Continued nasal congestion

[tpfalcon]

Since just before Christmas I started getting nasal congestion every night. Sinuses would ache sometimes, didn't have a cold or anything before this started. I would drain sometimes and have a little bit of light green phlem or however its spelled. My doctor gave me an antibiotic on two occasions about 5 weeks apart. I would feel better but they have not cleared it up. The only relief I get is with nasal sprays and I have read these are not good to take long term. I would spray at night so I could sleep and it would be fine until the next day at night and I would get more nasal congestion, so I was using the spray once a day. I do live in the northeast and it has been a cold dry winter and have been using a humidifier for around 4 weeks now. Most of the time I feel absolutely perfect except for the nasal congestion, I don't lose sense of smell or taste. On the worse days I would have sinus aching, pressure and sometimes a headache but not often with the headache. Most of the time its just a very annoying nasal congestion. Thanks

[healthyobsessed]

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Dietmar

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[Sloane]

Just curious, do you get earaches or notice any difference in your congestion based on barometric pressure?

I started having chronic nasal congestion a couple of years ago. After several antibiotics, over-the-counter medications, Claritin, and Allegra failed to help, my doctor prescribed Claritin D, which is what finally did the trick. It's Claritin plus an extra decongestant, and it's over-the-counter now. It might be worth a try . . .

[Kevin Pho, MD]

Hello - thanks for asking your question.

There are several treatments for nasal congestion - however, it depends on the cause.  

You state two antibiotic courses - make sure that they cover the organisms responsible for bacterial sinusitis.  You may want to consider either plain sinus films or a sinus CT to document clearing.  

If your symptoms are due to allergic causes (i.e. allergic rhinitis), then the treatment would be different.  

You are correct that decongestant nasal sprays should not be used long term.  However, steroid nasal sprays - examples are Flonase or Nasacort (by prescription) should be first line in treatment.  Less effective are antihistamines such as Claritin, Zyrtec, or Allegra.  If these symptoms do not control the allergic symptoms, then a referral to an allergist for immunotherapy may be considered.

If the cause of the nasal/sinus congestion is still in question, then a referral to an ENT specialist is reasonable.  A scope to evaluate for nasal polyps or other anotomical abnormalities should be untertaken.  Surgical draininge of the sinuses is also another consideration if all medical options have failed.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Thanks,
Kevin, M.D.