Post Nasal Drip Causing Nausea?

[ERKstomach]

I will attempt to make this as short as I can but get info across.

I used to suffer from migraines and always had a filled sinus; doctors always thought it was a sinus infection until I wound up in the ER 12/2007 so sick.  The ER treated migraine and saw blocked sinus - sent me to an ENT.  ENT realized I had a chronic blocked sinus and did a sinuplasty surgery (basically going through my nose with a small tube to open up and drain the sinus) in March 2008 - migraines are much better - really just have an occasional bad headache or when sinuses are bad I get a bad headache / migraine but nowhere near as severe.

Fast forward - in fall of 2008 I began having stomach problems - nausea, cramping, some bloating, gas.  I went to my doctor, a surgeon and a GI doctor - had all kinds of stomach tests done and a colonscoopy - everything is fine (yay) but nothing explained the sickness.  Never threw up.

In the winter it was somewhat better for the most part.  In March it began again.  I started realizing that my sinuses were acting up again and I was having alot of post nasal drip.  I've been exploring that now and am looking to treat that to see if that will help my stomach problems.  I have posted on the GI forum and it seems others believe I might be on track with the post nasal drip thing so I thought I should post on here regarding this.

I am healthy, not overweight, exercise 4-5 times a week - eat a pretty good diet.  I went to an allergist last week - scratch test came back negative but allergist has me coming back next week for the more invasive shots test.  He agreed I have post nasal drip and that it can cause people a variety of problems.

I'm at a wall as to how to proceed here.  All stomach stuff is fine.  Allergist and others think I might be onto something regarding post nasal drip.

I am using a sinus rinse 2x a day and using a vaporizer.  Any help is really appreciated - thank you!!!

[ERKstomach]

Hello,

Thank you for getting back to me with your response, I greatly appreciate it.

When going through all of this 'stomach stuff' with my doctor, GI doctor, surgeon, etc. they all said no Crohn's, no IBS, no glucouse / wheat intolerance, no H-pylori (sp).  So I gather this is good news.

At the allergist last week he did tell me that it is quite common for people to get an upset stomach from PND (oh joy).  He found out that I have an allergy to mold and this entire weekend was a very bad weekend for me.  I was nauseated, headache, stuffy, and my stomach feels worse when I lay down as it all drains into the back of my throat into my stomach.

When I was at the ENT last about 6 weeks ago as a result of all of this he did another CT scan as he was concerned that perhaps the blockage that he opened up became blocked and everything looks 100% fine - no swelling, no blockage, etc.

I was at first suffering from sinusitus (sp) and I was having sinus infections that were often caused by allergies.  Now the ENT believes I am suffering from rhinitis (sp) from allergies since I complain of post nasal drip, my nose runs both into my throat and from my nose so he felt an allergist might be best.

I am still using the nasal rinse, and I also use a vaporizer, and I'm on a nasal spray to help the post nasal drip but this weekend truly has been miserable and today isn't great either based on the rain.

Thanks for your help hopefully I'll get this sorted out someday!

[National Jewish Health]

I was able to find only one reference to a possible relationship between chronic sinusitis and inflammatory bowel disease (see the following).  These are not uncommon diseases and so their occurrence together in this report does not demonstrate a cause and effect.  If there is, however, that might account for the abdominal symptoms occurring at a time contiguous with the flare-up of your sinus disease.  One form of inflammatory bowel disease, Crohn’s Disease, is limited to the small intestine about 1/3 of the time and so might not be evident on colonoscopy.  You might want to ask the GI specialist who did your colonoscopy if Crohn’s Disease or some variant of it might explain your abdominal symptoms.  The good new is that, “all stomach stuff is fine.”  If that truly is the case, you may not wish to pursue the issue of your abdominal symptoms any further, at this time.

I suspect that the original cause of your sinus disease, “blocked sinus” has recurred or is “acting up” and resulting in increased post-nasal drip.  You may need careful exam of your nose and sinuses and probably a CT Scan of your sinuses

Good luck

Reference:
TITLE: Chronic sinonasal disease in patients with inflammatory bowel disease.
AUTHORS:Book, David T. Smith, Timothy L. McNamar, Justin P. Saeian, Kia. Binion, David G. Toohill, Robert J.
INSTITUTION: Department of Otolaryngology and Communication Sciences, Medical College of Wisconsin, Milwaukee, Wisconsin 53226, USA.
SOURCE: American Journal of Rhinology. 17(2):87-90, 2003 Mar-Apr.
ABSTRACT:  
BACKGROUND: The objective of this study was to explore the possible relationship between inflammatory bowel disease (IBD) and chronic sinonasal disease.
METHODS: A cross-sectional study was undertaken of 241 patients with Crohn's disease (CD) or ulcerative colitis from a tertiary medical center IBD clinic. Patient demographic data and information regarding IBD diagnosis and management, sinonasal disease diagnosis and management, and complications related to these diagnoses were gathered by retrospective chart review and a standardized patient survey.
RESULTS: One hundred sixty surveys (67%) were returned and analyzed. Overall 48% of patients with IBD reported chronic sinonasal disease symptoms. Patients with CD had a higher prevalence of sinonasal disease than patients with ulcerative colitis (53% versus 32%; p < 0.02). The subgroup of CD patients with obstructive bowel complications had the highest prevalence of sinonasal disease (68% versus 27%; p = < 0.001), with 23% reporting chronic rhinosinusitis, 13% reporting chronic rhinitis, and an additional 32% reporting chronic nasal or sinus symptoms.
CONCLUSION: The prevalence of chronic sinonasal disease is elevated in patients with IBD, occurring in approximately one-half of patients followed at a tertiary IBD center. Patients with CD experiencing obstructive complications had significantly increased rates of sinonasal disease. The relationship between chronic sinonasal disease and obstructive CD is not defined, but several hypotheses are generated.