Nasal

Do your symptoms include:

  • Stuffy
  • Congestion
  • Itchy
  • Runny
  • Constant drip with throat clearing
  • Sinus pressure headache
  • Fatigue
  • Reduced or loss of smell

We can find your triggers and best treatment.

Nasal Problems

Nasal problems including hay fever and nonallergic rhinitis are among the most common medical problems.  Allergic rhinitis in fact may affect 30 to 40% of the population in the United States.  It is more common in children than in adults.  Although allergic rhinitis related to pollen exposure from the outdoors and indoor allergy exposures from mites, molds and animal dander constitute most of the cases; 35% of patients have nonallergic triggers as well including things like smoke, irritants, odors, particular air pollution that may trigger off symptoms. 

It is clear that nasal symptoms of hay fever and nonallergic rhinitis affect the quality of life and aggravate comorbid conditions like in the sinuses, ears and lungs that affect the quality of sleep and add to the significant amount of medical costs.  Patients oftentimes have loss of time from working, school or decreased productivity at the workplace or in the school environment as manifested by decreased learning.

Triggers

We divide causes of nasal stuffiness, congestion, drip, post nasal clearing and reduced smell into allergic and nonallergic triggers that are best defined by allergy skin testing.  Skin testing determines whether someone in fact has an underlying allergic predisposition.  Skin testing is the most accurate way of identifying allergic sensitization.  There are other causes of rhinitis including reactions to medications, exercise, cold air, after eating, infection, associated with hormonal changes like during pregnancy and during menstrual cycles, and oftentimes it can be related to drug use including abuse of nasal vasoconstrictors like Afrin, birth control, antihypertensive medicines, or medicines to improve urinary flow for prostate hypertrophy. 

Symptoms

Nasal symptoms may also be part of a more systemic  inflammatory immunologic disorder like granulomatous disease, Wegner’s sarcoid, midline granuloma, amyloidosis, thyroid disease, and relapsing polychondritis.  Thorough history and examination will oftentimes exclude these other conditions.  In addition, it is important to identify other considerations that may affect nasal symptoms including the presence of or absence of septal deviation, adenoid or tonsillar hyperplasia, nasal polyps, nasal tumors, intranasal foreign bodies, evidence of laryngopharyngeal or gastrointestinal reflux (when stomach reflux involves the upper esophagus, voice box, throat, and pharyngeal areas.) 

Treatment

History, physical exam, as well as diagnostic skin testing and upper endoscopy and at times CAT scans may be helpful in evaluation of patients.  Appropriately chosen patients for immunotherapy do extremely well over the long term with decrease in medication requirement, improving the symptoms and improving quality of life.  Sublingual immunotherapy is a new form of immunotherapy that is not as effective as conventional allergy immunotherapy but may have some role in some limited patients.  There are a variety of medication choices for patients who have upper respiratory allergies of seasonal and perennial nature including intranasal or oral antihistamines , intranasal steroids, combination of intranasal antihistamine and nasal steroids, intranasal cromolyn, intransasal decongestants, oral antihistamines with and without oral decongestants, leukotriene modifiers, and intranasal anticholinergic medications.  Oftentimes, we will have patients also use nasal lavages to help with clearance of mucus and improve deposition of some medications in the nasal airway.

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    POLLEN COUNT


    March 23, 2017

  • Trees: Very High

  • Grass: Not Seen

  • Ragweed: Not Seen

  • Other Weeds: Not Seen

  • Mold Spores: Moderate

  • Predominant allergen(s):Juniper/Cedar, Maple and Birch Tree Pollen

  • How do we count pollen?

Announcements:

Philadelphia & South Jersey's 2017 pollen season has started!

The Asthma Center • (215) 569-1111 • (856) 235-8282
205 N. Broad Street Suite 300 Philadelphia, PA 19107
©2016 THE ASTHMA CENTER, ALL RIGHTS RESERVED
The allergists and asthma doctors at The Asthma Center strive to provide the best allergy, asthma, immunology, and sinus care to patients using the latest diagnostic tools and treatment strategies. Our allergists are focused on fostering strong communication with patients and improving quality of life. We have decades of medical experience treating patients, and our allergists are recognized as Top Doctors and Super Doctors. Taking care of our patients is our top priority!