Dr. Shyam Kalyan. N
Otolaryngology (E.N.T)
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hello doctor,
I am a 32-year-old male. I am having chronic idiopathic pancreatitis. I am regularly on Agna 25000 three times, and Cretox CP three times a day.
My problem are cold and cough for two years approximately. Almost four to five days a week. Even sleeping under the fan my nose gets blocked in the morning and nowadays I feel uncomfortable when dust is around as well. I did total IgE, and the report showed quite a high IgE value. Please diagnose and suggest medicine.
Hello,
Welcome to icliniq.com.
We are happy to help you.
I understand that you have these complaints for a few years. It most probably is a manifestation of allergic rhinitis. The total IgE in serum is just an indication of the allergy status at the time of taking the blood sample. It is not very significant in allergy practice. Nevertheless, it shows that you have an allergy. You need some medicines to keep allergies under wraps and prevent blockages and colds. You also need to find out which allergen is offending and causing the problems. The best way to diagnose is by getting a skin prick test done at a good allergy diagnostic lab.
Meanwhile, you will be benefitted from an antihistaminic with Leukotriene inhibitor combination, steroid nasal spray, and allergen avoidance. You would need to be taking these for about two to three months. Allergen avoidance is the best solution. Could you provide us with more details about the complaints so that we can guide you better?
Is the problem seasonal or perennial? Does it only occur at night when you lie down under the fan or at any time of the day? Does it get worse in winter or when you visit any hill station? Where do you live? Do you smoke? What is your diet like? Do you get exposed to vehicular exhaust pollution or smoke and dust of any kind? Have you tried nasal sprays before? Is the cough wet or dry? Is there any breathing difficulty or wheezing? Is there any change of voice?
Patient's Query
Hello doctor,
Thankyou for the reply.
Although the problem lies throughout the year I feel it becomes more obvious every time the season changes. Mostly it occurs at night and I feel my nose blocked when I wake up in the morning. The frequency is more in winter. I live in a tropical country. I smoke very seldom, twice a week on average I guess.
My diet is absolutely fat-free and small in quantity. I do not get exposed to pollution or dust very often now although I used to play a lot in the fields in my childhood but never faced any issues. If I remember well I might have used nasal spray once or twice before. The cough is wet, light green in color, running nose, itching inside the mouth in the upper gums above the tongue, waterfalls in quite large quantities from the eye in the night, and itchy inside the right ear. A lot of cough keeps coming out throughout both from nose and mouth throughout the day. Breathing difficulty is not there and I cannot hear wheezing. I feel that my voice gets heavier during the episodes.
Hi,
Welcome back to icliniq.com.
You need to stop smoking. Quit it entirely. Smoking affects sinonasal and respiratory mucosa causing poor mucociliary clearance and hence aggravates your allergy problem.
I would suggest you do not lie down under the fan or air-conditioner directly. Keep the AC at an optimum temperature of 75.2 to 78.8 degree Fahrenheit and with mild blower speed. If needed put fan at one speed with mild Aircon. Do not lie down directly under the AC. Do not inhale vehicular dust smoke and polluted air. Do some breathing exercises and yoga.
Eat a healthy diet and avoid excess milk. You would need Montelukast 10 mg, Levocetirizine 5 mg for a few weeks. Additionally, you start on Fluticasone furoate nasal spray. Read the pamphlet properly regarding how to use the spray. If you have any doubts regarding the same revert back to me.
Do let me know if there is anything more I can clarify and help you with. Practice social distancing and take abundant care.
Patient's Query
Hello doctor,
Thank you for the reply.
I do not smoke and I do exercise. But symptoms come back immediately as soon as I stop the medicine. How do I treat it permanently?
Hi,
Welcome back to icliniq.com.
Please explain the complaints. duration, worsening, relief, etc. What exactly are the complaints?
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Otolaryngology (E.N.T)
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