Hi,

Thank you for your query.

1. Request your doctor to refer you to an ENT Specialist who can examine your nose and also do diagnostic nasal endoscopy. The appearance of the interior of the nose may give an indication of the cause for your perennial rhinitis. Ths helps differentiate acute allergy (purplish red mucosa) , chronic allergy (pale mucosa) and vasomotor (intrinsic) rhinitis (red mucosa), besides any physical obstructions.

2. There is no cure for allergy. To control or reduce the symptoms, avoidance of allergens and triggers is the best option. In case of non-specific or ubiquitous allergens or triggers, the best option is to take a trial of the following medication.

3. An anti-histamone (such as rupatidine, fexofenadine or levoctrizine), an anti-leukotriene (such as montelukast), a steroid nasal spray (such as mometasone, fluticasone or ciclesonide) and regular steam inhalation. All these should be taken once a day for at least two weeks. Always take medication under medical supervision.

4. If there is a good response, continue the medication in consultation with your physician. Discuss this with your physicians.

5. If the response to the trial of medication sis poor, get a plain CT PNS (Para Nasal Sinuses) with 1 mm coronal, axial and sagittal cuts done on a multi-slice CT Scan machine. This is the gold standard imaging for sinusitis.

6. If need be, you can upload the CT Scan images; I will be able to give you an accurate assessment. Allergic fungal sinusitis must be ruled out.

5. There are a few new options such as radio-frequency surface ablation of nasal turbinates (helps reduce allergic memory), co-ablation in addition to Balloon Sinuplasty which may help.

I hope that I have answered your queries. If you have any further questions, I will be available to answer them.

Regards.

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Hi,

Thank you for writing back.

You may follow up directly at bit.ly/Dr-Sumit-Bhatti

Wishing you good health,

Regards.

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