Question: My son has recurrent colds throughout winter(oct-feb, he is fine in the summer & the rest of the year)..his recent x-ray showed he has perihilar peribronchial thickening.He is 4 years old. He had bronchiolitis when he was 7months old. I am just worried..this time he had cold, I just looked inside his nose and his right nostril is fully blocked to the extent that no air can pass (his inferior turbinates are fully swollen)...using nasacort nasal spray but it isn't effective..Iam very concerned, couldn't get an ENT appointment until next month.Please help

Thank u for your answer.
1.Yes he gets his annual flu shot.
2.I give him 1 spray in each nostril once a day as he is only 3.5 yrs old.

Can u please elaborate on Perihilar Peribronchial thickening? Is that reversible? Does that really suggest of mild persistent asthma? Will it go away on its own?

Can u give Singulair & other anti-histamine as a combination?

His swelling inside the nose has subsided now.

Just want to have a right action plan before next winter starts...what do u suggest?

One last question I have is do the albuterol puffs or nebuliser usage regularly makes it habit forming? Which one is better to use for cough-nebuliser or spacer with MDI?

Thank you so much for the detailed answers Dr XXXXXXX

I have now uploaded my son's chest x-ray which was taken a month ago, can you please take a look at it and let me know your opinion. He had one taken in Dec 2015 which was clear (don't have a copy of it to upload). Also, this time I am writing in detail about my son's visits to the doctor.

I go to a regular Pediatrician and upon her advice I got my son seen by both a Pediatric Pulmonologist and also to an Allergy Specialist.

The Pulmonologist took the x-ray I uploaded and as discussed earlier suggested that he might have mild persistent asthma. She gave me an action plan which suggested usage of Flovent 44mcg 2 puffs twice a day for 2 months and the rescue inhaler Albulterol every 4 hrs as needed. Since I saw her, my son didn't have bad cough or wasn't wheezing so I just used albuterol as and when needed.

After that I went to an allergy specialist who did a skin prick test and suggested my son had allergic rhinitis like u mentioned and said he has mild sensitivity to cat, dog and dust. He advised nasal sprays and when my son has very bad coughs to use Q-var puffs.

After these two visits, I saw his regular pediatrician to get a correct action plan and by this time he came up with a new cold with mostly upper congestion in his nose which is always the case. So this time, she suggested to go check with an ENT for which I didn't get an appointment until next month.

His condition improved since usage of nasal spray with singulair and fexofenadine combination.

After reading your response last night, I was confused again. After reading the side effects of Flovent and in between doctors visits, I never bought it and made my son take it's puffs.

Since it is a month since that x-ray was taken and my son has only mild cold now no cough...do u still suggest me to start the Flovent now or should I wait for him to be seen by an ENT and then take a proper action plan with his regular Pediatrician's help?

Please advise. Also, my son is a very picky eater, to see him suffer with these colds and take lot of medications makes me feel helpless. Appreciate any advise on it too.

Thank you so much for your time and valuable input. Look forward to hearing from you.

1. I am not sure about the X-ray as only his dad was allowed in the x-ray with him & he thinks he might have moved while taking the x-ray. Usually he is very scared of the x-ray but this one they took with him standing & not lying down so he didn't cry buy might have moved.
2. We have no pets at home, I mentioned this in my earlier posts so didn't include that detail again.
3. We live in carpeted apartment & I tend to keep everything dust free & vaccum regularly. Since we live in US, we have heaters running in winter & there is lint accumulated around the vents.