Which Specialist Should You See for Allergic Rhinitis and Breathing Issues?

Which department should I consult?

Hello Doctor,
1.
I have allergic rhinitis, and when I run, I feel very short of breath and dizzy.
If I run more than about 400 meters, I experience difficulty breathing, as if I can't get enough air.
It feels like the world around me is spinning, my vision becomes temporarily blurred, and I feel a sensation of congestion in my nose and throat.
My heart races, and it is very distressing.
Could you please explain the cause of this? Is it related to my allergic rhinitis? Thank you.
2.
When I have a bowel movement, I also feel very dizzy, and my heart rate increases.
What could be the possible factors contributing to this? Thank you.
3.
Regarding the two points above, do I need to see a doctor? Which specialty should I consult? Thank you.

Mingyue, 20~29 year old female. Ask Date: 2010/05/12

Dr. Wu Fangcan reply Family Medicine

1.
Allergic rhinitis often causes swelling and thickening of the nasal mucosa, leading to a narrowing of the nasal passages.
This can result in insufficient airflow during exercise, causing difficulty in breathing and potential hypoxia, which may lead to symptoms such as blurred vision and dizziness.
This is indeed related to allergic rhinitis and should be addressed by an otolaryngologist.
2.
When having a bowel movement, if the stool is hard and dry, straining can increase abdominal pressure, which may reduce blood flow back to the heart, resulting in dizziness and a rapid heartbeat.
It is recommended to consume more fruits and vegetables and stay hydrated to soften the stool and prevent this issue.
3.
For any concerns, it is advisable to first consult a family medicine physician.

Reply Date: 2010/05/12

More Info

When dealing with allergic rhinitis and associated breathing issues, it is essential to understand the underlying mechanisms and potential specialists who can provide the appropriate care. Based on your symptoms, it seems you are experiencing significant discomfort during physical activities, particularly running, and also during bowel movements. Let's break down your concerns and provide guidance on the next steps.

1. Symptoms During Exercise: The symptoms you describe—shortness of breath, dizziness, and a sensation of tightness in your nose and throat—can indeed be related to allergic rhinitis. Allergic rhinitis can cause nasal congestion, which may lead to difficulty breathing, especially during exertion. When you run, your body requires more oxygen, and if your nasal passages are blocked, it can lead to a feeling of breathlessness. The dizziness and blurred vision you experience could be due to a combination of hyperventilation (breathing too quickly) and reduced oxygen intake. Additionally, if you have underlying asthma, exercise can trigger bronchospasm, leading to similar symptoms.
2. Symptoms During Bowel Movements: Feeling dizzy and experiencing a rapid heartbeat during bowel movements can be attributed to several factors. Straining during a bowel movement can lead to increased pressure in the chest and abdomen, which might affect your heart rate and blood flow. This phenomenon is sometimes referred to as the "Valsalva maneuver," where straining can cause a temporary drop in blood pressure followed by a rapid increase in heart rate. If you have allergies or respiratory issues, the added strain might exacerbate your symptoms, leading to dizziness and a racing heart.

3. Seeking Medical Attention: Given the severity of your symptoms, it is advisable to seek medical attention. You should consider visiting an Ear, Nose, and Throat (ENT) specialist first, as they can evaluate your nasal passages and throat for any obstructions or inflammation caused by allergic rhinitis. They may perform tests such as a nasal endoscopy or allergy testing to determine the specific allergens affecting you.
If the ENT specialist finds that your symptoms are related to asthma or if they suspect that your breathing issues are more complex, they may refer you to a pulmonologist (a lung specialist) for further evaluation and management. A pulmonologist can conduct lung function tests to assess for asthma or other respiratory conditions.

Additionally, if your symptoms during bowel movements continue to be problematic, you might also consider consulting a gastroenterologist to rule out any gastrointestinal issues that could be contributing to your symptoms.

In summary, your symptoms are concerning and warrant a thorough evaluation. Start with an ENT specialist to address your allergic rhinitis and breathing difficulties. They can guide you on the next steps, including potential referrals to other specialists if necessary. Managing allergic rhinitis effectively can significantly improve your quality of life and alleviate the distressing symptoms you are experiencing during physical activities and daily routines.

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