Persistent Nasal Congestion and Sore Throat: Seeking Effective Solutions

Nasal congestion and throat issues that won't improve?

Hello Doctor, I would like to inquire about my issues with nasal congestion and sore throat.
I have a history of nasal allergies, but I have never experienced nasal congestion for this long; it has been almost three months.
I have visited several clinics without improvement.
During this time, I have had some runny nose, but it occurs infrequently and is not continuous.
Currently, the doctor diagnosed me with allergic rhinitis and prescribed me a chronic medication, but it doesn't seem to be very effective.

In early August, I started feeling a slight itch and mild pain in my throat.
After seeing a doctor, it improved a bit, but then I began to feel like something was stuck in my throat when swallowing.
A few days later, I started experiencing dryness and some pain.
One doctor suggested that my thyroid might be enlarged and recommended an endoscopy, but another doctor said it wasn't necessary and that I just had pharyngitis, advising me to drink more water.

I moved from Neihu, Taipei to Zhubei, Hsinchu at the end of June this year.
My nasal congestion started on May 23, and I had a COVID-19 test in mid-June, which was negative.
I would like to ask the doctor if further testing is necessary.

Zhuang Xiansheng, 20~29 year old female. Ask Date: 2021/08/14

Dr. Ji Zhaoyun reply Otolaryngology

Hello, regarding allergic rhinitis, there are several important concepts: the individual's constitution and environmental allergens and irritants are the main triggering factors.
If one parent has allergic rhinitis, the likelihood of the child developing allergic rhinitis is four times higher.
The most common allergen is dust mites, followed by animals, insects, molds, and pollen.
Recently recognized fine particulate matter (PM2.5) is also an important irritant.

Treatment typically starts with oral medications and nasal sprays, and surgery may be considered if necessary.
The primary medications include oral antihistamines and intranasal corticosteroid sprays used in combination.
Depending on the situation, local antihistamines/vasoconstrictors or oral leukotriene receptor antagonists may also be used.
If symptoms do not improve with medication and there is significant structural obstruction, such as a deviated septum, enlarged inferior turbinates, or nasal valve narrowing, appropriate surgery can be performed to improve the condition.
Recently, minimally invasive surgical techniques have been developed, which require shorter operation times and do not necessitate hospitalization, making them widely applicable.
To avoid allergens and reduce irritants, wearing masks, maintaining a good home environment, regularly cleaning bedding, avoiding extreme temperature/humidity changes, and reducing outdoor activities during severe PM2.5 air pollution are key points for daily care.
Although allergic rhinitis can be bothersome, with appropriate medications or combined surgery, and by avoiding allergens and irritants as much as possible, it can be well-controlled, significantly improving the quality of daily life and making academic and work tasks easier to manage.
As for the throat condition you mentioned, it could be chronic pharyngitis.
It is advisable to seek medical attention for laryngoscopy (to rule out any masses) and medication treatment.
In addition to medication, daily lifestyle recommendations include avoiding lying down for two hours after eating and steering clear of coffee, tea, cigarettes, alcohol, fried foods, and spicy foods, as these can help improve symptoms.
Lastly, regarding your situation: "I moved back to Zhubei, Hsinchu from Neihu, Taipei at the end of June this year.
My nasal congestion issue started on May 23, and I had a COVID-19 test in mid-June, which was negative.
I would like to ask the doctor if I need to be tested again." It is recommended that if you have concerns, it is best to seek a medical examination.
Wishing you peace and health.

Reply Date: 2021/08/14

More Info

Persistent nasal congestion and sore throat can be quite distressing, especially when they linger for an extended period, as you have experienced. Based on your description, it seems that you are dealing with allergic rhinitis, which can lead to nasal congestion, post-nasal drip, and throat discomfort. Here’s a comprehensive overview of potential causes, treatments, and recommendations for your situation.

Understanding Your Symptoms
1. Nasal Congestion: This is often caused by inflammation of the nasal mucosa due to allergens, irritants, or infections. In your case, since you have a history of nasal allergies, it is likely that allergens are exacerbating your symptoms. Common allergens include pollen, dust mites, pet dander, and mold.

2. Sore Throat: The sensation of having something stuck in your throat, along with dryness and pain, can be attributed to post-nasal drip, which occurs when mucus accumulates in the back of the throat. This can irritate the throat lining, leading to inflammation and discomfort.

3. Duration of Symptoms: The persistence of your nasal congestion for nearly three months suggests that there may be an underlying issue that needs to be addressed. Chronic nasal congestion can lead to complications such as sinusitis, which may require different treatment approaches.

Recommended Treatments
1. Allergy Management: Since you have been diagnosed with allergic rhinitis, it is crucial to manage your allergies effectively. This can include:
- Antihistamines: These medications can help reduce allergic reactions and relieve symptoms. If the prescribed medication is not effective, consult your doctor about trying different antihistamines or adjusting the dosage.

- Nasal Corticosteroids: These are often more effective than antihistamines for nasal congestion and can help reduce inflammation in the nasal passages. Ensure you are using them correctly for optimal results.

- Saline Nasal Irrigation: Rinsing your nasal passages with saline solution can help clear mucus and allergens, providing relief from congestion.

2. Hydration: Staying well-hydrated is essential, especially if you are experiencing throat discomfort. Drinking plenty of fluids can help keep your throat moist and may alleviate some of the irritation.

3. Avoiding Irritants: Identify and minimize exposure to potential irritants such as smoke, strong odors, and pollution. This can help reduce inflammation and improve your symptoms.

4. Consultation with Specialists: If your symptoms persist despite treatment, consider consulting an ear, nose, and throat (ENT) specialist. They may recommend further evaluation, including imaging studies or allergy testing, to identify specific triggers or underlying conditions.

5. Throat Care: For your sore throat, consider:
- Throat Lozenges: These can provide temporary relief from throat pain.

- Humidifiers: Using a humidifier in your home can add moisture to the air, which may help soothe a dry throat.

When to Seek Further Evaluation
Given that your symptoms have persisted for three months, it may be beneficial to undergo further evaluation. If you experience any of the following, seek medical attention promptly:
- Severe or worsening symptoms
- High fever
- Difficulty swallowing or breathing
- Persistent pain that does not improve with over-the-counter treatments

Conclusion
In summary, your persistent nasal congestion and sore throat are likely related to your history of allergic rhinitis. Effective management of your allergies, along with supportive care for your throat, is essential. If your symptoms do not improve with current treatments, consider seeking further evaluation from a specialist. Remember, addressing the underlying cause of your symptoms is key to finding relief.

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