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Q. My sinuses feel swollen along with stomach pain at night. What could be the reason?

Answered by
Dr. B. Vageesh Padiyar
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Mar 28, 2022

Hi doctor,

I am having a hard time with my sinuses. I might be allergic to something that causes my sinuses to swell. I cannot seem to pinpoint it down, but if I have dairy (ice cream with sugar in it), gluten like a bowl of pasta, or any alcoholic drinks, after going to bed at night, I wake up three to five hours later, and my stomach muscles are super inflamed and swollen. It feels like they are being squeezed super hard right behind my nose, deep in the sinuses. This happens three to four times a week. Could it be food allergies? Could it be acid reflux?. I do not experience heartburn. I have tried everything to prevent airborne allergies. I have HEPA filters in my room. I use a clean bed and sheets.

I had surgery two years ago to fix my deviated septum. It solved the problem of getting air through. But it did not stop the swelling.

I wake up in the morning, and I have bags under my eyes each day. And I suffer from tinnitus, and it feels like my brain is swollen while getting headaches.

I am worried that I am taking too much Tylenol to be able to sleep. And I try to avoid it, and I use Otrivin at times.

Please give me any suggestions you have.

Thank you.

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Hi,

Welcome to icliniq.com.

Thanks for briefing me regarding the problem in concern.

There are two things that are possibly causing your symptoms.

1. Vasomotor Rhinitis.

In this condition, you have inflammation due to some triggering factors (it could be airborne or food and beverage related). It could also be environment-related.

Typically the symptoms here include an inflammation in the nasal cavity which causes a tense and heavy feeling in the sinuses and may be associated with a headache. Invariably many may not have sneezing or rhinorrhea which is mostly a feature of allergic rhinitis.

2. GERD (gastroesophageal reflux disease) with LPR (laryngopharyngeal reflux).

Even though you might be asymptomatic or never had gastric issues in between, the inflammation in the nasopharynx often exists in the hidden form and can resurface when adequate care is not taken.

You might have questions like, why does hidden acid reflux become so problematic?

As you know the stomach usually has got cells that release hydrochloric acid and thus keep the gastric environment acidic in nature. Whereas, your entire mucosal lining from the nasopharynx, throat, and food pipe (esophagus) is not meant to handle anything acidic. Of the three structures, the nasopharynx and throat are the most sensitive due to their rich nerve supply. If in a given situation, your mouth, throat, or food pipe chronically comes in contact with acidic contents, an inflammation starts, which the body initially takes care of. But, once this compensation wears out, you start developing symptoms that you have mentioned.

Please try to follow the advice mentioned below,

1. Maintain a strict diet, eat on time.

2. Avoid spicy, oily, and cold food or drinks.

3. Keep a gap of two hours between the meals and going to bed.

4. Do not overeat, rather keep your stomach half empty and have regular intermittent light food like fresh-cut fruits in between major meals.

5. Gargle with saltwater eight to 10 times a day for 15 days.

6. Avoid alcohol and smoking as it can potentiate reflux.

7. Try to maintain a left lateral position while sleeping to reduce the chance of reflux.

I suggest,

Tablet Pan-D (Domperidone and Pantoprazole) 40 mg, once in the morning before breakfast for one month.

Syrup Mucaine gel 1 teaspoon three times a day 20 minutes before each meal for one month.

Make sure you follow the precautionary measures as much as possible as mere medications will not fetch long-term relief.

Please understand that this typically takes four to six weeks for things to normalize and for symptoms to subside and chiefly depends on how much you have been able to follow the precautions mentioned above as 80 percent of the treatment lies there. Please make sure you avoid all possible trigger factors that are contributing to the issues you are facing.

I hope I have answered your query in detail. If there is anything more you need to know, please do let us know.

Warm Regards.


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