After having sinus surgery and countless allergy testing, my ENT's only recommendation seems to be Nasacort and Astelin -- neither of which can stop my initial sneezing and accompanying congestion which is quite debilitating. This is becoming quite frequent with no seasonal remarkability. Please help!

It sounds like you and your ENT physician have been working hard on your problem without great success. Chronic allergy, as you know, may have a serious effect on your “quality of life.”

It is likely you have already worked on reducing substances in your home to which you might be allergic. Some of these factors would include plants, feather pillows and pets. Hopefully you do not smoke. Molds are common in homes as are dust mites, both of which can cause year-round allergic symptoms. Sometimes substances at work can contribute to an allergic reaction. An air purifier can be quite helpful at times.

The types of medications that are useful include antihistamines (such as Astelin) and nasal steroids (such as Nasacort). Decongestants are helpful for many patients such as pseudophedrine. Montelukast (Singulair), a leukotriene inhibitor, is relatively new and also a very good medication for some patients.

Another consideration is allergy shots which desensitize your system to specific causes of allergy. These injections are tailored to the specific substances to which you are allergic based on allergy testing.

While many ENT physicians are very knowledgeable about allergy, sometimes a second opinion is in order, especially if you have exhausted most of these approaches. An allergist is another type of specialist who may have some additional suggestions to consider.

While I unfortunately do not have a specific answer, I hope this list might include some approach you have yet to try.

Thank you for your question.

Dr. Joshua Rassen

-- Joshua Rassen, MD, is a board-certified internist and geriatrician in northern California. He has a private practice in geriatrics and internal medicine and is the Chief of the Division of General Internal Medicine at California Pacific Medical Center.

First published March 29, 2005
Last updated January 31, 2007
Copyright © 2005 Consumer Health Interactive