Sinus drainage and phlegm in chest

[NM2004]

Hi, I have post-nasal drip from allergies.  My sinuses are really irratated and I am positive it is not an infection.  I take Astelin, Nasonex, Zyrtec, and Singulair everyday.  I am allergic to pseudoephedrin, aspirin, amoxicillan and erythromycin.  I now have build up in my chest and drainage affecting my throat and voice.  Besides expertorant and nasal wash, which I have been doing are there any other suggestions.  I am assuming this recent flare up is due to visiting my sister who has a dog I am allergic to, but I would appreciate any additional advice because this does occur when pollen counts are very high.  Thanks!

[National Jewish]

Postnasal drip is drainage from the nose and sinuses dripping down the back of the throat.  There could be several reasons for this drainage.  One reason is an allergy, like yours to dogs and pollen.  A second reason is a non-allergic, non-infectious irritation in the sinuses that can linger after a cold.  A third reason is chronic irritation of the sinuses.  Postnasal drip can cause a build up in the chest along with irritation of the throat and voice.

The fat content in dairy products can thicken mucus.  Generally eating dairy products with less fat content is helpful.  Drinking plenty of water will help to thin the mucus so that it moves more easily.  As long as you are not on a fluid restriction you should be drinking 6 to 8 8-ounce glasses of non-caffeine non-alcoholic fluid daily.

An antihistamine, like the Zyrtec® (cetirizine), can dry up the postnasal drip.  However, it may make the mucus thicker and more difficult to move.  A decongestant like Sudafed® (pseudoephedrine) can thin the postnasal drip and decrease the swelling so it drains easier.  A combination antihistamine-decongestant will do both.  Check with your doctor to see if Zyrtec-D® (cetirizine/pseudoephedrine), a combination antihistamine-decongestant, would help you more.  Often an antihistamine and decongestant are more helpful when taken on a regular basis like you are doing.  Singulair® (montelukast sodium) helps when the irritation is due to allergies.

A nasal wash helps remove mucus and germs from your nose and sinuses.  This can temporarily decrease the postnasal drip and lessen irritation.  It is most helpful when done daily before using any nasal spray.  A prescription antihistamine nasal spray, like Astelin® (azelastine), helps when the postnasal drip is due to allergies.  When the postnasal drip is thin and watery Atrovent® Nasal Spray (ipratropium bromide) may help to dry this up.  I did not see this noted in your list of medicines.  A prescription nasal steroid spray, like Nasonex® (mometasone), decreases mucus production by decreasing the inflammation of the nose and sinuses.  This may prevent the postnasal drip and irritation.  A nasal steroid spray does not provide immediate relief of symptoms.  It may require several weeks of routine use to become effective.  Sometimes it takes the antihistamine, the decongestant, and the nasal wash followed by the Atrovent® Nasal Spray (ipratropium bromide), and the nasal steroid spray ALL used routinely to keep the postnasal drip from bothering you.  Please read our Nasal Wash MedFact at http://www.nationaljewish.org/medfacts/nasal.html for more information about this technique.  Share this information with your doctor to see if you would benefit from this daily treatment.  Another suggestion to talk with your doctor about is switching one medicine at a time so that you try a different one than the one that you have been using in each of the different types of medicines.  By doing this you may be able to find one that works better for you.