Why is my blocked nose and breathlessness not improving?

Question

Hello doctor,

I have been suffering from a blocked nose and shortness of breath for the past ten days. I have taken Taxim 200 mg twice daily for five days; Montina L at bedtime; a multivitamin; and Methylprednisolone 4 mg twice daily for five days, but there is no relief. The blocked nose and shortness of breath are still present. How can I manage this?

Please help.

Answer 1

Hello,

Welcome to icliniq.com.

I read your query and understood your concern.

Congestion in nose with difficulty breathing for ten days without response to treatment of antibiotics and steroids is indicative that it might not be a straightforward bacterial infection.

Some possible reasons for your case include:

Viral sinusitis or allergic rhinitis.
Obstruction due to sinus blockage.
Bronchospasm or asthma causing breathlessness.
Less commonly, a chest infection.

An antibiotic like Cefixime and a steroid for five days should have given some relief if the cause was bacterial or inflammatory. Since there is no improvement, the cause may be allergic or airway-related rather than infection.

I would suggest you check for the following:
Difficulty breathing more at night or with exertion.
Allergy.
Dust sensitivity.
Asthma.
Fever or thick yellow or green nasal discharge.

I would suggest you follow these instructions:

Steam inhalation regularly.
Use a saline nasal spray or drops to open the nasal passage.
Continue antihistamine regularly, including Montelukast if prescribed.
A nasal steroid spray is more effective than tablets for a blocked nose.
If breathlessness is present, you may need an inhaler, such as a bronchodilator.

The following investigations are needed if your condition is not improving:

Chest examination by a doctor.
Chest X-ray.
Pulmonary Function Test to exclude asthma.
Evaluation of sinuses if obstruction is present.

I would recommend that you visit an emergency room in case of the following:

Difficulty breathing even while resting.
Tightness in chest and/or wheezing.
Dizziness or presence of low oxygen.

Do not take any more steroids or antibiotics without consultation. This is generally treatable as soon as the cause is known, but your shortness of breath should be evaluated properly right now, rather than with self-medication.

I hope I have answered your query. You can write to me directly through iCliniq for any further assistance.

Take care.