Persistent Runny Nose: Treatment Options for Sinusitis

Q: Persistent Runny Nose: Treatment Options for Sinusitis

Hello： If you continue to have clear nasal discharge or sneezing, it is often caused by allergic rhinitis. <br>If symptoms persist without improvement, it is recommended to continue follow-up visits for medication management. <br>Wishing you safety and health. <br>Sincerely, Dr.

Persistent nasal discharge?

On February 25th, I went out and caught a cold, resulting in a runny nose the next day.
After seeing two doctors without improvement, I bought medication from a pharmacy and took it for seven days, but there was no change, so I stopped seeking medical care.
On March 19th, I visited a different hospital, and on the 23rd, during a follow-up appointment, my symptoms had not improved.
The nasal discharge was slightly thicker and would drip down to my throat; when I examined it, it was clear.
Sometimes, I experienced frequent sneezing.
I would like to ask the doctor if sinusitis can improve with medication without surgery.
The medications prescribed on the 23rd were: 500 mg Amoxicillin, 200 mg Acetylcysteine, 50 mg Thiazide (stomach medication), 30 mg Ambroxol, and 10 mg Phenylephrine (0.5 tablets, four times a day), along with 10 mg Cetirizine to be taken at bedtime.

Jia You, 40~49 year old female. Ask Date: 2018/03/25

Dr. Zheng Jueyi reply Otolaryngology

Hello: If you continue to have clear nasal discharge or sneezing, it is often caused by allergic rhinitis.
If symptoms persist without improvement, it is recommended to continue follow-up visits for medication management.
Wishing you safety and health.
Sincerely, Dr.
Cheng Jue-Yi, Director of the Department of Otolaryngology, Taoyuan Hospital, Ministry of Health and Welfare.

Reply Date: 2018/03/25

More Info

Persistent runny nose and sinusitis can be quite bothersome and may significantly impact your quality of life. Based on your description, it seems you have been experiencing symptoms consistent with sinusitis, particularly with the presence of thickened nasal discharge and post-nasal drip. Let's break down your situation and discuss treatment options.

Understanding Sinusitis
Sinusitis is an inflammation of the sinus cavities, which can be caused by infections (viral, bacterial, or fungal), allergies, or other factors. Symptoms often include nasal congestion, runny nose, facial pain or pressure, reduced sense of smell, and sometimes fever. In your case, the persistent runny nose, sneezing, and post-nasal drip suggest that you may be dealing with either acute or chronic sinusitis.

Treatment Options
1. Medications: The medications prescribed to you are quite standard for treating sinusitis:
- Antibiotics (Amoxicillin): This is typically prescribed if a bacterial infection is suspected. It's important to complete the full course even if you start feeling better.

- Mucolytics (Acetylcysteine): This helps thin mucus, making it easier to expel.

- Ambroxol: This is another mucolytic that can help with mucus clearance.

- Phenylephrine: A decongestant that can help relieve nasal congestion.

- Cetirizine: An antihistamine that can help reduce allergic symptoms and nasal discharge.

2. Nasal Irrigation: Using saline nasal sprays or performing nasal irrigation (like a neti pot) can help clear out mucus and allergens from your nasal passages.

3. Steam Inhalation: Inhaling steam can help soothe irritated nasal passages and loosen mucus.

4. Avoiding Triggers: If allergies are a contributing factor, identifying and avoiding allergens (like dust, pollen, or smoke) is crucial.

5. Rest and Hydration: Ensuring you get enough rest and stay hydrated can support your immune system in fighting off infections.

When to Consider Surgery
Surgery is generally considered when:
- Symptoms persist despite extensive medical treatment (usually after 12 weeks of conservative management).

- There are anatomical issues (like nasal polyps or a deviated septum) that contribute to chronic sinusitis.

- There are recurrent infections that significantly impact quality of life.

In your case, if the medications do not lead to improvement within a reasonable timeframe, it may be worth discussing further diagnostic options, such as a CT scan of the sinuses, to evaluate for any underlying structural issues.

Follow-Up
Since you have already seen multiple doctors without significant improvement, it might be beneficial to consult an ENT specialist who can provide a more thorough evaluation and possibly recommend further treatment options. They may also consider allergy testing if allergies are suspected to be a contributing factor.

Conclusion
In summary, while many cases of sinusitis can be managed effectively with medications and home care, persistent symptoms warrant further evaluation. If you do not see improvement with the current treatment plan, do not hesitate to seek a second opinion or further evaluation from a specialist. Your health and comfort are paramount, and there are various avenues to explore for relief.

Similar Q&A

Chronic Nasal Congestion and Ear Issues: Seeking ENT Treatment Options

Dear Dr. Chi, I have been experiencing nasal congestion and runny nose every day for the past 20 years, and my symptoms worsen with even a slight cold, leading to recurrent otitis media and sinusitis. I have undergone surgery for sinusitis once and regularly use decongestant nasa...

Dr. Ji Zhaoyun reply Otolaryngology
Hello Mr. Wu, Common symptoms of sinusitis include nasal congestion, yellow-green nasal discharge, fever, facial pain, foul odor, and changes in smell, although not all symptoms may be present. Diagnostic methods include endoscopy and imaging studies. If acute sinusitis persist...

Understanding Nasal Congestion: Causes, Treatments, and Surgical Options

Hello Dr. Tsai: I have had nasal congestion issues since childhood, and I often experience a runny nose (especially in the morning). I have undergone many medical examinations, and most doctors have diagnosed me with sinusitis. My 7-year-old child has similar symptoms. I have pur...

Dr. Cai Zhenggu reply Otolaryngology
Hello MAO: Based on the symptoms you described (nasal congestion and runny nose in the morning), it appears to be allergic rhinitis rather than sinusitis. Allergic rhinitis does not require surgery; it can be improved with nasal sprays in conjunction with oral medications. Respon...

Persistent Nasal Discharge in Children: Causes and Treatment Options

Hello, my daughter is in the fourth grade this year and has been suffering from nasal allergies for a long time. However, medication has not been effective, and she has a runny nose every day, sometimes thick and sometimes thin, and occasionally has a phlegmy sound. No matter wha...

Dr. Zheng Jueyi reply Otolaryngology
Dear Xiao Mei, Hello. If your allergic rhinitis problem persists without improvement, it is advisable to seek medical evaluation to determine if it has progressed to chronic sinusitis. If it is merely a case of nasal allergies, it is recommended to continue long-term medication ...

Understanding Persistent Nasal Symptoms: Allergies and Treatment Options

Hello Dr. Zheng, My wife has always been healthy and rarely had any major issues, even catching colds infrequently. However, in recent years, she has suddenly started experiencing frequent runny noses, using dozens of tissues in a single day. She has seen doctors, and while medi...

Dr. Zheng Jueyi reply Otolaryngology
Dear Lao Yue: It is recommended to seek medical examination to determine if it is allergic rhinitis or chronic rhinitis. Most cases can be treated with oral antihistamines or nasal sprays, and symptoms such as runny nose and sneezing should see significant improvement. Wishing yo...