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Doctors' Answers to "Frequently Asked Questions" - Nasal Problems

These comments are made for the purpose of discussion and should NOT be used as recommendations for or against therapies or other treatments. An individual patient is always advised to consult their own physician.

Nasal Congestion [posted 10/12/98]
Question: Are there any medications for nasal congestion that won't cause urinary retention?

Answer: Nasal steroids and nasal atrovent.

Nasal Passage Problems [posted 8/12/98]
Question: I have been experiencing problems with my nasal passages for the past two months or so. I have allergies, but they never act up until spring. Symptoms include new and dried blood discharge with regular mucus when I blow my nose, occasional very light irritation at the back of the throat I hardly ever notice, and sneezing occasionally. I don't have a cough, and don't seem to have the energy that I used too. Are these serious symptoms, and what could I possibly have? I looked into my nose with a magnifying lighted mirror and toward the far reaches that I could see were the bloody areas in the left nostril were. The right was not as bad.

Answer: Probably not, try some over the counter Intal nasal spray. Nasal steroids (prescription) may also help, but if they persist you need a formal examination.

Nasal Membrane
Question: I am a recovering substance abuser. I spent virtually everyday for three years high on Coke and/or Methamphetamine. I now have a hole in the middle of my septum that goes clear through from one nostril to the other. What kind of surgical procedure will fix this and is it absolutely necessary to have it done? Will I suffer the dryness and sinus problems I have now, if I choose not to have it fixed?

Answer: Septal perforation is quite common in cocaine uses. An ENT (Ear-Nose-Throat Specialist) physician can repair the damage if it is not too severe. This does not have to be done, however most patients will have chronic nasal congestion until it is repaired.

Post-nasal drip
Question: Is there any permanent treatment for post-nasal drip? I believe my post-nasal drip causes me to get the 'common cold' more often than I should and it makes them stay longer because my throat is constantly irritated. I also have sore throats often when I do not have a cold. At one point a doctor prescribed an antihistamine for the post-nasal drip which I took and it caused me to sleep for 16 hours straight! This of course was an unacceptable solution. I am a smoker and I realize that smoking is not good for the condition.

Answer: Post nasal drip is very common and also very irritating. Smoking and environmental exposure are a common cause. So are dry rooms. The most easily correctable cause is to humidify your house and place of business. Many antihistamines are sedating. Some of the newer ones like Claritin and Allegra are much less so. Also, if there is any allergic component, a nasal steroid may be helpful. Some medicines like clonidine and occasionally beta-blockers can cause a stuffy nose. Finally, your smoking is probably the biggest contributor.

"Clogged Throat"
Question: This problem wakes me at night as my throat becomes clogged with "phlegm" and at times have coughing bouts to clear it. Any suggestions as to what drug to take. I was diagnosed with "slight" hiatus hernia but this problem doesn't seem to interfere with quality of life.

Answer: I suspect that you are really having significant reflux causing your problem. Elevate the head of your bed four inches, avoid eating 2-3 hours before bedtime, minimize caffeine and nicotine. Also, over the counter medications like Zantac, Tagamet, Pepcid taken at bedtime will help. If you can lose weight it is probably the biggest help in improving reflux. If you continue to have reflux see your physician for additional medications.

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