Allergic Rhinitis: Symptoms and Treatment Insights

Nasal allergies?

Hello Dr.
Zheng,
I would like to ask a question.
I have a history of nasal allergies, but my symptoms have not been as severe as they are now.
When I visited the clinic, I was experiencing intense sneezing and nasal congestion.
The clinic used a nasal irrigation device, and I produced an excessive amount of clear nasal discharge, using 5 to 6 tissues.
However, after the irrigation, my nasal discharge continued to flow, and I remained congested when I got home.
Even after finishing the medication, my condition did not improve significantly (I also have dark circles under my eyes).

Recently, I have been experiencing persistent nasal congestion on one side, and I often find myself sneezing uncontrollably.
When my nose is not congested, the discharge is clear, with occasional slight yellowish secretions (similar to dried nasal mucus).
Additionally, I have noticed that during the night, my nasal congestion becomes particularly severe, and I feel like there is mucus that needs to be expelled.

I have also observed that upon waking, the discharge from my eyes is particularly hard, and my eye sockets feel very dry, prompting me to rub my eyes.
Is this indicative of sinusitis? Furthermore, is the increasing presence of yellow nasal discharge a sign of a severe nasal cavity infection?

A-Ning, 20~29 year old female. Ask Date: 2016/04/13

Dr. Zheng Jueyi reply Otolaryngology

Hello, the symptoms still resemble allergic rhinitis.
If the symptoms are more severe, it is recommended to combine oral medications and nasal sprays for treatment.
Wishing you safety and health.
Sincerely, Dr.
Cheng Jue-Yi, Director of the Department of Otolaryngology, Taoyuan General Hospital, Ministry of Health and Welfare.

Reply Date: 2016/04/13

More Info

Allergic rhinitis, commonly known as hay fever, is an allergic reaction that occurs when your immune system overreacts to allergens in the air. This condition can lead to a variety of symptoms, which can significantly impact your quality of life. Based on your description, it seems you are experiencing a range of symptoms that could be associated with allergic rhinitis or possibly even a sinus infection.

Symptoms of Allergic Rhinitis
The symptoms of allergic rhinitis typically include:
1. Sneezing: Often occurs in bouts and is triggered by exposure to allergens.

2. Nasal Congestion: This can lead to difficulty breathing through the nose, which you mentioned experiencing.

3. Runny Nose: The nasal discharge is usually clear and watery, but can become thicker and change color if there is a secondary infection.

4. Itchy Eyes, Nose, or Throat: This is a common symptom that can accompany nasal symptoms.

5. Postnasal Drip: This occurs when mucus drips down the back of the throat, leading to a cough or sore throat.

6. Fatigue: Chronic nasal congestion can lead to poor sleep quality, resulting in fatigue and dark circles under the eyes.

Possible Complications
In your case, the presence of yellow nasal discharge and the sensation of nasal congestion could indicate a secondary bacterial infection, such as sinusitis. Sinusitis can occur when the nasal passages become blocked and fluid accumulates in the sinuses, creating an environment conducive to bacterial growth. Symptoms of sinusitis may include:
- Thick, colored nasal discharge: This can be yellow or green, indicating infection.

- Facial pain or pressure: Especially around the cheeks, forehead, or eyes.

- Reduced sense of smell: This can occur due to nasal congestion.

- Fever: Sometimes present in cases of bacterial sinusitis.

Treatment Options
1. Antihistamines: These can help alleviate symptoms of allergic rhinitis by blocking the action of histamine, a substance in the body that causes allergic symptoms.

2. Nasal Corticosteroids: These are effective in reducing inflammation in the nasal passages and can help with both nasal congestion and runny nose.

3. Decongestants: These can provide temporary relief from nasal congestion but should not be used for extended periods due to the risk of rebound congestion.

4. Saline Nasal Irrigation: This can help clear out mucus and allergens from the nasal passages, providing relief from congestion.

5. Allergy Shots (Immunotherapy): For long-term relief, allergy shots may be considered, especially if you have identified specific allergens that trigger your symptoms.

When to Seek Further Medical Attention
If your symptoms persist despite treatment, or if you experience severe facial pain, swelling, or fever, it is important to follow up with your healthcare provider. They may recommend imaging studies, such as a CT scan, to assess for any complications or structural issues in the sinuses.

In summary, your symptoms could be indicative of allergic rhinitis exacerbated by a possible sinus infection. It is essential to manage both the allergic component and any potential infection to achieve relief. If your current treatment is not effective, consider discussing alternative options with your healthcare provider.

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