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Dr. Andrew Rynne

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Suggest treatment for allergic rhinitis

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Dr. Riddhi Shah

ENT Specialist

Practicing since :2008

Answered : 507 Questions

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Posted on Thu, 16 Mar 2017 in Ear, Nose and Throat Problems
Question: Hello Doctor,

i am suffering from Allergic rhinitis.i am taking the montek LC (1 a day )and symbicort (twice a day) inhaler. But i am always having running nose and the mucus does not comes out. The mucus which comes out little that will be veryy thick and yellow in color. but always have choke nose. And to much difficulty to inhale from nose.

History: it started at 2 years back. when i have shifted to area where backside jungel area is there. i started getting cough and cold. then when i consulted doctor for the same they advised me to take montek lc for 3 months. i continued it for 3 months after that as i stopped.. in a month a started getting heavy breathing . i was unable to take stair case for 2 floors. then i started using the Asthalin inhaler. in the month of AUG 2016 i got acute asthma attach. and the asthalin medicine and inhaler did not work out. then i have consulted doctor so they prescribed the 'prednisolone' for 12 days. i was all fine. after that doctor has given e the Symbicort inhaler to use for 3 month. but i started getting cold. after that in the month on dec 2016 again i have got the acute bronchitis attach and was hospitalised. i was recovered. but then in 15 days again i got the cold. i have asked doctor for the same. they prescribe montek LC and same inhaler. but the running nose still i will be having it. after continuing the same medicine. The mucus is so thick that it does not comes out from nose easily. the nose polyps are swollen. one day one nostril polyps with be swollen another day another one. the nose is whole choke. Can breathe. i took steam also but still relief for only some time. Can you please advise something on this. it will be really great help
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Answered by Dr. Riddhi Shah 35 minutes later
Brief Answer:
Please see the answer.

Detailed Answer:
Hi,thank you for posting your query on health care magic.

I have gone through your query and can understand your concern.

I have gone through your prescriptions.
Spirodyn (Doxofylline )works by relaxing the muscles in the walls of the airways.
Symbicort inhaler contains Formoterol and Budesonide.
Formoterol works by relaxing the muscles in the walls of the airways. This opens the airways and makes breathing easier.
Budesonide belongs to a group of medicines called as corticosteroids.Budesonide is used in the treatment of allergic disorders and asthma .It works by reducing swelling and inflammation in the nose, throat, lungs.
Montek LC(Montelukast with Levocetrizine) -helps against Allergy.

Looking at your symptoms, you are probably suffering from Allergic rhinitis (Inflammation of nose due to Allergy)leading to Nasal Polyps and Allergic Bronchial Asthma.

It would be advisable that you undergo Allergy tests(it would help to find out that to which substances you are Allergic) so that you can take precautions to avoid those substances.

You might be having Allergy from dust particles/pollens/animal proteins from the jungle area.

The management of allergic rhinitis consists of 3 major categories of treatment, (1) environmental control measures and allergen avoidance, (2) pharmacological management, and (3) immunotherapy.

Environmental control measures and allergen avoidance involve both the avoidance of known allergens (substances to which you are found allergic on allergy testing) and avoidance of nonspecific, or irritant, triggers like Dust mites/pollens/mold in the house.

For dust mites, covering the mattress and pillows with impermeable covers helps reduce exposure. Bed linens should be washed every 2 weeks in hot water to kill any mites present. Thorough and efficient vacuum cleaning of carpets and rugs can help. Dust mites thrive when indoor humidity is above 50%, so dehumidification, air conditioning, or both is helpful.

Control measures for mold allergy focus on reduction of excessive humidity and removal of standing water.

For animal allergy, complete avoidance is the best option.
For avoidance of pollens,close your doors and windows.Avoid goind out in the early morning,when there are more chances of contact with the pollens.

Exposure to smoke, strong perfumes and scents, fumes, rapid changes in temperature, and outdoor pollution can be nonspecific triggers in patients with allergic rhinitis. Consider avoidance of these situations or triggers if they seem to aggravate symptoms.

You might find relief by taking following medicines in addition to the prescribed medicines which you are taking:

Steroid Nasal spray like Mometasone-helps against allergy and reduces inflammation-it has also role in reducing the size of the polyps in the nose.
Oral Decongestant like Phenylephrine and Nasal decongestant drops like Xylometazoline-they help to decongest the nose and sinus cavity and helps in nasal blockage (if you are not suffering from Hypertension)
Mucolytic like Amboxol-it will help in breaking the thick mucus.
Saline nasal spray-helps to moist the nasal cavity and removal of allergen particles from nose,
Vitamin C lozenges-they help in reducing dry mouth

Also do steam inhalation. Do warm saline gargles. Avoid cold food.Drink lots of fluids(warm).

If the nasal polyps are causing Nasal obstruction severely,then it would be advisable to have surgery for polyp removal by nasal Endoscopy(called Functional Endoscopic Sinus Surgery) after consulting an ENT specialist Doctor.

Immunotherapy: may be considered more strongly with severe disease, poor response to other management options in which the patient is introduced to gradually increasing doses of Allergen to which the patient is known to be sensitive on Allergy testing.

Hope this answers your queston.I would be happy to answer if you have any follow-up questions.Take care.
Above answer was peer-reviewed by : Dr. Nagamani Ng
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