Question:
Have had moderate off and on sore throat since a bout of bronchitis and
laryngitis four months ago. Have gone to GP, ENT, and Allergist. All
agreed that my problem is post-nasal drip and not infection causing the sore
throat. This is something that I have had for most of my life, but with no
sore throat problem until now. My present ENT/Allergist tested me and found
I was allergic to several molds and dog and cat and many foods. I have read
here that the food testing can give false positives (I had injections under
the skin for all tests) but Dr. insists that most of my problem in due to
food allergies. For the last month I've been taking allergy shots for the
molds and dog/cat and trying to rotate foods with no results. I'm using
Flonase, Humibid
LA and vitamins. My nasal secretions are clear, but in the morning I cough
up a little yellow mucus from my throat. If I stop the Humibid, the mucus
thickens and sore throat worsens. Is this being caused by food allergy or
sinusitis? Anyone have any ideas?
Answer:
You say you have been to an ENT. What type of examination did he perform?
Have you had imaging of the sinuses - MRI, X-rays, whatever? My ENT is also an Allergist, he only looked at my throat with the heated
mirror and said I had a lot of irritation and could see the post-nasal drip.
He looked in my nose also, but didn't do a lot of tests. I have a high
deductible private insurance and didn't want to spend a lot on tests. I did
decide to have the allergy testing done because I do believe I'm allergic to
a lot of air-borne stuff but didn't think I was allergic to many foods. The
tests came positive to quite a lot of my frequent foods. My ENT thinks that
the foods are contributing a lot to the post-nasal drip. I have tried to
rotate and eliminate some, but it is very difficult and I haven't seen a lot
of results. So what should I try now? It is worth remembering that the presence of active allergy does not rule
out the possibility of other disease. Chronic sore throat is not to be
expected in most cases of uncomplicated allergy. Profuse drainage of pus is
not a necessary concomitant of chronic sinus infestion. If the allergy
treatment had been brilliantly successful there would be nothing further to
ask for; in this case it might be worth asking for imaging studies.
Remember also that X-rays of the sinuses do not tell very much about the
state of the ethmoid sinuses. Ask your doctor if he thinks you might have
chronic ethmoid sinusitis. "Diagnosis and Treatment
Before starting treatment, your doctor will take a
complete medical history and perform a physical examination.
Acute sinusitis is usually treated with antibiotics
and decongestants. Chronic sinusitis may need long-term
treatment (eight weeks or longer) for maximum
effectiveness. Medical treatment options include antibiotics,
decongestants, medicines that thin the mucus, nasal
steroid sprays, and oral steroids. Some antihistamines have side effects, and only patients
with documented allergies should use them. Discuss
over-the-counter antihistamines with your physician;
the side effects may be greater than the benefits. If treatment does not cure your sinusitis, or it recurs,
a CAT scan may be necessary to evaluate the sinuses and
the drainage channels in the nose that are not visible on
a routine examination. Small telescopes (endoscopes)
may also be used to look directly inside the nose. " All contents copyright © 1992-1999 the Author(s) and
The University of Iowa. All rights reserved. If your present otolarygologist can't solve the problem,
you may need to consult another one for a 2nd opinion.
