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What Causes Cheesy Build Up In Nose?

Posted on Tue, 29 Apr 2014

Question: my nose smells....no, really! the interior back, like cheese. also periodic, almost hard, build-up at back of throat that has to be snorted up and swallowed...too far back to blow out. (no taste). episodes of congestion, but they go away when standing. i have ms, so i'm taking a white cell suppressor- 'rebif'....is bacterial build-up the problem? should i flush my sinuses?

Answered by Dr. Sumit Bhatti (1 hour later)

Brief Answer: As below: Detailed Answer: Hi, Thank you for your query. 1. You have a Post Nasal Drip (PND). A cheesy build up may suggest a fungal infection or a 'biofilm' formation in the sinuses and nasal cavity. A plain CT Para Nasal Sinuses (PNS) may be done. An MRI is more likely to pick up a fungal infection. As you are on Rebif, this is more likely. 2. The smell that you get through your nose when you inhale is most likely due to a mild sinus infection or stagnant mucus including drying up of normal nasal secretions and build up of waste products of inflammation, infection, immune system by-products and gases like nitric oxide and ammonia. Have you had a recent cold, cough or fever? 3. If there is nasal and sinus inflammation you may take a trial of treatment including antibiotics, anti-allergic decongestants, nasal steroid sprays, saline nasal washes, mouthwashes, tongue cleaning, anti-reflux medication and probiotics. 4. If medical treatment fails, Balloon Sinuplasty is a minimally invasive way to irrigate and open any blocked sinuses. 5. You may follow up with the answers to the above questions, results of the above investigations and treatment for further recommendations. I hope that I have answered your query. If you have any further questions, I will be available to answer them. Regards.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Sumit Bhatti (2 days later)

thanks, doc....i was hoping for something more exotic! for someone on an immuno-suppressant (rebif) for over 10 years, i do not get colds, etc. my stuffy nose - one nostril, on the TN side- comes and goes thru the day. left side. though tempted, i do not use spray....bounce-back. i am also blessed with trigeminal neuralgia, which causes a continual dribbling of thin mucus that i can't wipe, blow out, or snort up w/o setting off an attack, so there is that complication. left side. lately, when i nap, i sometimes get an acidic taste and some brief mid-chest pain indicating acid reflux, but no burping or continuing symptoms..sore throat, etc. my SEVERE bruxism and seizures have worn and chipped my teeth, but my dentist also says acid reflux might play into it, so you are spot-on. i have signed up with my e-n-t dr. of long ago and will present your findings. i am sure you both will agree. let him decide on my future course of action. my question, (at last): as rebif may be a co-conspirator, when i see my neurologist, do i have grounds to suspend using it? you have been very thorough and helpful as a guide to future actions. thanks, XXXXXXX c.

Answered by Dr. Sumit Bhatti (2 days later)

Brief Answer: As below: Detailed Answer: Hi, Thank you for writing back. 1. Believe me, fungal infections, 'biofim', Balloon Sinuplasty is all exotic stuff worth a look at. 2. There is no harm in using steroid nasal sprays. Decongestant nasal sprays have a rebound action. 3. Take a trial with the various medications used for Trigeminal Neuralgia such as Tryptomer (amitriptyline), Tegretal (carbamazepine), Gabapentin and pregabalin. Remember that these medications may cause sedation and blurring of vision. Allowing the neuralgia to remain chronic without these medications may change the way the brain perceives these pain signal, making then resistant to further treatment. Sometimes it is a nerve exit root compression which needs to be ruled out by MRI Scans. 4. Take regular anti-reflux medications and make lifestyle changes to reduce the gastritis. A night guard for the teeth may help, especially if you have Bruxism or grinding of the teeth. 5. The decision on the Rebif is best left to the discretion of your Neurologist. I hope that I have answered your query. If you have any further questions, I will be available to answer them. Regards.

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