Nasal drip for over a year

[imeccentric]

I have had continuous nasal drip for over a year.  My sinuses are clear(Just came from an ent specialist who went in and looked).  I've tried at least 4 different antibiotics, 4sprays, etc. all with no change.  It is nearly impossible to  swallow and the coughing it is causing has caused me to tear the last nissan stomach surgery I had.  The ent said to go back to my regular Dr.(who, in my opinion)is less qualified for this.  About the same time as this started, my hematocrit dropped to around 35 so I am also taking iron (1000mg/day of iron sulfate and 1500mg vit C).  I am a 62 year old male in excellent health otherwise.  Had allergy testing done and was not allergic to anything.

[friggy]

What you may have (not 100% certain) is a chronic fungal infection, which can cause the post-nasal drip without other sinusitis problems.  A former Mayo Clinic researcher, Dr. Jens Ponikau, has a patent to find an anti-fungal spray, but it hasn't come to fruition yet.

The problem often lodges in the upper sinuses, where sprays and saline irrigation won't reach, due to gravity.  A Flip-Turn Sinus Flush often works:

http://www.medhelp.org/user_journals/show/2322

The Flip-Turn Sinus Flush is mildly risky, because you have to bend over to do it, preferably in a shower, but you can also do it outside on soft ground.  Or, go to the comment I made on July 13, 2009 on how to do a sit-up method.

Note that, in between my severe bouts of sinusitis, before I developed the flush, I would go for months at a time with just a post-nasal drip, like yours. Nowadays, my wife has to call my name, as she can no longer track me in the house by my coughing.

[ENTMD]

Well, I suppose one can't entirely rule out a chronic fungal infection with the information you have given, but this would seem unlikely.  You already said that and ENT doc looked in your nose/sinuses with a scope and didn't see anything.  Why would the next thought be a chronic infection that was inexplicably missed right in front of the doctors eyes??  Look, even with fungi, there is still inflammation and the signs of inflammation should have at least been observed.  Judging by what you said, they weren't.  (as an aside, there are reasons --- documented in the literature -- that suggest why Ponikau's irrigations are not widely used).

You did say some things that are strong clues suggesting an alternative diagnosis.  You have had a Nissen in the past and you have symptoms that are commonly associated with severe (laryngopharyngeal) reflux -- chronic cough and pharyngitis ("post-nasal drip" is commonly confused with this).  I would strongly encourage you to see a Gastroenterologist.

[imeccentric]

I belong to an HMO and have no say in who I see, but I do have a good Gastroenterologist..  About 4 months after this coughing started, I did tear part of my nissan apart(he went down in with a scope to verify part had been torn loose).  Unfortunately , they just keep referring me down the line, with waits up to 2 months to see anyone else.  I know I have torn even more of it loose just this last week(I can tell because of the lump in the throat, pain, and reaction to eating has changed).  I see him in 3 weeks to recheck my iron levels since I became anemic after tearing the nissan loose.  They are so overworked, they don't have time to spend on anyone who falls out of the norm , and most really don't listen to us anyway.  My first nissan lasted all of about 3 weeks before it came undone , and I've had nothing but trouble since the second was done(5 years of belching, pain, hiccups, eating solid food, nausea,  etc).  At least  the coughing tore enough to allow me to finally eat solid foods again:)   I appreciate the replies and will talk to my gastroenterologist again with the possibilities you raised.

[ENTMD]

Wow, that's a rough story.  Sorry to hear it.  Best of luck with the GI doc.