What if your allergic symptoms are not controlled by nasal irrigation AND nasal steroids?
Unfortunately, many people still suffer with allergies even with maximum nasal irrigation and steroids. Additional symptoms of clear constant nasal dripping and drainage down the back of the throat can be annoying. Others may suffer from thick nasal mucus starting in the nasal cavity and draining into the throat. The thick secretions can be difficult to clear. Many people treat the excessive drainage with over the counter anti-histamines. However, an oral antihistamine pill circulates throughout the body, and for some patients the side effects are unpleasant. Another, option is local treatment, such as an antihistamine nasal spray or more effective is nasal irrigation with an antihistamine mixed into the irrigation. Local nasal sinus irrigation decreases the medication effect to the rest of the body. Some of our patients have found that normal saline irrigation and the antihistamine, Azelastine, is so effective, they have titrated the medication to very low levels and/or only use as needed.
The second allergic symptom noted i.e., thick nasal drainage can be very difficult to treat, even with nasal irrigation. Be sure, first and foremost, that you have adequate water intake. For most adults, this translates to 64 ounces of water a day. As we age, some patients have dryer nasal and oral mucosal surfaces; as well as thick post-nasal mucus. A simple anti-oxidant vitamin, Acetylcysteine, when formulated in a powder for nasal irrigation, has benefited many patients by decreasing the thickness (viscosity) of the mucus. Some patients, inadvertently, cause thick mucus by taking oral decongestants. Oral decongestants should be used cautiously, as they can also raise blood pressure.
As always, minimize your nasal medication usage to obtain the maximum clinical control of your allergies. Enjoy the great outdoors!