Since I discussed H2RAs, I thought I’d delve into its sibling medication, H1RAs, which are generally referred to as antihistamines. These are the meds that you take when you have an allergy resulting in a histamine release that might cause runny nose, congestion, coughing, sneezing, itchy/watery eyes, hives, etc. (Of course, if you have difficulty breathing and throat swelling, use an Epi pen/go to the ER.)They are divided into the first and second generation namely based on their FDA approval dates, but they also tend to have some different aspects associated with each grouping.
The OGs (1st Gen) cross the blood-brain barrier, so they have the most noticeable drowsiness effects but also potentially stronger effects on blocking histamine in multiple areas of the body (GI tract, blood vessels, respiratory tract). They are also less specific to bind only to histamine receptors so they can also have more anticholinergic (dec digestion, urination, and saliva) effects. Some oral options include diphenhydramine (Benadryl-OTC/Rx), doxylamine (Unisom-OTC/Rx), cyproheptadine (Rx), brompheniramine (Dimetapp-OTC/Rx), chlorpheniramine (Chlorine-Tabs-OTC/Rx), meclizine (Travel Ease-OTC/Rx), dimenhydrinate (Dramamine-OTC/Rx), hydroxyzine (Rx), promethazine (Phenergan-Rx), etc. These meds are meant to be used on an as needed basis unless under medical supervision. Caution should always be taken when driving due to drowsiness potentials.
Second gens are generally considered safer from less risk of drowsiness and drug interactions. Many are also longer lasting, so many can be dosed once every 24 hours continuously. Some oral options include loratidine (Claritin-OTC/Rx), cetirizine (Zyrtec-OTC/Rx), fexofenadine (Allegra-OTC/Rx), desloratidine (Clarinex-OTC/Rx), levocetirizine (Xyzal-OTC/Rx). These are all generally considered to be equally effective, so one is not necessarily recommended over the other. As with any drug, always tell your medical providers if you take any OTC meds because these can still have drug or disease state interactions.
Some antihistamines available in nasal spray and ophthalmic dosage forms include azelaztine (Astelin, Astepro-OTC/Rx, Optivar-Rx), olopatadine (Patanase-Rx, Pataday-OTC/Rx), ketotifen (Zaditor-OTC/Rx). These have less systemic side effects, while still exerting direct action against symptoms.
Other allergy medications include nasal decongestants taken orally like pseudoephedrine (Sudafed-OTC/Rx), and phenylephrine (Sudafed PE-OTC/Rx), or intranasally like phenylephrine (Neo-Synepherine-OTC/Rx), oxymetolazine (Afrin-OTC/Rx) and tetrahydrolozine (Tyzine-Rx). Oral nasal decongestants can increase blood pressure because they work to constrict blood vessels and should not be used long term. They can also cause CNS excitability and heighten anxiety. Nasal spray decongestants should be limited to only 3 days of consecutive use because they can cause symptoms to worsen with continuous prolonged use.
Corticosteroid nasal sprays may also be used to alleviate allergy symptoms from stuffy or runny nose like fluticasone (Flonase-OTC/Rx), mometasone (Nasonex-OTC/Rx), budesonide (Rhinocort-OTC/Rx), beclomethasone (Beconase-Rx), triamcinolone (Nasocort-OTC/Rx), and flunisolide (Rhinalar-Rx). These are listed in order of their general potency. They also have less systemic side effects, while still exerting direct action against symptoms, though it may take several weeks of regular use before their full effects can be felt. While there are some prescription steroid eye drops also available, these are generally reserved for more persistent, severe eye allergy symptoms.
Finally, there are also mast cell stabilizers like cromolyn (Gastrocro-PO-Rx, Nasalcrom-NS-OTC/Rx, and Ophth-Rx) and lukotriene receptor antagonists like montelukast (Singulair). Mast cell stabilizers work to prevent histamines from being released, and lukotriene blockers prevent their inflammatory action involved in allergic reactions and asthma.
There is no evidence that adding medications from the same drug type is beneficial (ex: 2 oral antihistamines), yet a combination of those from different types are often used (ex: oral, nasal, and/or eye drop antihistamines, decongestants, and steroids. As always folks, let your medical providers know if you are using these OTC.
I thought this link had some great info if you want to read more! Allergy medications: Know your options

Hi everybody,
Bare with me because this will be a long post. Haven't shared my journey with NAR on here yet but now is as good a time as any. I will start from the start, hopefully this information will help some people, hopefully the community has more suggestions for me.
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I (M35) have suffered with NAR from 3 years now and it has significantly affected my life. Before this I had never been allergic to anything, healthy weight and lifestyle. It all started when we got our rescue cat, the next day I developed runny/congested nose, post nasal drip, feeling lethargic and tired, feeling like I had a bit of the flu. Didn't think anything of it as I had previously lived with a cat and thought might just have picked up a cold. This continued for a few weeks with no change and I went to the doctors where they advised I was allergic to the cat, advised taking nasonex nose spray and antihistamines and had a blood test to confirm allergies. The blood test returned negative to all allergies to animals, cat, dog, cockroach etc.
I was on the nasonex and antihistamines for a month with no change in symptoms and me and my wife discussed what to do next, unfortunately we had both become attached to the cat by now and didn't want to rehome him, so I put my mind to fixing the problem in other ways. I tried the other nose sprays on the market, rhinocort, otrivin, beconase but they did not work. I tried cleaning the house more, sleeping in seperate room to the cat, feeding the cat some pet food designed to reduce allergies, bought an air purifyier, tried nose filters, sudofed tablets, tried taking all of the different antihistamines available over the counter but nothing changed any of my symptoms in the slightest. Also tried the nasal rinse 2x per day for a week but this also did not work.
I'll just add here that the nasal decongestant spray does work but can't be used for longer than 3 days in a row so it is not a long term solution.
Unfortunately I knew I couldn't live with this condition the way it was, I feel like it doesn't sound like much but having a constantly blocked nose, low energy and tiredness, unable to get a good sleep ever, slight sore throat from the post nasal drip, constantly producing and swallowing mucus every day with no end in sight had made me miserable and debilitated and the days were getting harder and harder to face.
I went back to my doctor and had a CT scan on my sinuses to see if anything was wrong physically and there wasn't, my doctor prescribed me antibiotics to see if it was any sort of infection, there was no change. I got a referral to an allergy immunologist specialist.
The specialist advised that it was NAR and not related to the cat and that this was a coincidence, even though the symptoms had never been there before and lined up with the exact time getting the cat. Unfortunately this specialist wasn't very good and did not explain things to me or do any kind of testing. She prescribed me dymista.
The dymista has helped, the combination of antihistamine and steroid has taken away some of the yucky feeling I was getting though the day and I am grateful for that, unfortunately it doesn't do enough for me to be able to live a normal life and does not unblock my nose at all. And so I continued to suffer and try to find a solution.
My next step was to get a referral to an ENT specialist. I saw an ENT who gave me a skin prick test which came back negative to all allergies. This specialist advised that the cause was most likely the cat and painted a grim picture of what my future would look like if my body continued to react the way it was, lower quality of life, worse sleep patterns, side effects of the dymista etc. And so after trying everything and with the specialists advise we decided that the only thing we could do was to rehome our cat. We rehomed the cat to my inlaws house who already had a cat and lived 15 minutes away, that way we could still see him, knew he'd be cared for and loved and well looked after and he was still in the family. It was tough but the cat was very happy there, had the whole run of this large 2 story home, had company always and had a great cat tree outside on the verandah which was fenced off so the cats could go outside whenever they wanted. So the cat was ok, unfortunately me and my wife were heartbroken and missed him terribly. But we knew that If I was to get better it was the right thing to do.
Unfortunately my symptoms did not improve. A few months went by and we thought maybe the allergens were in the house so we hired a professional cleaner and got the house de-allergies (some sort of denaturing process using a spray). A few more months went past and there was no improvement. A year past and we moved to a completely new home that had never been lived in (new build) and my symptoms did not change.
After a month of living in or new home, our cat suddenly passed away from a rare genetic blood disorder which resulted in him having a stroke (aged 2). It was one of the worst days of our lives and the whole family was devastated.
So even after moving to a new home, the cat passing away and not having lived with a cat for a year there was no change in my symptoms. I went back to the ENT to get some answers but she had none for me other than the next options would be surgery.
We decided to get a puppy as this would help us both out and chose a breed that I had grew up with previously that did not shed (maltese shitsu). We were both apprehensive after what happened with the last pet but went ahead with it. Day 1 my symptoms flared up alot which never happens and I thought I had made things worse, however they went back to normal after a day. The owner gave us one of his blankets which had been used by all of their pets dogs/cats and so we got rid of it. The dog has been with us a year now and sleeps with us on the bed and there has been no change in symptoms so I am grateful for this.
I went back to my doctor who gave me a referral to another allergy specialist. This specialist was really good and she did some more skin prick testing and gave me a formal diagnosis of NAR. She gave me an article on the condition which I had found to be similiar to my own experience and prescribed me Montelukast (10mg) an anti inflammatory used for allergies and asthma. Unfortunately I have been on this for 2 weeks now with no improvement.
I have found that when I travel to visit my parents in a different part of the country that my symptoms improve and get better (about 3 hours flight away) so I know it has to be caused by something in the environment, and the specialist confirmed this. However I have a life, job, wife, family, house where I live now and can't just give up everything to move away. I know this option would make my wife unhappy as her family is a huge support to her where we live currently.
I have another doctors appointment in a week to discuss the new medication and what other options area available in the form of anti inflammatories. I feel the theory is solid, reduce the inflammation and swelling in the sinuses and that leads to better breathing. At this stage I have 4 options left, surgery, trying other anti inflammatories, moving or accepting it as it is and trying to move on. Unfortunately accepting things won't work very well for me, they symptoms stop me from living a normal life, I never feel comfortable doing anything anymore and have been unhappy for a long time because of this. I have started drinking more as this at least makes me feel good for a while, am putting on weight, am getting more anxious and more depressed. I put my life on hold until I get better but it never happened. I see a psychologist and am not in any danger, it all just really sucks. And I know other people have it worse, and other stories of NAR have worse symptoms than me, but its hard.
So the things that have worked for me are Dymista and living away from where I am currently.
Sorry for the long post, I hope other people can see what has worked for me and can get some relief. I hope other people have more luck with this condition, I am still trying things and will provide another update in the future.
Has anyone else had a similiar experience or has any other suggestions for me on what to try next?
Has anyone had any sort of surgery which has worked?
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More than 50 million Americans have symptoms of allergies throughout allergy season and throughout the year, and these symptoms often interfere with carrying out daily activities that many of us take for granted. What was once a simple walk in the park becomes far more complicated when it’s spring and pollen levels are spiking, exacerbating allergy symptoms. Allergies are the most common health issue affecting children in the United States and are also the sixth most common chronic illness. Many people think of antihistamine medications as the first choice for relieving allergy symptoms, but not everyone understands which allergy medications are antihistamines and which are not. Popular decongestant medications like Zyrtec, Xyzal, Loratadine, Nasacort, Afrin, Azelastine, Cetirizine, Fexofenadine, Nasonex, and Flonase all have different pros and cons, but Flonase is one of the most popular drugs on the market today. Is Flonase an antihistamine, or does it fall into a different drug class?

What is Flonase?

Flonase is an over the counter nasal spray and nasal steroid that is used to treat symptoms of allergies. Flonase is also sold under the generic name fluticasone propionate. Flonase was first approved for the treatment of allergies by the U.S. Food and Drug Administration (FDA) in 1994, when it became available by prescription. In 2014, Flonase was made available for purchase over the counter for the treatment of allergies.

Is Flonase an Antihistamine?

While most people associate antihistamines with allergy relief, Flonase is not an antihistamine. Flonase belongs to a class of drugs called corticosteroids; specifically, it is a synthetic glucocorticoid steroid. When we are exposed to allergens, our bodies produce allergic substances that cause nasal symptoms and allergy symptoms like itchy, watery eyes, nasal congestion, sneezing, and more. Antihistamine medications like Benadryl, Claritin, and Zyrtec only block Unlike antihistamine medications, such as Benadryl, Allegra, and Claritin, which stop one cause of allergic substances in the body (histamines), nasal corticosteroid sprays like Flonase block six key allergic substances, including histamines, to provide relief. Because Flonase is capable of blocking more allergic substances, it is capable of providing more comprehensive relief. Studies have shown that Flonase and other nasal corticosteroids provide more effective allergy symptom relief than oral antihistamines.

What Conditions is Flonase Used to Treat?

Allergic rhinitis, or hay fever, refers to a common group of symptoms that occur when an individual with allergies is exposed to an allergen. Allergens are substances in the environment that do not cause problems for most people but can produce a strong reaction in people who are allergic to them. Allergens are found in both indoor and outdoor environments, and people can be allergic to a variety of different substances. The immune system of a person with allergies responds to the presence of an allergen by attacking it, causing an inflammatory response. Inflammatory mediators, including histamines, are released during an allergy attack, causing a number of reactions that are commonly associated with hay fever, including runny nose, nasal congestion, sinus pressure, itchy/watery eyes, and itchy nose or throat. Inflammatory mediators cause these symptoms by binding to the receptors in cells in the nasal passages.
The symptoms of allergic rhinitis can be triggered by many different substances. Indoor allergens like pet hair, pet dander, mold, smoke, dust mites, and perfumes are some of the most common causes of perennial (year-round) allergies. Outdoor allergens, including pollen that is produced by grasses, trees, weeds, and flowers, are more likely to cause seasonal allergies. Some people experience only seasonal allergies, while others experience only perennial allergies. Some people are allergic to both indoor and outdoor allergens and experience some symptoms of allergic rhinitis seasonally and others perennially.

How Does Flonase Work?

Glucocorticoid steroids like Flonase pack some extra punches that give them an advantage over antihistamines when it comes to controlling allergies. Glucocorticoid steroids decrease swelling and inflammation that is typically caused by allergic responses to allergens. Unlike antihistamines, which only block the allergic response caused by histamines, corticosteroids treat allergy symptoms by blocking allergic responses from six different types of cells in the nasal passages. As a result, glucocorticoid steroids are more effective at reducing and preventing symptoms of allergic rhinitis than antihistamines. Inflammation in the nasal passages during an allergy attack causes symptoms that include runny nose, sneezing, excess mucus production and other upper respiratory symptoms. Corticosteroids reduce the inflammation, which in turn reduces the symptoms.

How Do I Use Flonase?

Flonase can be purchased over the counter under the brand name medication or in its generic form, fluticasone propionate. The medication is sold in the form of a nasal spray, and it delivers 50 mcg of the active ingredient, fluticasone propionate, regardless of whether the generic or brand name drug is purchased. Flonase is available in a formula that has been specially formulated for children, and it is also available as part of a new line of products called Flonase Sensimist. Flonase Sensimist was developed in response to patients that appreciate the effectiveness of Flonase but wanted to avoid a powerful spray or strong scent. Flonase Sensimist provides a gentle mist that does not include any alcohol or have a noticeable scent. The Sensimist line has also eliminated the occurrence of post nasal drip, which is a common side effect of nasal sprays. Adults can use Flonase for up to six months, while the maximum recommended duration for children is two months. Flonase is approved for use and adults and children ages 4 and older.

How Much Does Flonase Cost?

Over the counter medications like Flonase are accessible and affordable for most patients because there are many options regarding where they can be purchased. Flonase can be found at any pharmacy, drug store, or big box store, and it is sold in a generic form as well as the brand name form. Patients who know that they will be using Flonase on a long term basis can purchase the generic version of the medication at a very low cost from warehouse membership clubs like Costco and Sam’s Club. Pharmacy discount cards can also provide additional savings; you can expect to pay about 12 to 13 dollars for the generic version of Flonase, which is about half of the cost of the brand name medication. One bottle of the medication usually contains 120 sprays.

What Risks are Associated With Flonase?

Flonase is generally considered safe for use by most people, which is why it has been approved by the FDA for over the counter sales. Nonetheless, corticosteroid nasal sprays like Flonase do carry certain risks of use, which are often more notable for people with certain medical conditions. It’s important to give your doctor a complete medical history prior to using Flonase, particularly if you have any of the following conditions:

• Eye infections caused by herpes
• Liver problems
• Nose sores, injury, or surgery
• Eye infections
• Tuberculosis
• Any untreated viral, bacterial, or fungal infection
• Recent exposure to chickenpox or measles
• Eye problems such as cataracts or glaucoma
• Weakened immune system

What Side Effects are Associated With Flonase?

Thanks to its excellent safety record and low incidence of side effects, Flonase was approved by the FDA in 2014 for over the counter sales. Most people will not experience any side effects while taking Flonase, but those who do will generally experience mild side effects that do not require medical attention. Common side effects of Flonase that usually do not include medical attention include:

• Burning, irritation, or inflammation in the nose
• Asthma symptoms
• Headache
• Bloody nose
• Sore throat
• Cough

Rarely, Flonase causes serious side effects that require medical attention, including allergic reactions. Although rare, it is also possible for both Flonase and Nasacort to cause serious side effects that may require medical attention, including allergic reactions. Serious side effects of Flonase that may require medical attention include:

• Cataracts
• Worsening of infections even with eye drops
• Nose bleeds and sores in the nose
• Decreased wound healing
• Severe allergic reaction
• Slowed growth rate in children and adolescents
• Puncture of the nasal septum
• Glaucoma

What Drugs Does Flonase Interact With?

Flonase doesn’t interact with many prescription drugs, but it’s still important for patients to check the list of drug interactions for any medications they may be taking in order to ensure that using Flonase will not impact the effectiveness of their other medications. Make sure to check with your doctor or pharmacist if you have any questions about drug interactions between your current medications and Flonase or Nasacort, speak to your doctor or pharmacist. Flonase is known to interact with the following HIV medications:

• Saquinavir
• Atazanavir
• Ritonavir
• Indinavir
• Nelfinavir
• Lopinavir

Hi everyone,
I’ve been taking nasonex (mometasone furoate) since my my early 20s or so and it’s been life changing (I’m 26 years old now). It’s so effective I haven’t thought about it in years. Anyway, something brought my attention to my allergies and my doc told me about immunotherapy. My concern with it is, though it might lessen symptoms it mightn’t completely stop my allergies, and therefore I’d be taking nasonex with it anyway, so maybe it’s not worth the time? I’d really appreciate some advice and/or experience on this. Allergic to dust mites I believe, though confirming on Wednesday.
Thanks for your time :)

Is there any difference for nasal polyps? Especially for the clogged nose?

Tìm hiểu viêm xoang mạn tính
Viêm xoang mạn tính là một bệnh lý thường gặp khi các khoảng trống trong mũi (xoang) bị viêm và sưng lên ít nhất 12 tuần cho dù bạn có điều trị hay không.
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Bệnh này còn được gọi là bệnh viêm xoang mũi mạn tính, làm cản trở quá trình dẫn lưu các chất dịch, gây ra dịch mủ. Người mắc bệnh này sẽ gặp khó khăn khi thở bằng mũi, vùng quanh mắt và mặt sẽ sưng lên và cảm thấy đau vùng mặt.
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Bệnh viêm xoang mạn tính có thể do nhiễm trùng, polyp mũi hoặc bị sẹo vách ngăn mũi. Bệnh này thường xảy ra ở người trẻ và trung niên nhưng cũng có thể gặp ở trẻ em.
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Triệu chứng viêm xoang mãn tính
Dấu hiệu và triệu chứng của bệnh viêm xoang mạn tính
Để xác định chẩn đoán bệnh viêm xoang mạn tính, bác sĩ sẽ dựa vào 2 trong 4 triệu chứng sau:
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Dịch tiết từ mũi đổi màu, dày hoặc chảy ngược vào họng (dẫn lưu mũi sau)
Nghẹt hoặc sung huyết mũi dẫn đến khó thở bằng đường mũi
Đau và sưng quanh mắt, cằm, mũi hoặc trán
Giảm khả năng ngửi và nếm ở người lớn hoặc trẻ em.
Các triệu chứng khác có thể bao gồm:
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Đau tai
Đau răng hàm trên
Ho có thể nặng về đêm
Đau họng
Hơi thở hôi
Mệt mỏi
Buồn nôn.
Bệnh viêm xoang mạn tính và cấp tính có các triệu chứng giống nhau nhưng bệnh cấp tính là tình trạng các xoang nhiễm trùng tạm thời khi trời lạnh. Triệu chứng của bệnh mạn tính thì kéo dài hơn và làm bạn mệt mỏi nhiều hơn. Sốt không thường gặp trong bệnh viêm xoang mạn tính nhưng có thể gặp trong viêm xoang cấp tính.
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Bạn có thể gặp các triệu chứng khác không được đề cập. Nếu bạn có bất kỳ thắc mắc nào về các dấu hiệu bệnh, hãy tham khảo ý kiến bác sĩ.
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Khi nào bạn cần gặp bác sĩ?
Bạn nên gặp bác sĩ nếu có bất kỳ triệu chứng sau:
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Viêm xoang kéo dài không dứt sau khi điều trị
Các triệu chứng kéo dài hơn 7 ngày
Các triệu chứng không cải thiện sau đi khám bác sĩ.
Đặc biệt, bạn nên đến khám bác sĩ ngay lập tức nếu có các triệu chứng nặng sau:
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Sốt cao
Sưng hay đỏ quanh mắt
Đau đầu nghiêm trọng
Nhìn mờ, nhìn đôi
Cứng cổ.
Nếu bạn có bất kỳ dấu hiệu hoặc triệu chứng nêu trên hoặc có bất kỳ câu hỏi nào, xin vui lòng tham khảo ý kiến bác sĩ. Cơ địa mỗi người là khác nhau. Vì vậy, hãy hỏi ý kiến bác sĩ để lựa chọn được phương án thích hợp nhất.
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Nguyên nhân gây bệnh viêm xoang mãn tính
Nguyên nhân gây ra bệnh viêm xoang mạn tính
Một số nguyên nhân gây ra bệnh viêm xoang mạn tính bao gồm:
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Polyp mũi phát triển gây tắc nghẽn đường thoát lưu dịch của mũi hoặc xoang.
Lệch vách ngăn mũi, phần nằm giữa 2 lỗ mũi dẫn đến tắc nghẽn đường thoát lưu dịch mũi.
Các bệnh như biến chứng của xơ nang, trào ngược dạ dày thực quản, HIV hoặc bệnh gây suy giảm miễn dịch làm tắc nghẽn đường thoát lưu dịch mũi.
Nhiễm trùng đường hô hấp, thường là cảm lạnh có thể gây viêm và làm dày màng lót các xoang, gây tắc nghẽn đường thoát lưu dịch. Nhiễm trùng có thể do vi khuẩn, virus hoặc nấm.
Di ứng như sốt mùa làm tắc nghẽn đường thoát lưu dịch.
Nguy cơ mắc phải viêm xoang mãn tính
Những yếu tố làm tăng nguy cơ mắc bệnh viêm xoang mạn tính
Có nhiều yếu tố làm tăng nguy cơ mắc bệnh viêm xoang mạn tính như:
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Đường thoát lưu dịch mũi bất thường, như lệch vách ngăn hay polyp mũi
Hen suyễn có liên quan đến bệnh viêm xoang mạn tính
Việc nhạy cảm với aspirin gây ra các triệu chứng đường hô hấp
Rối loạn hệ thống miễn dịch, như HIV/AIDS hoặc bệnh xơ nang
Tiếp xúc thường xuyên với hóa chất như khói thuốc lá.
Bạn có thể kiểm soát bệnh này bằng cách giảm thiểu các yếu tố nguy cơ. Hãy tham khảo bác sĩ để biết thêm thông tin chi tiết.
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Điều trị hiệu quả viêm xoang mãn tính
Những thông tin được cung cấp không thể thay thế cho lời khuyên của các chuyên viên y tế. Hãy luôn tham khảo ý kiến bác sĩ.
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Những kỹ thuật y tế dùng để chẩn đoán bệnh viêm xoang mạn tính
Bác sĩ sẽ tìm ra những chỗ đau ở mũi, mặt và khám bên trong mũi.
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Các xét nghiệm khác để chẩn đoán bao gồm:
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Nội soi mũi: ống nội soi mềm, dài có gắn đèn được đưa vào mũi giúp bác sĩ thấy rõ bên trong xoang.
Xét nghiệm hình ảnh: CT scan hoặc MRI cho hình ảnh chi tiết các xoang và mũi giúp xác định lớp viêm dày hoặc tình trạng tắc nghẽn làm khó đưa ống nội soi vào.
Cấy mũi xoang: phương pháp này thường không cần thiết. Tuy nhiên, khi bệnh không đáp ứng với điều trị hay ngày càng nặng hơn, cấy dịch có thể xác định nguyên nhân do vi trùng hay nấm gây ra.
Kiểm tra dị ứng: nếu nghi ngờ bệnh được kích hoạt bởi dị ứng, bác sĩ sẽ xét nghiệm dị ứng da. Phương pháp này rất an toàn và nhanh chóng giúp bác sĩ xác định nguyên nhân gây bệnh.
Những phương pháp nào dùng để điều trị bệnh viêm xoang mạn tính?
Mục tiêu điều trị bệnh viêm xoang mạn tính bao gồm:
​
Giảm tình trạng viêm
Giữ đường thoát lưu dịch thông thoáng
Hạn chế các nguyên nhân gây bệnh
Giảm tần số bùng phát bệnh.
Các phương pháp điều trị để làm giảm các triệu chứng bao gồm:
​
Nhỏ hoặc xông mũi bằng nước muối giúp giảm tắc nghẽn và rửa sạch các chất kích thích gây dị ứng.
Corticosteroid: thuốc giúp ngăn ngừa và điều trị viêm, như fluticasone (Flonase®, Veramyst®), triamcinolone (Nasacort 24®), budesonide (Rhinocort®), mometasone (Nasonex®) và beclomethasone (Beconase AQ®, Qnasl®). Nếu không hiệu quả, bác sĩ sẽ rửa mũi kếp hợp nước muối và vài giọt budesonide (Pulmicort Respules®) hoặc khí dung mũi.
Corticosteroid uống hoặc tiêm: những thuốc này được dùng để giảm viêm khi bạn bị viêm xoang nặng, đặc biệt là do polyp mũi. Corticosteroid uống có thể gây ra các tác dụng phụ nghiêm trọng khi sử dụng thời gian dài, vì vậy chúng chỉ được dùng để điều trị những triệu chứng nặng.
Thuốc làm giảm nhạy cảm với aspirin nếu như nguyên nhân là do aspirin. Dưới sự theo dõi của bác sĩ, bạn sẽ được tăng liều aspirin hàng ngày lên nhằm tăng sức chịu đựng.

Hi Reddit.
· Age: 27
· Sex: Male
· Height: 178 cm
· Weight: 81 kg
· Race: Caucasian.
· Duration of complaint: More than 10 years
· Location (Geographic and on body): Denmark, Nose
· Any existing relevant medical issues (if any): None
· Current medications (if any): None
(English is not my first language, so please excuse any mistakes. Also please just ask if something does not make sense.)
I’m looking for some advice and help for my BF.(M27)
He is experiencing problems with his nose that becomes stuffy all the time in varying degree. He has been having issues for more than 10 years, and it is affecting his sleep, because he can’t stop focusing on it, and he find it difficult to breathe when lying down. He feels a great urge to sniff all the time, and his mood drops a lot when his nose gets all stuffy. Not getting enough sleep also result in him never really feeling rested and he has trouble getting up in the morning. It was worst for the first few years before the first surgery (see the list below). Sometimes it was so bad that he could hardly get any air through his nose. Some months after the first operation the worst of it had gone, and it wasn’t as bad as it had been earlier. However it is far from perfect, and it is something he still notice. It is especially a problem when he is lying down because he rarely feels like he gets a good night sleep. He thinks that is sometimes get worse some hours after having eaten, but we have not been able to connect it to any specific food. However there seems to be a slight improvement when he has been on strict diets. Below we have made some list containing medicine, alternative treatment, examinations and operations that he has tried.
Medicine:
- Lomudal Nasal Spray
- Benaliv Nasal Spray
- Allergodil Nasal Spray
- Dymista Nasal Spray
- Beconase Nasal Spray
- Avamys Nasal Spray
- Flixonase Nasal Spray
- Nasonex Nasal Spray
- Nasacort Nasal Spray
- Different kinds of Orale Antihistamine
- Gaviscon for acid reflux
Alternative treatments
- Nasal spray with capsaicin
- Nasal spray with Colloidal silver
- Saltwater Nasal Spray with and without mint
- Steam baths
- Nasal irrigation
- Humidifiers
- Air cleaners
- Various moisturizing nasal sprays
- Fish Oil with Omega 3
- Probiotics and prebiotics
- Enzyme supplements
- Various strict diets without gluten, sugar, milk products, etc.
Examinations
- Allergy Tests
- Arthroscopy
- Sleep Apnea Study
Operations
- 1st operation was to help a skewed nose partition and a reduction of the turbinate. This helped after some time – especially when he stands up though it is still an issue when he tries to sleep.
- 2nd operation was to try to reduce turbinate. This one hasn’t had any big effect yet.
We have been trying to switch between different temperatures in our home, sleeping with the window open and closed, but he feels his nose is getting really dry when the window is open.
He avoids alcohols and candy and cakes whenever he can, because he is afraid that it might make it worse. When it gets really bad and he almost doesn’t get any proper sleep, he gets irritated and it really annoys him and he becomes somewhat depressed by it. It sometime really takes its tool on our relationship, because it affects him so much.
We don’t know what else to try, so any advice is greatly appreciated.

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Hello,
My 4 year old daughter has never complained of any headache (or other issues). On July 23rd she started having diarrhea and high fever. After a few days and worsening symptoms we brought her to the ER with a fever of 104. After tests were completed (blood, stool, urine, etc) she was diagnosed with having samonella poisoning + mild dehydration. She was released after 36 hours in hospital.
The following day in the evening she first complained of a headache above her left eye brow. The next day she complained several times about a headache in the exact same spot. This continued for another 3 days with no particular pattern (sometimes mornings, sometimes afternoon. with exercise or without, etc). We brought her back to the hospital worried about bacterial infection spread, etc (though she had no fever and the samonella had pretty much fully improved). They suggest it was likely mild dehydration still and to wait and see.
A full week went by with continued daily headaches. So we went her pediatrician who did an xray and saw some mild sinus infection (though she had no sinus symptoms whatsoever). Prescribed nasonex for 10-14 days and sent us in our way.
After a week on Nasonex headaches were still occurring with the exact same pattern. So we went back to the children's hospital as since being released with samonella she has had 4-10 headaches daily going on 20+ days.
All the doctors performed physical and neurological tests and found nothing wrong. At the children's hospital they also opted to do a CT scan to rule out anything dangerous as it is atypical for a 4 year old to have headaches. The CT scan came back completely normal according to docs.
The recommended trying to "break" the headache by IV dose of an anti-nausea drug (can't remember the name) + anti-histamines. Following that they released her a few hours later and told us to administer Advil every 6-8 hours for 3 days. For 72 hours she did not complain of a headache once. We gave her last dose before bed after 3 days and the very next day the headaches returned. Same pattern.
We had a follow up with our pediatrician today who assured us that because neurological exams were good, symptoms are consistent and the CT scan was clear that it was nothing dangerous. Despite that, we are beside ourselves with worry.
Next steps is waiting for an appointment at pediatric neurologist and we have an optometrist appointment in a few days. In the meantime she has been prescribed 200mg B2 to see if that helps (treating as a migraine).
Relevant details:

• 4-10 episodes daily (not skipping days, ever). Lasting from 30 second to maximum ~5 minutes. Ongoing ~ 24-25 days. Always, without exception in the exact same spot: above left eye brow.
• Happens any time of day. Sometimes the first of the day is around 7am, other times 11am-12pm or later. Even distribution approximately between early in the day VS late in the day.
• Appears suddenly, like within an instant.
• Pain seems mild/discomfort and not severe/excruciating. It'll stop her in her tracks and she holds her head for a minute and then she is back running and playing within minutes like it never happened. Never any tears or seeming too upset, more just telling us.
• No nausea, vomiting. We asked if anything looks "strange or fuzzy" and she says no (aura). No other symptoms and before/after the episodes she is a regular 4 year old running, playing, etc.
• Advil 100% controlled it over 72 hours, but we had to stop for risk of rebound headache
• Her mother is prone to migraines and has been diagnosed + treated for them start around the same age (but her presentation was of severe pain, light sensitivity, etc that lasted hours).
• It all started the day after being released from hospital with samonella. Never had a single headache complaint ever before that.
• There has been some regression since getting out of hospital. We noticed she is sucking her thumb again while sleeping (stopped 1.5 years ago), she also gets very anxious about doctor appointments now (blood tests + IV were very traumatizing for her)

Does anyone have any idea what might be causing this? It seems this pattern is quite atypical based on everything I have been told and read about. At the same time all doctors we have talked to said that based on the current investigation it is very unlikely to be anything dangerous. Would you agree?
Thanks for the input while we wait for the next appointments.

Hi all!
I am back with another skin conditions post. This one is on perioral dermatitis.
Admittedly, when I began researching this, I knew zilch about PD except that it was acne-like breakouts around the mouth, and as I began to research it, it seems that there isn't a whole lot that is known about it. Fortunately, it is a highly treatable condition that seems to overlap to a degree with rosacea (earning it the earlier name of "steroid rosacea") and even seborrheic dermatitis.
As always, please feel free to correct or inform me of anything wrong, and also feel free to post/discuss what helps your PD.

What is Perioral Dermatitis

Perioral dermatitis (PD) is a chronic, recurrant inflammatory disease that most commonly occurs in the perioral region of the face (the area around the mouth). It can also affect the area around the nose, and in roughly 20% of cases, it can manifest around the eyes (though it goes by another name if around the eyes: peri-orificial dermatitis).
It afflicts around 1% of the population of the United States, particularly those with fair skin, and predominately occurs in women between 18-45, with 20s and 30s having peak incidence.
It presents as small, red, tender, sometimes itchy bumps that can flake and burn. While commonly mistaken for acne, it is distinct from acne in that it only presents in specific locations, spares the small area around the lips, and lacks pustules (whiteheads).

Causes of Perioral Dermatitis

The causes of perioral dermatitis are unclear. It is a relatively "young" disease that was only first described as a distinct condition in 1964. It is first and foremost an inflammatory condition, and is aggravated by ingredients and habits that can create inflammation either in the skin or in the body.
While I was researching PD, the one constant that showed up again and again is that it is aggravated by corticosteroid use -- both topical and inhaled. To specify, that means not just creams like kenalog, triamcinolone, and over-the-counter hydrocortisone, but also asthma inhalers (including Advair, Flovent, and ProAir aka Albuterol) and nasal allergy mists like Beconase, Flonase, Nasonex, Omnaris, and Veramyst.
Less commonly, but still a factor to consider are hormones, where monthly shifts can put the condition into overdrive. More frustrating is that oral contraceptives can worsen PD in some.
Other causes can be fluoridated toothpaste, high SPF value sunscreens¹, sunscreens with the filters zinc oxide and titanium dioxide, the ingredient "isopropyl myristate," improperly removing makeup or sleeping in makeup, occlusive ointments (Vaseline, Aquaphor, and oils, for example), heavy creams with occlusive ingredients, and cold creams (wipe-off cleansing creams that leave a residue, like Pond's). In one case, a woman's favorite lip balm (containing the ingredient propyl gallate) caused her PD.⁶

Treatment

PD can look like many other conditions, such as acne, angular cheilitis, rosacea, or seborrheic dermatitis, and requires treatment of a professional due to the inflammatory nature of the condition.
The most important thing for anyone suffering from PD is to discontinue steroid use - whether cold-turkey or weened off with the management of a healthcare professional. While topical steroids can seem to improve the condition, they frequently create a rebound effect, which can make the condition worse.
Once steroids are removed, the skin will get worse before getting better. This is the toughest part of PD for most people. Topical antibiotics or topical immunosuppresants (such as Pimecrolimus or Elidel) are frequently prescribed due to their tremendously helpful anti-inflammatory effects on PD, and azelaic acid can prove useful in some cases. In very severe cases, oral antibiotics can be prescribed in addition to topicals.
While healing from PD, the skin should not be cleansed with any cleanser, and makeup and skincare products should be avoided completely until the condition resolves. And no matter how tempting, PD should never be scrubbed, as this worsens the inflammation.
Once treated, it is encouraged to use liquid or gel sunscreens as well as soap-free cleansers that do not dry out the skin, as TEWL (trans-epidermal water loss) is significant in people who suffer from PD.

Long-Term Care

Some people have PD once in their lives, while others may combat it on and off for several years. If you fall into the latter, it is important to try to avoid triggers that can cause the condition to reoccur (particularly steroid use). That means cleansing your skin each day with gentle cleansers, always removing makeup (removing it with a wipe does NOT count - you need to cleanse it away thoroughly with an oil cleanser that rinses cleanly), and using light products, particularly around the areas typically affected.
Prescriptions like azelaic acid and over-the-counter .1% adapalene (Differin)² may also help to manage the condition in the long-term.
I've put together a list below of some cleansers and moisturizers that are recommended for people suffering from PD. Again, like with my rosacea list, this is not a be-all-end-all list. None of the products listed contain isopropyl myristate or heavy occlusive ingredients.

Recommended Products

Creamy Cleansers

CeraVe Hydrating Cleanser

Ingredients: Purified Water, Glycerin, Behentrimonium Methosulfate and Cetearyl Alcohol, Ceramide 3, Ceramide 6-II, Ceramide 1, Hyaluronic Acid, Cholesterol, Polyoxyl 40 Stearate, Glyceryl Monostearate, Stearyl Alcohol, Polysorbate 20, Potassium Phosphate, Dipotassium Phosphate, Sodium Lauroyl Lactylate, Cetyl Alcohol, Disodium EDTA, Phytosphingosine, Methylparaben, Propylparaben, Carbomer, Xanthan Gum.

Aquanil

Ingredients: Purified Water, Glycerin, Cetyl Alcohol, Benzyl Alcohol, Sodium Laureth Sulfate, Stearyl Alcohol and Xanthan Gum.

La Roche-Posay Toleriane Hydrating Gentle Face Cleanser

Ingredients: Aqua/WateEau (La Roche-Posay Prebiotic Thermal Water),​ Glycerin​,​ Pentaerythrityl Tetraethylhexanoate​,​ Propylene Glycol​,​ Ammonium Polyacryloyldimethyl Taurate​,​ Polysorbate 60​,​ Ceramide NP​,​ Niacinamide​,​ Sodium Chloride​,​ Coco-Betaine​,​ Disodium EDTA​,​ Caprylyl Glycol​,​ Panthenol​,​ T-Butyl Alcohol,​ Tocopherol​.

La Roche-Posay Toleriane Dermo Cleanser

Ingredients: Wate/Aqua, Ethylhexyl Palmitate, Glycerin, Dipropylene Glycol, Carbomer, Sodium Hydroxide, Capryl Glycol/Caprylyl Glycol, Ethylhexylglycerin.

Avene Extremely Gentle Cleanser Lotion

Ingredients: Avene Thermal Spring Water (avene Aqua), Cetearyl Alcohol, Serine, Cetrimonium Bromide, Coco-Glucoside, Dipotassium Phosphate, Disodium Edta, Disodium Phosphate, O-Phenylphenol, Sodium Cetearyl Sulfate, Water (Aqua).

Spectro Jel Cleanser for Blemish-Prone Skin - Fragrance Free

Ingredients: Aqua, Butylene Glycol, Glycerin, Hydroxypropyl Methocellulose, Polysorbate 20, Cetyl Alcohol (moisturizer), Hydrated Silica, PEG-12 Dimethicone, Diazolidinyl Urea, Carbomer, Triethanolamine, Sorbitan Oleate.

Foaming Cleansers

CeraVe Foaming Cleanser

Ingredients: Purified Water, Cocamidopropyl Hydroxysultaine, Glycerin, Sodium Lauroyl Sarcosinate, PEG-150 Pentaerythrityl Terastearate, PEG-6 Caprylic/Capric, Glycerides, Niacinamide, Propylene Glycol, Sodium Methyl Cocoyl Taurate, Ceramide 3, Ceramide 6-II, Ceramide I, Hyaluronic Acid, Cholesterol, Sodium Chloride, Phytosphingosine, Citric Acid, Edetate Disodium, Dihydrate, Sodium, Lauroyl Lactylate, Methylparaben, Propylparaben, Carbomer, Xanthan Gum.

Olay Foaming Face Wash Sensitive

Ingredients: WateEau, Glycerin, Sodium Myristoyl Sarcosinate, PEG-120 Methyl Glucose Dioleate, Sodium Lauroamphoacetate, Aloe Barbadensis Leaf Juice, Polyquaternium-10, PEG-150 Pentaerythrityl Tetrastearate, Glycol Distearate, Sodium Laureth Sulfate, Cocamide MEA, Laureth-10, Disodium Lauroamphodiacetate, Sodium Trideceth Sulfate, Citric Acid, Disodium EDTA, Phenoxyethanol, DMDM Hydantoin.

La Roche-Posay Toleriane Purifying Foaming Cleanser

Ingredients: Aqua/WateEau (La Roche-Posay Prebiotic Thermal Water),​ Glycerin​,​ Coco-Betaine​,​ Propylene Glycol​,​ Sodium Cocoyl Glycinate​,​ PEG-120 Methyl Glucoside Dioleate,​ Sodium Chloride​,​ Ceramide NP​,​ Niacinamide​,​ Sodium Hydroxide​,​ Disodium EDTA​,​ Capryloyl Glycine​,​ Caprylyl Glycol​,​ Citric Acid​,​ Acrylates Copolymer​.

Makeup Removers

Clinique Take the Day Off Cleansing Balm

Ingredients: Ethylhexyl Palmitate, Carthamus Tinctorius (Safflower) Seed Oil, Caprylic / Capric Triglyceride, Sorbeth-30 Tetraoleate, Polyethylene, PEG-5 Glyceryl Triisostearate, Water / Aqua / Eau, Tocopherol, Phenoxyethanol.

Kose Softymo Speedy Cleansing Oil

Ingredients: Mineral Oil, PEG-8 Glyceryl Isostearate, Cetyl Ethylhexanoate, Cyclomethicone, Water, Simmondsia Chinensis (Jojoba) Seed Oil, Isostearic Acid, Glycerin, Phenoexyethanol.

Moisturizers

CeraVe PM Facial Moisturizing Lotion

Ingredients: Purified Water, Glycerin, Caprylic/Capric Triglycerides, Niacinamide, Cetearyl Alcohol, Ceramide 3, Ceramide 6-II, Ceramide 1, Phytosphingosine, Hyaluronic Acid, Sodium Hydroxide, Dimethicone, Behentrimonium Methosulfate, Ceteareth-20, Polyglyceryl-3 Diisostearate, Cholesterol, Xanthan Gum, Carbomer, Disodium EDTA, Dipotassium Phosphate, Potassium Phosphate, Sodium Lauroyl Lactylate, Methylparaben, Propylparaben.

CeraVe Daily Moisturizing Lotion

Ingredients: Purified Water, Glycerin, Caprylic/Capric Triglyceride, Behentrimonium Methosulfate and Cetearyl Alcohol, Ceteareth-20 and Cetearyl alcohol, Cetyl Alcohol, Polyglyceryl-3-Diisosterate, Dimethicone, Hyaluronic Acid, Ceramide 1, Ceramide 3, Ceramide 6-II, Cholesterol, Phytosphingosine, Potassium Phosphate, Dipotassium phosphate, Methylparaben, Propylparaben, Disodium EDTA, Sodium Lauroyl Lactylate, Polysorbate 20, Carbomer, Xanthan Gum.

CeraVe Baby Moisturizing Lotion

Ingredients: Active - Dimethicone, 1\%. Inactive - Purified Water, Caprylic/Capric Triglyceride, Cetostearyl Alcohol, Cetyl Alcohol, Emulsifying Wax, Niacinamide, Ceramide 3, Ceramide 6-II, Ceramide 1, Hyaluronic Acid, Allantoin, Tocopheryl Acetate, Lauric Acid, Zinc Citrate, Polygylceryl-3 Diisotearate, Behentrimonium Methosulfate, Sodium Lauroyl Lactylate, Arginine PCA, Potassium Phosphate, Dipotassium Phosphate, EDTA, Sodium PCA, Phytosphingosine, Cholesterol, Xanthan Gum, Carbomer.

La Roche-Posay Toleraine Facial Fluid

Ingredients: Aqua/Water, Squalane, Glycerin, Dipropylene Glycol, Sodium Carbomer, Ethylhexyloxyglycerin/Ethylhexyglycerin, Capryl Glycol/Caprylyl Glycol.

EltaMD PM Therapy Facial Moisturizer

Ingredients: Purified Water, Ethylhexyl Isononanoate, Niacinamide, Glyceryl Stearate, PEG-100 Stearate, Hydroxyethyl Acrylate/ Sodium Acryloyl Dimethyl Taurate Copolymer, Hydrolyzed Rice Protein, Linoleic Acid, 1-3-Bis (N-2-(Hydroxyethyl) Palmitoylamino) -2- Hydroxy Propane, C10-30 Cholesterol/Lanosterol Esters, Sodium Hyaluronate, Glycereth-26, Cetearyl Glucoside, Thioctic Acid, Distearyldimonium Chloride, Tocopheryl Acetate, Xanthan Gum, Oleth-3 Phosphate, Butylene Glycol, Phenoxyethanol, Iodopropynyl Butylcarbamate, Disodium EDTA, Sodium Bisulfite, Sodium Hydroxide.

Sources

1. Physical sunscreens with high sun protection factor may cause perioral dermatitis in children
2. Perioral dermatitis successfully treated with topical adapalene
3. Perioral dermatitis00159-8/abstract)
4. The Treatment of Perioral Dermatitis, Acne Rosacea, and Seborrheic Dermatitis
5. Guideline: Perioral dermatitis
6. Lip and Perioral Dermatitis Caused by Propyl Gallate

All of My Posts

Guides

• Purging, Irritation, and Gram-Negative Folliculitis
• Dehydrated Skin: An Updated Guide
• A Guide to Your Dermatologist: When to go, picking a doctor, prepping for your first visit, and tackling shame and depression
• Perioral Dermatitis
• Keratosis Pilaris: An Updated Guide
• Rosacea
• Rosacea: Recommended Products
• Evaluating Your Routine: Hydroxy Acids
• Evaluating Your Routine: Sunscreen
• Evaluating Your Routine: Moisturizers
• Evaluating Your Routine: Cleansers

Tryna decide between these two. Any personal experiences on which one has worked better for you?