Q. My nose is always blocked and has mucus. Kindly help.

Answered by Dr. Shyam Kalyan N and medically reviewed by iCliniq medical review team.

 

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Hello doctor,

My nose is always blocked and have mucus, from past four months. To open up my nostrils, I have to use Otrivin, else my nose stays blocked.


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Dr. Shyam Kalyan N
MBBS (MADRAS MEDICAL COLLEGE)., DLO., CERTIFICATE IN ALLERGIC RHINITIS MANAGEMENT., DNB
Allergy Specialist, Otolaryngology (E.N.T

Hello,

Welcome to icliniq.com.

In your condition, we must rule out certain etiologies as follows:

  1. Allergic rhinitis.
  2. Chronic Sinusitis.
  3. Nasal Polyposis.
  4. Growth or lesion inside the nose.

This would require you telling us in more details your problems. Let me ask you certain questions and please provide answers to those as objective 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 lump inside the throat?
  6. Facial pressure or a headache?
  7. Increased watering of eyes?
  8. Any time did blood come out of the nose?
  9. Any association of your nose block with any symptom in 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. Your place of studies or work does it have a lot of dust pollution or pollen?
  13. Did you change your place recently?

Please let us know about all these. If you have done any test or scanning or investigation for this purpose please upload the films and reports in your follow-up query to me.

For more information consult an allergy specialist online --> https://www.icliniq.com/ask-a-doctor-online/allergy-specialist

 

Thank you doctor,

The answers to your questions are as follows:

  1. Yes, thin. Light green type.
  2. Yes, there is sneezing.
  3. Yes, since the nose is blocked.
  4. Not sure.
  5. Yes. I do have tonsils from past few months.
  6. A headache sometimes. I do not understand what is facial pressure.
  7. I had watery eyes, and continuous sneezing two days ago, not from past months.
  8. Yes, when I was cleaning my nose. Just once in past few months.
  9. Maybe.
  10. Maybe.
  11. No.
  12. No.
  13. No.

I have not done any screening test, or follow up regarding this, if you need any test to be done, please let me know. I will do them. Also, the main issue is the nose is always blocked, but one way its open, keeps switching, one nostril stayed blocked, and another open, and then vice versa, this is happening from past four months. Also, I had nose surgery when I was 11 years old since I broke my nose due to faceplant, and underwent surgery to fix the nose. Is it related somehow? Am I suffering from deviated septum?

 

Dr. Shyam Kalyan N
MBBS (MADRAS MEDICAL COLLEGE)., DLO., CERTIFICATE IN ALLERGIC RHINITIS MANAGEMENT., DNB
Allergy Specialist, Otolaryngology (E.N.T

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 do want you to get a couple of tests. I would want to suggest the following to you, if you were to come to me and show me in my clinic. First I would like to examine your nose nevertheless.

  1. If you have not had a course of antibiotics, I would recommend you take one. A course of Clarithromycin as per your weight for five days will be ideal. This drug has both antibacterial and anti-inflammatory effect.
  2. Stop using Otrivin. The side effect of Otrivin (Xylometazoline) is rebound congestion of the nose and prolonged use causes rhinitis medicamentosa. Stop Otrivin straightaway.
  3. 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 contact us. The spray takes time to act. You may have to use it for 4 to 6 weeks. After two weeks we can reduce the dose.
  4. 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 PM. 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, I can suggest a substitute for Levocetirizine.
  5. After 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 in every couple of days. If the bitterness is uncomfortable you may cook the gooseberry and then consume.
  6. Take a picture of open throat trying to focus on the tonsils and send 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.
  2. Complete blood count (it should include Hb, TC, DC, ESR, platelets among others).

Nose block could be due to the septum that is deviated. Probably with growth and puberty the alignment of septum could have changed mildly. But alternate side nose block is not usual with DNS (deviated nasal septum). DNS causes one side block usually. Alternate opening and closing of nostrils physiological but in you, this seems to be not the case.

For more information consult an allergy specialist online --> https://www.icliniq.com/ask-a-doctor-online/allergy-specialist

 
 
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