INFLAMMATION in SINUSES, INFERIOR TURBINATE HYPERTROPHY in CT.

Resolved question:
Hi,

For over 2 months I have had a buildup of mucus in the back of my nose/top of my throat. I try to clear it out but it is really difficult because it feels so far up but sometimes I can spit out thick, white/cloudy mucus. My nose does not run in the front. There is a gross taste in my mouth. I also feel nauseous. This problem persists all day and is most uncomfortable in the morning when I feel most nauseous and sometimes I gag while trying to spit out the mucus. It also influences my eating habits.

A CT scan showed mild inflammation in the ethmoid and left maxillary sinuses and inferior turbinate hypertrophy. The mucus is overly thick. (I'm translating from Chinese because I was in China at the time)

2 years ago I was allergy tested and told I am allergic to a large variety of environmental allergens (dust mites, pollen, animal dander, etc etc)

I started to seek care from my doctor a month ago. My doctor prescribed singulair, cetirizine and I've tried 3 different steroid nasal sprays. I also use nasal irrigation but it doesn't seem to help. I used cetirizine for a month and was told to discontinue when symptoms did not improve. I continue to use singulair 10mg daily and omnaris 2 puffs per nostril once daily. My doctor then referred me to an ENT specialist but wait times in Canada are very long.

I have another chronic problem for about 6 months now. I was diagnosed with bile reflux gastritis via an upper endoscopy and I have H pylori. Symptoms are bloating, pressure on my lower ribs, nausea (related to nose problem or stomach?), and feeling very full all the time. I take pantoprazole 40mg once daily and was told yesterday to up the dose to twice daily and was prescribed motillium. Waiting to see a gastroenterologist as well because PPI therapy wasn't very effective.

As well, I have daily tension headaches from TMJ dysfunction (2 years, reason why I was referred to the allergist and also an ophthalmologist), not responding to ibuprofen and acetaminophen, I have kind of just endured it, but a dentist told me to come in and discuss making a splint.

My parents both have similar symptoms as me, I hear them getting up in the morning and trying to hack out phlegm, and they clear their throats throughout the day. my younger brother does not have this problem but he is 14 years younger than me.

Any ideas? I'm open to discussing this in depth.

Edit: I wrote this two days ago. Yesterday, I decided to take benadryl and up the dose. I took 150mg of benadryl before bed and the mucus production feels like it's been reduced quite a bit, however, I still have this feeling in the back of my mouth/throat/nose (really hard to tell, but I feel like it's the top or back of the soft palate). It feels irritated and I feel my gag reflex like all the time (maybe it wasn't nausea to begin with but the gag reflex) I can't really spit out any phlegm anymore but this feeling was probably what made me so miserable to begin with. Could this be an enlarged adenoid? An enlarged uvula?

Submitted: 4 Days
Category: ENT Specialist

Expert:  Dr. Sunil Jalan replied 4 Days.

Hello,
Thank you for posting your medical query to DoctorSpring.com
In order to help you fully, I would appreciate further details regarding your condition:
1. What are your current symptoms? How long have you had them? (Nasal congestion or discharge / headache / body ache / fever as measured by a thermometer / cough )
2. Have you taken the flu vaccine this year?
3. Do you have any pre-existing medical conditions? For example high blood pressure? Migraines? These could be explainations for the exploding sensation in your head.
4. Do you currently take any medications?
I look forward to your reply

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Patient replied :

Hello,
I feel All the symtoms, Nasal congestion and discharge / headache / body ache / cough/ eyes tear all the time. I am not sure if I have fever or not! The pressure I feel in my head comes and goes
it starts mild then becomes unbearable then mild again, it disappears then it starts all over again. All the symtoms started 3 days ago but the head pressure started this morning.
2- I did not take the flu vaccine.
3 no pre-existing medical conditions
I started taking the following medications yesterday:
azithromycin tablets, USP unit of 6 tablets x 250 mg
Contact cold+ flu maximum strength
dristan 12-hr nasal spray


Expert:  Dr. Sunil Jalan replied 3 Days.

Hello,
Thank you for using Doctor spring
You are suffering from cold and cough with bodyache and headache for two days, so you have URI (upper respiratory tract infection)
Amoxicillin is first line antibiotic for URI, But azithromycin is also effective.
as you have started continue azithromycin 500mg once dialy (two tablet of 250 mg at a time).
Contac cold with flu maximum contains acetaminophen, chlorpheniramine maleate and phenylephrine hydrochloride. This is also a good combination, you shold start getting symptomatic releif now. So you continue same and if not improving then only you require investigations.
Hope this helps
Best regards
Dr Sunil Jalan

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