What could cause persistent nasal congestion?

Hello,

Welcome to icliniq.com.

In your condition, we must rule out specific etiologies such as allergic rhinitis, chronic sinusitis, nasal polyposis, and growth or lesions inside the nose. This would require you to tell us your problems in more detail. Let me ask you certain questions, and please provide answers to those as objectively as possible.

1. Any nasal discharge? If yes, is it thick or thin? Color?
2. Associated sneezing?
3. Reduced sense of smell?
4. Post nasal drip?
5. Frequent clearing of throat or change of voice or throat pain or feeling of a lump inside the throat?
6. Facial pressure or a headache?
7. Increased watering of eyes?
8. Any time did the blood come out of the nose?
9. Any association of your nose block with any symptoms in the ear or throat?
10. Any ear block or reduced hearing or ear fullness or bubbles feeling inside the ear?
11. Any allergies? Dust or pollen or house mites or fungus?
12. Does your place of study or work have a lot of dust pollution or pollen?
13. Did you change your place recently?

I hope this helps.

Please revert so I can assist you further.

Thank you.

Hi,

Welcome back to icliniq.com.

Your history points towards a sinus problem. It could be aggravated by the deviated nasal septum. Additionally, an allergic cause for the prolonged duration of complaints has to be ruled out, too. I want you to take a couple of tests. First, I would like to examine your nose.

If you have not had a course of antibiotics, I would suggest you take one. A course of Clarithromycin, at your weight, for five days will be ideal. This drug has both antibacterial and anti-inflammatory effects. Stop using Otrivin (Xylometazoline hydrochloride). The side effects of Otrivin are rebound nose congestion and prolonged use, which causes rhinitis medicamentosa. Stop Otrivin straightaway.

Use Mometasone furoate nasal spray. It is an anti-inflammatory medicine that removes edema and inflammation inside the nasal and sinus cavities. Take one puff in each nostril twice daily. There is a specific method of using the spray that is given in the pamphlet. If you need help with that, please contact us. The spray takes time to act. You may have to use it for four to six weeks. After two weeks, we can reduce the dose.

I would put you on a combination of Montelukast 10 mg and Levocetirizine 5 mg. Take this medicine once a day in the evening at 7 p.m. It produces a mild sedative effect. It removes a histaminic component of your disease and removes allergic influence. Continue this for a week. If the sedation is not acceptable, let me know, and I can suggest a substitute for Levocetirizine.

After the bath, immediately dry your hair. Avoid smoking and drinking till we find a permanent solution to your problem. While going outside, stay away from dust, smoke, and pollution. Wear a mask if need be. Drink plenty of water. Take a multivitamin supplement daily or at least every alternate day. Take vitamin C-rich fruits like orange or gooseberry once every couple of days. If the bitterness is uncomfortable, you may cook the gooseberry and then consume it. Take a picture of the open throat, trying to focus on the tonsils, and send it to me. Avoid steam inhalation and warm saline gargles. Eat less spicy and fewer masala foods. Avoid cold drinks and aerated drinks for a while.

The tests I would recommend are:

1. Serum IgE (immunoglobulin E).
2. Complete blood count (it should include Hb (hemoglobin), TC (total count), DC (differential count), ESR (erythrocyte sedimentation rate), and platelets, among others).

The nose block could be due to the deviated septum. Probably, with growth and puberty, the alignment of the septum could have changed mildly. However, an alternate side nose block is not usually used with DNS (deviated nasal septum). DNS causes one side to be blocked, usually. Alternate opening and closing of the nostrils are physiological, but this is not true.

I hope this helps.

Please revert so I can assist you further.

Thank you.