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Thursday, May 23, 2013
Allergies to cold weather
Hi I have bad nasal polyps and sinusitis for past 15 years. I had two surgeries for plolyps and now my ENT doctor suggest me to go for another surgery. I went to an allergist and she told me that you don`t have any allergy but when my last surgery done, doctor tols me that your allergy level in blood is high (I don`t understand what this mean). When it`s cold out there, I feel very bad sinus pressure and headace stuffy nose. One interesting thing which I noticed that when I got pregnant all symptoms went away and I can breathe through nose and small things, but when it`s over, it came back. Same situation noticed in my second pregnancy. What I wanted to know that why my polyps come bakc so fast instead of using steroid nasal spray (Beconaze) and antihistamine tablets also using sinus rinse, and secondly is there any relation between hormomal changes and sinusitus becuase in my menstrual periods this condition gets worse. Third question, is there any other thing which I can do to control my syptoms instead of another surgery. Please give me answer of my question. Thanks.
Nasal polyps are a chronic debilitating problem of the sinuses. The cause is unknown but thought to be virally mediated. Studies have shown that the surgical approach is not any better than the medical approach; as you can attest, the polyps often come back and unless they are effectively managed will continue to cause problems. Allergies are not a cause of nasal polyps; more people with nasal polyps are non-allergic than allergic. Testing by an allergist is quite different than that performed by an ENT doctor. The ENT doctor's testing tends to lead to more falsely positive tests. Not knowing the doctors you are seeing, I would probably rely more on the allergist's testing.
To answer your question regarding hormonal influences on chronic rhinitis; yes, hormones can increase congestion. Patients on oral contraceptives tend to get more congested. Interestingly, pregnant women with rhinitis 1/3rd of the time get better, 1/3 of the time get worse and 1/3rd of the time stay the same.
Finally, I would recommend you have a consultation with a board certified allergist experienced in the management of chronic nasal polyps. Depending on where you live, you could be seen by us in Cincinnati. Otherwise, you can go to the American Academy of Allergy Asthma and Immunology to find an allergist and try to find someone who medically manages nasal polyps aggessively.
Jonathan Bernstein, MD
Associate Professor of Medicine
College of Medicine
University of Cincinnati