment. All the best, Dr Rajkishori Godhi.
Note: Consult an experienced Otolaryngologist / ENT Specialist online for further follow up on ear, nose, and throat issues - Book a Call now.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Dr. Rajkishori Godhi

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What Is The Cause And Treatment For Nasal Congestion?

Brief Answer: allergy should be ruled out Detailed Answer: Hello sir, Welcome to healthcaremagic. I have looked at your scans. In your history you have mentioned that you suffer from frequent colds - 4-5 times per year. Frequent colds can occur in patients with allergies of the nose - allergic rhinitis. Inferior turbinate hypertrophy is also caused by allergies of the nose. Please see your ENT to confirm the presence of allergic rhinitis. If indeed you have allergic rhinitis then the treatnment is rather simple. You will need local steroid sprays , anti histamine tablets. But many times in long standing allergic rhinitis, inferior turbinate hypertrophy may fail to respond to the treatment. So it may require surgery, But surgery is considered only when the medical management has failed to give you relief. Decongestant nose drops should never be used continuously for more than 6 days at a time. They are known to cause reflex congestion and worsen nasal congestion. My advise to you will be to try local steroid sprays and anitistamines before you consider surgery. Talk to your doctor about it. Although CT scans do help us to diagnose enlarged turbinates but we rely on symptoms of the patient to determine whether surgery is indicated rather than on CT findings. Feel free to follow up , Regards, Dr Rajkishori Godhi.