question-icon

Suggest treatment for chronic allergic sinusitis

default
Posted on Wed, 3 Jun 2015
Question: Dear Doctor,
I have a sinusitis problem which is ruining my life daily...I recently did a a CT Scan of the PNS and found that my frontal and ethmoid sinuses are blocked ...A small polyp/mucus retention cyst is seen in the right ethmoid air cell .minial mucusal thickening is seen in both hemi -spenoid sinus causing obliteration of the ostia...I tried duonase nasal spray and was getting suffocated with this spray...a choking sensation in my guts..I am also unable to sleep daily and cannot concentrate on my work because of this problem...daily i experience heaviness in the head...hazzy concentration and loss of interest in daily activities...In addition to this I also have some gastric problems..I have undergone all the test of the abdomen ..endoscopy..ct scan..sonography...everything was normal...as a temporary relief measure I use a water based enema daily...I find that only when I take an enema to relieve my guts only then can I sleep peacefully...else whenever there if a food intake and no motions that night i cannot sleep...what is the linkage between these two problems ? How do I get it resolved ? are there any additional tests to do ?
doctor
Answered by Dr. Krunal Karade (1 hour later)
Brief Answer:
your clinical history & CT it appears that you having chronic sinusitis.

Detailed Answer:
Hi,
Thanks for the query.

I have read your query , reviewed your medications and understand your concern.

As per your clinical history & CT it appears that you are most probably having chronic allergic sinusitis .

There is no linkage between this two problems .

You using Combination Steroid nasal spray Duonase for chronic allergic sinusitis . It is a combination of Fluticasone / Azelastine . Azelastine can cause constipation in 2% individuals .

If I were your treating doctor , I would advice
change nasal spray to FLOMIST NASAL SPRAY 1 puff each nostril twice daily ,
Saline nasal spray 3 puff each nostril thrice daily like solspre &
salt water gargle twice daily .
Gargle with water 20 mins after nasal spray use to remove any spray coming to throat .

For stomach problem , consult gastroenterologist .

Hope this information helpful to you .If you have any further questions I will be happy to help.

Regards.
Above answer was peer-reviewed by : Dr. Pradeep Vitta
doctor
default
Follow up: Dr. Krunal Karade (28 hours later)
Dear Doctor,

I have tried using FLOMIST NASAL SPRAY with no relief in the past too...My main problem is that on the intake of food....i feel a strong pulling catch in the sinuses.....like the whole area is blocked ( similar to the feeling of wax in the ear) ..i feel the cranial nerves behind the head get strained and as a result of this I am unable to sleep every night nor can i concentrate or do anything...The moment i pass motions...the muscles in the head are eased and only then can i think and sleep ...y is this happening ? what is the correlation..i have been to 15 gastroenterologists with no proper solution to my problems..i feel depressed almost every day and each day is a drag ....sometimes i don't feel like living because of this problem...
doctor
Answered by Dr. Krunal Karade (1 hour later)
Brief Answer:
Some neural mechanism link between troubled stomachs and stuffy noses.

Detailed Answer:
Hi,
Thanks for the follow up query.

Newer Research show some connection between gastroesophageal reflux disease (GERD) & chronic sinusitis in some individuals .

Some neural mechanism link between troubled stomachs and stuffy noses but still unknown .

Individuals in research , took the popular anti-reflux medication Prilosec (omeprazole) for 12 weeks show improvement along with sinusitis treatment .

I would advice , add omeprazole to above treatment plan .

You will get relief.

Hope this information helpful to you .

Regards.






Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
default
Follow up: Dr. Krunal Karade (16 hours later)
Dear Doctor,

Thankyou for your advice...Is there any tests I can do to make sure I have this condition ? I have done several tests in the past and spent tons of money on many doctors..so just need to make sure before I can go ahead with anything.
doctor
Answered by Dr. Krunal Karade (15 minutes later)
Brief Answer:
The following studies are used to evaluate patients with suspected GERD

Detailed Answer:
Thanks for the follow up query.

The following studies are used to evaluate patients with suspected gastroesophageal reflux disease (GERD):

1) Upper gastrointestinal endoscopy
2) Esophageal manometry
3) Ambulatory 24-hour pH monitoring

Hope this information helpful to you .

Regards.


Above answer was peer-reviewed by : Dr. Shanthi.E
doctor
Answered by
Dr.
Dr. Krunal Karade

ENT Specialist

Practicing since :2009

Answered : 1000 Questions

premium_optimized

The User accepted the expert's answer

Share on
Suggest treatment for chronic allergic sinusitis

Brief Answer: your clinical history & CT it appears that you having chronic sinusitis. Detailed Answer: Hi, Thanks for the query. I have read your query , reviewed your medications and understand your concern. As per your clinical history & CT it appears that you are most probably having chronic allergic sinusitis . There is no linkage between this two problems . You using Combination Steroid nasal spray Duonase for chronic allergic sinusitis . It is a combination of Fluticasone / Azelastine . Azelastine can cause constipation in 2% individuals . If I were your treating doctor , I would advice change nasal spray to FLOMIST NASAL SPRAY 1 puff each nostril twice daily , Saline nasal spray 3 puff each nostril thrice daily like solspre & salt water gargle twice daily . Gargle with water 20 mins after nasal spray use to remove any spray coming to throat . For stomach problem , consult gastroenterologist . Hope this information helpful to you .If you have any further questions I will be happy to help. Regards.