Nasal Allergies and Cough: When to See an ENT Specialist

Nasal, oral, and cough issues?

Hello, I have been experiencing nasal allergies for a long time, and in the past two to three years, it has become that whenever my menstrual period approaches, my nose starts to run excessively (clear mucus).
I find myself constantly blowing my nose and sneezing throughout the day, and my sinuses feel very itchy.
When it becomes unbearable, I take an antihistamine, but as soon as I do, after my nose feels relieved, I develop painful bumps on both sides of my nostrils that resemble pimples, which do not drain and are quite painful.
This then leads to severe coughing.
Additionally, inside my mouth, on both sides of my cheeks, the area that is usually smooth feels rough when I run my tongue over it.
When I shine a flashlight on it, it appears to have a texture similar to broken skin, but it is neither painful nor itchy, just rough.
If I seek medical attention, should I see an otolaryngologist or another specialist? Thank you.

yvonne, 30~39 year old female. Ask Date: 2016/05/02

Dr. Zheng Jueyi reply Otolaryngology

Hello, it is recommended to visit the ENT department for examination.
Wishing you safety and health.
Sincerely, Dr.
Cheng Jue-Yi, Director of the ENT Department, Taoyuan General Hospital, Ministry of Health and Welfare.

Reply Date: 2016/05/02

More Info

Nasal allergies can be a significant source of discomfort and can lead to a range of symptoms that affect daily life. Based on your description, it sounds like you are experiencing allergic rhinitis, which is characterized by symptoms such as a runny nose, sneezing, nasal itching, and post-nasal drip, particularly during certain times of the month, like your menstrual cycle. This pattern suggests that hormonal changes may be influencing your allergy symptoms, which is not uncommon.

When it comes to managing nasal allergies, it is essential to understand the underlying causes and appropriate treatment options. Allergic rhinitis can be triggered by various allergens, including pollen, dust mites, pet dander, and mold. In your case, the timing of your symptoms with your menstrual cycle may indicate a hormonal influence on your immune response, which can exacerbate allergic reactions.

The symptoms you describe, such as the clear nasal discharge, nasal itching, and the development of painful bumps on your nasal wings after taking allergy medication, suggest that you may be experiencing a combination of allergic reactions and possibly secondary infections or irritations. The bumps you mentioned could be a result of irritation from frequent nose blowing or could be related to the use of certain medications that may cause side effects.

Given the complexity of your symptoms, it is advisable to consult an Ear, Nose, and Throat (ENT) specialist. An ENT doctor can perform a thorough examination of your nasal passages and throat, potentially using endoscopy to visualize any underlying issues. They can also assess for conditions such as nasal polyps, which can develop in individuals with chronic nasal inflammation and allergies, and may require specific treatment.

In addition to seeing an ENT, you might also consider consulting an allergist. An allergist specializes in diagnosing and treating allergies and can perform allergy testing to identify specific triggers. This can help tailor your treatment plan more effectively, whether it involves avoiding certain allergens, using antihistamines, nasal corticosteroids, or other medications.

In terms of immediate management, here are some strategies you might consider:
1. Avoid Triggers: Identify and minimize exposure to known allergens. Keeping windows closed during high pollen seasons, using air purifiers, and regularly cleaning your living space can help.

2. Medications: Over-the-counter antihistamines (like cetirizine or loratadine) can help alleviate symptoms. However, if you notice adverse effects like the bumps you described, discuss this with your doctor. Nasal corticosteroids (like fluticasone) can also be effective in reducing inflammation and nasal symptoms.

3. Saline Nasal Rinse: Using a saline nasal rinse can help clear out allergens and mucus from your nasal passages, providing relief from congestion and irritation.

4. Stay Hydrated: Drinking plenty of fluids can help thin mucus and reduce post-nasal drip, which may alleviate coughing.

5. Monitor Symptoms: Keep a diary of your symptoms, noting when they occur and any potential triggers. This information can be valuable for your healthcare provider.

In conclusion, given your symptoms and their impact on your quality of life, seeking an evaluation from an ENT specialist is a prudent step. They can help determine the best course of action, which may include further testing, medication adjustments, or referrals to other specialists, such as an allergist, for comprehensive management of your nasal allergies and associated symptoms.

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