Symptoms of postnasal drip, congestion, and runny nose are typically classified as symptoms of rhinitis. It can either be seasonal or perennial (year-round). These symptoms by themselves are not necessarily a sign of an allergy. This is important because assuming that these are allergic in nature can lead to incorrect treatment decisions. Although allergy is a common cause, these signs and symptoms can be due to other more chronic diseases such as a chronic sinus infection. It is also common that anatomic abnormalities can lead to exacerbation of these symptoms and without their correct identification and correction symptoms will not improve despite even aggressive medical management.
Dr. Jerome Hester is an ear, nose, and throat specialist with decades of experience. He takes a comprehensive approach with every patient, always assessing the entirety of the symptoms and performing a thorough anatomic inspection of the nasal passages and sinuses as well as a complete history of the individual’s symptoms in order to create a personalized treatment plan. As mentioned, these symptoms can be signs of a chronic sinus infection. You may visit our post, Why Sinusitis Keeps Coming Back, to learn more.
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Rhinitis Overview
Inflamed sinus and nasal passageways are hallmarks of rhinitis and they lead to a list of
common symptoms that include:
- Congestion
- Stuffiness
- Decreased smell and taste
- Runny nose
- Postnasal drip
- A sore throat that is secondary to the postnasal discharge
- Snoring
- Sneezing
- Coughing
- Headache
- Nasal itch and irritation
- Watery eyes
Allergic Rhinitis
Allergic rhinitis is a disease process where the aforementioned signs and symptoms are caused by an environmental or dietary allergy. Many times this can be identified by visiting an allergist and in Dr. Hester’s evaluation, if he deems this to be necessary and it has not been completed, this referral will be made. However, even in those cases of allergic rhinitis sometimes more conservative management can identify and avoid those causes.
These can be triggers such as:
- Pets (cat and dog dander)
- Seasonal allergies
- Dust
- Grass and pollen(particularly when outdoors doing yard work, mowing the lawn, etc.)
- Mold/mildew spores (often an issue here in the Bay Area where the climate can be damp)
- Dietary sensitivities
If identification and avoidance are not successful, the use of a nasal rinse is a simple way to improve symptoms. One may use simply normal saltwater by mixing a tablespoon of table salt with an 8-ounce glass of tap water and irrigate the nose 1 to 2 times a day. There are premade dispensers for this kind of irrigation or a simple bulb syringe can be used. This mechanism works by simply flushing the nasal cavity clear of any irritants or allergens that may have entered the nasal cavity, therefore not allowing them to caused inflammation. It is unlikely to be curative of the problem but can be a simple way to improve one’s symptoms.
Medications can also be used. These include over-the-counter antihistamines, nasal steroid sprays, and other prescription nasal sprays that are aimed directly at decreasing drainage. Although these may be effective, they typically require constant usage during the period of time that the patients have symptoms. If, in fact, the symptoms are present year-round, this would mean that the patient is on these drugs constantly. Although overall fairly safe, any medication can have side effects and it is important for the patient to either consult their physician or certainly read the package insert for the over-the-counter.
The second subset of rhinitis is non-allergic rhinitis which is also commonly called vasomotor rhinitis. There are many theories for the cause of this underlying disorder, but in this case, the patient may have all the symptoms that we have mentioned of rhinitis but, in fact, even if they pursue allergy testing no allergen can be found. Treatments are commonly the same as the use of nasal irrigations, over-the-counter antihistamines and nasal sprays, and prescription nasal sprays. However, success in this disorder is generally even lower than that of allergic rhinitis.
Recently, there have been two new procedures developed that are safe and effective office-based and treat both allergic and non-allergic rhinitis. The Clarifix procedure uses cryotherapy (cold therapy) while the RhinAer uses radiofrequency (heat therapy) to treat a location in the posterior aspect of the nasal cavity that controls the production of congestion and drainage in both types of rhinitis. Both techniques can be done under topical anesthesia in the office with no sedation and allow the patient to resume their normal activities essentially immediately. Effectiveness has been shown to be very high with minimal or no side effects. These procedures also can be done in conjunction with allergy treatment to improve symptoms even further. If you are interested in either one of these procedures you may make an appointment with Dr. Hester to discuss each treatment in great detail to see if it is appropriate for you and the potential benefits to your overall health.
More significant anatomic issues can also worsen symptoms of rhinitis. A deviated septum can cause blockage of the nasal cavity which when added to congestion and drainage makes breathing even worse. In many patients even marked improvement in congestion and drainage with medications or rinses is not enough to allow airflow through their nose. The underlying anatomic abnormality must be corrected in order to maximize nasal breathing. Other structures such as turbinates in the nasal cavity and the nasal valve which is also part of the internal nasal airway can cause an abnormal narrowing and can be treated. Many of these treatments are also simple treatments that can be done in the office and result in a marked improvement in nasal breathing and overall health.
Finally, when a patient has significant nasal obstruction and drainage and does not respond to conservative management the possibility that a chronic sinus infection is actually the underlying cause of these issues cannot be missed. Even without the more typical symptoms of sinus infections such as facial pain, pressure, or fever, a sinus infection can simply linger and cause congestion and drainage. If after a thorough evaluation it is thought that sinus disease could be a cause, diagnostic procedures will be recommended by Dr. Hester to fully evaluate the situation and lead to a treatment plan.
Make Your Appointment Today
Dr. Hester and his friendly staff are ready to diagnose and treat your rhinitis successfully. Contact us online to schedule an appointment or give us a call at (650) 268-5133. Dr. Hester will take his time to provide a thorough assessment of your medical history and current symptoms as well as a complete examination of your nasal passages and sinuses. Isn’t it time you breathe easily again? We’re here to make it happen.