How can I relieve severe morning allergic rhinitis symptoms?

Question

Hello doctor,

I have been diagnosed with allergic rhinitis. I saw many doctors and had a nasal septum deviation surgery last year too, to control the allergies but nothing helped. I have to take antihistamines twice every day. I take 180 mg Telfast. The symptoms are very similar to having the flu. I have a runny nose, watery eyes, sneezing, extremely itchy nose, and cough every now and then. It is impossible to control them now. Every morning, when I wake up, I wake up to these severe symptoms. The below-listed things seem to help during the symptoms.

When I drink a cup of hot tea after I wake up.
When I wear a cap during the night (it helps a lot with the morning crisis).
When I apply some pressure on my nose, on both sides.
When I take any medicine that has an antihistamine.
When I avoid usage of AC (but I live in a very hot country).

Please help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I read your query and can understand your concern.

Allergy is a genetic disorder and does not have a permanent cure. When we know we are allergic to some substance, the best way to avoid allergy is to stay away from it. This form of allergen avoidance is not practical in your case. To establish that it is an allergy indeed, we must have the values of serum IgE (immunoglobulin E). When it is elevated, it signifies an allergy.

Next, we will find out which substance or protein is causing the allergy in your system. For the same, we have a skin prick test as well as a comprehensive allergy profile. Once we know the causative factor, allergy can be offset by avoiding that particular agent carefully. If the allergen is ubiquitous, then we may need to perform immunotherapy to make you immune to the allergen. Immunotherapy can be done subcutaneously or sublingually.

In addition to the above, we should rule out any possible foci in the nasal cavity and sinuses. For the same, a CT (computerized tomography) scan of the paranasal sinuses is essential, as is a diagnostic nasal endoscopy done in an ENT's (ear, nose and throat specialist) office. If you have any reports, kindly attach those in the next query. We shall have a thorough look. Till then, continue Fexofenadine 120 mg with Montelukast and Nasonex spray (Mometasone).

I hope this helps.

Kindly revert so I can assist you further.

Thank you.