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Byline: Dr Elena Douse

Q. My nose is persistently blocked and congested, and I constantly need to blow it. This has been going on for more than a year and decongestants don't seem to help. I now can't breathe through my nose at all. Are there any other treatments I can try? A. It sounds like you are suffering from rhinitis which is inflammation of the mucosal lining of the nose. The lining swells, causing narrowed airways and a blocked feeling in the nose. Soft, fleshy outgrowths of the mucosal lining, known as polyps, may develop at the back of the nose, blocking the airways further and making symptoms worse. Rhinitis is often due to allergies to pollens, moulds or pet hairs. It may be worth trying a daily antihistamine, but I suspect you would benefit from steroid nasal drops or a steroid nasal spray such as Beconase, Flixonase or Nasonex. When applied daily up the nostrils, these sprays and drops can help shrink back the swollen polyps and lining, and hence open up the airways. These products can be prescribed by your GP, and are the first line treatment for rhinitis. If no improvement is seen after two to three courses of treatment, your doctor can refer you to an Ear Nose and Throat surgeon, who may need to resort to surgery to hoover out troublesome, persistent polyps.

Q. I keep getting very sore, painful cuts, spots and dry areas up my nose. Sometimes when I blow my nose in the mornings I see a small amount of dry blood and crust on the tissue. Any idea what causes these and is there anything I can do to get rid of them? A. The nasal mucosa is very sensitive with lots of nerve endings, so any cut or spot inside the nose can be very painful. Sore, cracked areas often develop after a common cold or can be caused by nose picking. When cracks appear, bugs can invade and infection can ensue, giving rise to the very sore patches and spots you are experiencing. Your GP can prescribe antibiotic creams such as Naseptin or Bactroban, which, when applied in and around the nostrils, are effective in treating infection and will also help coat, moisturise and protect the nasal mucosa. Q. For the last month I have been getting nosebleeds approximately three times a week. It always bleeds from the left nostril and lasts for about 10 minutes. I have never suffered from nosebleeds before. Can anything be done to stop these nosebleeds as they are now starting to affect my social and personal life? A. Recurrent nosebleeds, particularly when persistent from only one nostril, are usually caused by a tiny fragile blood vessel bleeding on the surface of the nasal mucosal lining.

Troublesome, fragile vessels, which continue to break down and bleed, will often need to be cauterised (burnt away). Your doctor can inspect the lining of the nose and "zap" any offending bleeding points with a special stick containing the corrosive chemical, silver nitrate. The vessel is effectively burnt away and hopefully, this will be the end of the problem. Don't worry, its not as bad as it sounds - doctors will usually put some topical anaesthetic on the area prior to treatment!

NOSEBLEED TIPS Sit down and bend your head forward.

Firmly pinch the front fleshy part of your nose for 10-15mins. Apply an ice pack (or bag of frozen peas) to the forehead and back of the neck. The cold temperature shrinks blood vessels and helps stop bleeding. If the bleed does not stop with these measures after 20minutes, attend your local accident and emergency department. After a nosebleed, avoid blowing or picking the nose. Heat and exertion can start blood vessels bleeding again, so avoid hot baths, hot showers, hot drinks and exercise for the next few days. Make sure you see your GP to get your blood pressure and bloods checked as high blood pressure and blood-clotting abnormalities can prompt fragile vessels to bleed.


Send your questions to Dr Elena Douse c/o South Wales Echo, Six Park St Cardiff CF10 1XR
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Publication:South Wales Echo (Cardiff, Wales)
Date:Sep 3, 2009
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