Runny Nose and Coughing

For the last few years I have developed this coughing or heavy exhaling motion which I think it is due to my constant running nose.  I have gone through allergy testing which came out negative and 4 or 5 years ago an ENT specialist said it was sinusitis and after nasal wash and allergy medication like Claritin, no improvement. The strange part is the my nose is running during the day when I am active and busy but as soon as I lay down my nose dries up which stops the coughing. What can this be? I can handle the runny nose but the coughing is what is frustrating because it tiers me out. Any suggestions?

[Dr Rajput]

Hi, your symptoms are suggestive of chronic rhinosinusitis (ARS) which is a symptomatic inflammation of the nasal cavity and paranasal sinuses. It is commonly due to viral infection associated with the common cold. Otherwise it can be complicated by bacterial infection.

Firstly you need to undergo thorough physical examination; the blind swab or Endoscopic or sinus aspirate can be cultured to rule out secondary bacterial infection. Plain sinus films and sinus CT may show sinus fluid levels if present. You may have to undergo rhinoplasty if there is marked deviated nasal septum.

Usual treatment lining consists of following steps and mentioned drugs should only be taken after consultation from physician.
- Analgesics such as nonsteroidal anti-inflammatory and acetaminophen are recommended for inflammation relief.
- Mechanical irrigation with buffered, hypertonic saline nasal spray.
- Topical glucocorticoids (corticosteroids) or nasal spray.
- Topical decongestants, such as oxymetazoline for short term only.
- Antibiotics if bacterial infection suspected.

I suggest you to consult ENT specialist for further evaluation. Take care and regards.