Persistent Nasal Congestion: Seeking Solutions Beyond Western Medicine

Can't get over a cold?

Hello, doctor.
I have been experiencing thick but not severe clear nasal discharge in the nasopharyngeal area, along with persistent nasal voice.
I frequently feel the need to blow or sniff my nose to try to clear it, but since the amount is small, I often can't get it out.
However, the sensation of it being stuck in the nasopharynx is affecting my energy levels.
I feel a heaviness above my eyes and around my eyebrows, which is tiring and makes me want to sleep.
I have seen several Western doctors who only prescribed allergy medications, and my sinuses have not shown any signs of inflammation.
Unfortunately, there has been no improvement.
I have also consulted a few traditional Chinese medicine practitioners, but it seems there has been no effect.
As a result, even though I fall into a deep sleep every night, the quality of my sleep is poor.
Throughout the day, I feel dizzy and have blurred vision, similar to symptoms of sinusitis, but Western medical examinations have shown no issues.
I am unsure which direction to take for treatment.
Thank you.

JS, 40~49 year old female. Ask Date: 2019/06/13

Dr. Yan Sumei reply Traditional Chinese Medicine

Dear JS,
Thank you for your message.
The clear nasal discharge from the nasopharynx, persistent nasal voice, and heaviness around the eyebrows, along with the recurrent nature of your condition, suggest a possible nasal allergy.
Your symptoms seem to fluctuate, improving with medication but returning when not taken, which can indeed be quite distressing.
If the sensation of heaviness in your sinuses is causing discomfort and affecting your sleep, I recommend visiting a major hospital to consult with an otolaryngologist.
They may have more advanced techniques to help resolve your issues.
Wishing you health and peace!
Sincerely,
Yen Su-Mei
Department of Traditional Chinese Medicine
Nantou Hospital

Reply Date: 2019/06/13

More Info

Persistent nasal congestion can be a frustrating and debilitating condition, especially when it interferes with your daily life and sleep quality. Based on the symptoms you've described—thick mucus in the nasopharynx, nasal voice, and a heavy feeling in the forehead and eyes—it's clear that you're dealing with a complex issue that may not be fully addressed by conventional Western medicine alone.

Understanding Your Symptoms
Your symptoms suggest a few possible underlying conditions. Chronic nasal congestion can stem from several causes, including:
1. Allergic Rhinitis: This is a common condition where the nasal passages become inflamed due to allergens. Symptoms include sneezing, runny nose, and nasal congestion. If you have a history of allergies, this could be a significant factor.

2. Non-Allergic Rhinitis: This condition can be triggered by irritants like smoke, strong odors, or changes in weather. It can lead to similar symptoms as allergic rhinitis but without the immune response that characterizes allergies.

3. Chronic Sinusitis: Even if your doctors have ruled out sinusitis, it's worth noting that chronic sinusitis can sometimes present with minimal inflammation that doesn't show up on imaging tests. Symptoms can include nasal congestion, facial pressure, and post-nasal drip.

4. Structural Issues: Deviated septum or nasal polyps can obstruct airflow and contribute to chronic congestion. These conditions might not always be evident without specific imaging or endoscopic examination.

5. Vasomotor Rhinitis: This is a form of non-allergic rhinitis where the blood vessels in the nasal passages become overly reactive to various stimuli, leading to congestion and mucus production.

Treatment Options
Given that you've already explored both Western and traditional Chinese medicine without significant improvement, consider the following approaches:
1. Nasal Irrigation: Regularly using a saline nasal rinse can help clear mucus and allergens from your nasal passages. This can be particularly effective in managing symptoms of both allergic and non-allergic rhinitis.

2. Allergy Testing: If you haven't already, consider comprehensive allergy testing. Identifying specific allergens can help tailor your treatment plan, potentially leading to more effective management strategies.

3. Nasal Corticosteroids: If you haven't tried them yet, nasal corticosteroid sprays can significantly reduce inflammation in the nasal passages, providing relief from congestion and other symptoms.

4. Antihistamines: If allergies are a factor, non-drowsy antihistamines can help alleviate symptoms. However, if you find they are not effective, it may be worth discussing alternative medications with your doctor.

5. Lifestyle Modifications: Consider environmental changes that may reduce your exposure to allergens or irritants. This could include using air purifiers, avoiding known triggers, and maintaining a clean living space.

6. Consultation with an ENT Specialist: If you haven't seen an Ear, Nose, and Throat (ENT) specialist recently, it may be beneficial to do so. They can perform a thorough examination, including endoscopy, to assess for structural issues or other underlying conditions that may not have been previously identified.

7. Alternative Therapies: Some patients find relief through acupuncture or other holistic approaches. While the evidence is mixed, these therapies may provide symptomatic relief for some individuals.

8. Cognitive Behavioral Therapy (CBT): If your symptoms are exacerbated by stress or anxiety, CBT can help manage these feelings, potentially improving your overall well-being and sleep quality.

Conclusion
Persistent nasal congestion can be a multifaceted issue requiring a comprehensive approach to treatment. While Western medicine offers various options, integrating alternative therapies and lifestyle changes may provide the relief you seek. It's essential to work closely with your healthcare providers to explore all avenues and find a tailored treatment plan that addresses your specific needs. If symptoms persist, don't hesitate to seek a second opinion or further evaluation to ensure that all potential causes are being considered.

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