Chronic Nasal Congestion: Allergy or ENT Issues?

Is it an allergy or a nasal issue?

Symptoms: I experience nasal congestion when lying down, and I am prone to catching colds around my menstrual cycle.
Once I get sick, I have to see many doctors and take a lot of medication before I slowly improve.
However, since November of this year, my nasal congestion has not improved significantly.
When I asked my doctor, he said that many people experience this due to seasonal changes, but I have this issue every year and it is difficult to recover, which is very bothersome for me.
This often prevents me from sleeping, and I also have to take care of my two-year-old and my child who is not yet three.
The doctor mentioned that due to long-term nasal congestion, something has thickened in my nose, and suggested trying medication first; otherwise, I might eventually need laser treatment at the hospital.
I am considering switching hospitals for a consultation, but I feel like a test subject.
It might also be because I have taken too many medications that my menstrual cycle has become irregular.

I would like to know which department and which doctor I should consult for examination and improvement.
If I develop allergies, what should I do? Are there medications for treating allergies? (I have seen some health products marketed through direct sales that claim to be miraculous, but they are expensive...) I am not working but often spend money on doctor visits, which costs me around five to six thousand a month; I can't afford that!
Duration: Symptoms start appearing every year during the change of seasons, and this year they have not stopped.
Additional information: I am 162 cm tall, weigh 55 kg, and I am female.
After giving birth last April, I caught a cold in the summer and saw multiple doctors without success.
I eventually turned to traditional Chinese medicine and was finally cured.
However, during the winter, I either have a cough or nasal congestion, and I have seen both Western and Chinese medicine.
I have also consulted a Chinese doctor again...
but since this winter, I have had nasal congestion for one to two months, and traditional Chinese medicine has not been effective anymore, so I saw a Western doctor (ENT).
However, after having my nose treated, I only felt better for two to three days, and since it was out-of-pocket, it was quite costly...
It is really frustrating; the treatments covered by health insurance have not worked, and some have had no effect at all!
Previously, it was difficult to care for my baby, and I often lacked sleep, sometimes not being able to sleep at all during the night.
Now my child is one and a half years old, but I often sleep only around three or four in the morning.
I might have gotten used to it and cannot exercise...
I do not smoke or drink alcohol, and before having my second child, I rarely had prolonged colds, but during my confinement period, my eyes and nose were extremely itchy, prompting me to go out to see a doctor...

f9032, 30~39 year old female. Ask Date: 2007/12/26

Dr. Jian Huangqi reply Otolaryngology

1.
Nasal congestion and coughing while lying down may be due to inferior turbinate hypertrophy.
You can come to my clinic for a detailed examination and treatment.
2.
It is covered by health insurance.

Reply Date: 2007/12/26

More Info

Chronic nasal congestion can be a frustrating and debilitating condition, especially when it interferes with sleep and daily activities. Based on your symptoms and history, it seems you may be dealing with a combination of allergic rhinitis and possibly other ENT-related issues. Let's break down your concerns and explore potential avenues for treatment.

Understanding Your Symptoms
1. Chronic Nasal Congestion: Your description of nasal congestion that worsens when lying down and is persistent throughout the year suggests that there may be underlying anatomical issues, such as nasal polyps or a deviated septum, in addition to potential allergies. The fact that you experience this congestion more acutely during certain times of the year (like during seasonal changes) indicates that allergies could be a significant factor.

2. Allergic Rhinitis: Given your history of frequent colds and the fact that your symptoms seem to flare up with environmental changes, it is plausible that you have allergic rhinitis. This condition is characterized by nasal congestion, sneezing, and runny nose due to allergens such as pollen, dust mites, or pet dander. The cyclical nature of your symptoms, particularly around your menstrual cycle, could also suggest a hormonal influence on your immune response.

3. Impact on Daily Life: The inability to sleep well due to nasal congestion, coupled with the demands of caring for young children, can lead to significant fatigue and stress. This cycle can exacerbate your symptoms, making it even more challenging to find relief.

Recommendations for Management
1. Consult an ENT Specialist: Since you have already seen multiple doctors without satisfactory results, it may be beneficial to seek a second opinion from an ENT specialist who has experience in treating chronic nasal conditions. They can perform a thorough examination, possibly including nasal endoscopy, to assess for structural issues like polyps or a deviated septum that may require surgical intervention.

2. Allergy Testing: If allergies are suspected, consider undergoing allergy testing. This can help identify specific triggers, allowing for targeted treatment. Once allergens are identified, you can work with your doctor to develop a management plan, which may include avoidance strategies and medications.

3. Medications: Over-the-counter antihistamines, nasal corticosteroids, and saline nasal sprays can provide relief from allergy symptoms. If you are not already using a nasal corticosteroid, it may be worth discussing with your doctor, as these can reduce inflammation in the nasal passages and improve airflow.

4. Lifestyle Modifications: Implementing certain lifestyle changes can also help manage your symptoms. Keeping your living environment free from allergens (like dust and pet dander), using air purifiers, and maintaining good humidity levels can be beneficial. Additionally, practicing good sleep hygiene and finding ways to manage stress can improve your overall well-being.

5. Consider Alternative Therapies: If conventional treatments have not been effective, you might explore alternative therapies such as acupuncture or herbal remedies, but be sure to discuss these with your healthcare provider to ensure they do not interfere with any medications you are taking.

6. Financial Considerations: Given the financial burden of frequent medical visits, consider discussing your situation with your healthcare provider. They may be able to suggest more cost-effective treatment options or refer you to community health resources that can provide assistance.

Conclusion
Chronic nasal congestion can stem from a variety of causes, including allergies and anatomical issues. A comprehensive approach that includes consulting an ENT specialist, undergoing allergy testing, and exploring medication options can help you find relief. Additionally, making lifestyle changes and managing stress are crucial components of your overall treatment plan. Remember, you are not alone in this, and with the right support and treatment, you can improve your quality of life.

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