Hi

Thanks for the query

There are various reasons to get a lancinating type of pain in the throat, and the commonest of them are ulcer in the throat and granular pharyngitis.

According to the description given by you, the probable causes of the sharp pain could be:
1. The post nasal drip secondary to allergic nasal condition causing granular pharyngitis

2. The antihistaminic you are taking to get rid of the nasal allergy - which has the propensity to cause dryness of the throat and thus irritation

3. An ulcer in the throat

Only after examining the throat thoroughly, the exact cause of this problem can be found out. And it would be a bit difficult task for a GP to diagnose the most probable cause of your problem. Hence, it is better to consult an ENT specialist for the same. Till then, drink plenty of warm water; avoid those food stuffs which can cause pain, avoid salt gargles as this can further worsen your throat problem. I would also suggest you to use antihistaminic only when required.

Hope I have answered your query; I will be available for the follow-up queries.

Regards
Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon

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Hi,

Thanks for writing back.

Yes, you are right; Mouth breathing can cause dryness of the mucosa of the throat causing pain. Snoring is due to blockage of the nose secondary to nasal allergy and once the nasal stuffiness is relieved, eventually the throat problem will get resolved.

You can try using steroid nasal spray to decongest the nose and relieve the nasal allergy. This will also minimize the use of antihistaminic. Also, do steam inhalation 3-4 times a day, with this the nasal block will be relieved and mouth breathing can be avoided.

Wish you good health

Regards
Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon

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Hi,

Welcome back.

To be XXXXXXX doctors do not recommend the use of lubricating throat spray as the treatment for snoring. The aim is the treatment of the cause. There are various other factors which need to be followed that can help in reducing the snoring.

1.     Breathing problems can raise the risk of snoring; stuffy nose caused by a cold or allergies has to be treated
2.     Avoid using alcohol and medicines like sleeping pills or tranquilizers
3.     Quit smoking if any.
4.     Eat sensibly and exercise
5.     Sleep on one side of the body rather than on your back
6.     Regular sleep patterns help you sleep better and more restful sleep may reduce snoring
7.     Do steam inhalation every night before going to bed.
8.     Drink plenty of warm water

If all the above methods fail, then consult an ENT specialist for expert management.

Regards
Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon

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Hi

Thanks for writing back

Please don’t use Oxymetazoline nasal spray, it is not recommended for your condition. You are suffering from Allergic rhinitis for which you would require a steroid nasal spray (such as Fluticasone/Momentasone) and an antihistaminic. In the initial days of treatment antihistaminic has to be taken continuously and after a week or ten days it can be used only when required. Oxymetazoline will worsen your nasal problem and can lead to a condition called Rhinitis Medicamentosa if used for more than 5 days.

My suggestion to you is to consult a good ENT specialist and request for the above nasal spray.

Take care

Regards
Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon

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Hi

Welcome back

Fluticasone is one of the potent steroidal nasal spray, you need to use it for at least 4-5months and alongside you can use an antihistaminic (such as Fexofenadine or Levocetrizine). Antihistaminic has to be used initially for a week or 10 days continuously and later on to be used only when you are having allergic symptoms like sneezing, running nose, nasal stuffiness, etc.

It is better to consult your doctor for the appropriate dosage (which depends upon the nasal findings) and tapering of the steroidal nasal spray. Remember! Steroid nasal spray should not be stopped suddenly; it has to be tapered before stopping it.

Wish you good health

Regards
Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon

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Hi

Cetrizine is a fourth generation antihistaminic and even though it is claimed to be a non-sedating antihistaminic, some people do experience some amount of drowsiness. Also, the newer generation antihistaminic such as Fexofenadine or Levocetrizine is more potent than Cetrizine and causes almost no sedation.

It is very unusual to have nasal congestion following the use of steroid nasal spray (Fluticasone). It should be preferably used in the morning hours as soon as you get up from the bed and the oral antihistaminic needs to be taken in the night only before going to bed.

If you still continue to have nasal congestion following steroid nasal spray, then you would require a short course of oral steroids till the action of the nasal steroid takes over. Also, do steam inhalation 2-3 times a day, which gives excellent relief from the nasal congestion.

Hope this answers your query. Please accept my answer in case you have no follow up queries.

Wish you good health.

Regards.
Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon

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Hi

Thanks for writing back

Antihistaminic medicines block the production of histamine and reduce the allergic symptoms (sneezing, runny nose and watery and itchy eyes).

Histamine is a chemical released from the cells of the body (such as mast cells, basophils, etc.), in response to an allergen (such as dust, dander, pollen, smoke, etc.). When this histamine is released by the cells in the nose and eyes, it results in allergic symptoms like sneezing, runny nose, itchy eyes/nose and nasal congestion.

Antihistamine blocks the histamine receptors in the nose and halts the allergic symptoms. Antihistamines are the most commonly used medications to treat allergic rhinitis. Antihistamines begin to provide relief in 30 minutes to 2 hours. Antihistamines do dry up the runny nose caused by nasal allergy.

Topical corticosteroids are currently the most potent medications available for the treatment of allergic rhinitis. It helps in inhibition of allergen induced mediator release and reduces the allergic symptoms.

Hence, both the drugs act synergistically to reduce the prodromal symptoms, nasal allergy and inflammation of the nasal mucosa. Initially both are given together in order to control the acute symptoms, once this is controlled, steroid nasal spray alone will suffice in controlling the allergic related symptoms and should be used as prophylactic treatment. But sometimes when the symptoms are not controlled with steroids alone, you have to use either antihistaminic or mast cell stabilizers to suppress the allergic mediators.

Regards
Dr. Naveen Kumar N
ENT and Head & Neck Surgeon

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