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Ask Dr. Arun Phophalia Your Own Question
Dr. Arun Phophalia
Dr. Arun Phophalia, Doctor (MD)
Category: Health
Satisfied Customers: 35439
Experience:  MBBS, MS (General Surgery), Fellowship in Sports Medicine
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I have allergies all year round and I have to take sudafed

Resolved Question:

I have allergies all year round and I have to take sudafed pretty much daily. The worst is frequently I feel a lot of sinus pressure in my nose even though it is not stuffed up and I can still breathe, and at the same time this happens my throat gets very tight and my voice is strained to the point where it is hard to talk. My voice gets a good deal higher and softer and it feels like the lower range of my voice is unaccessable and I can barely talk. I notice it is worse when I go outside, but when I stay inside for a while my throat relaxes and I can talk normally again. What is wrong with me?
Submitted: 5 years ago.
Category: Health
Expert:  Dr. Arun Phophalia replied 5 years ago.


Your symptoms are typical of chronic sinusitis. A coronal CT of the sinuses and/or fiberoptic nasal endoscopy is diagnostic for it. Some physician may recommend nasal smear also to differential the allergy and infection. The aim of treatment is; relieve the obstruction, treatment of the infection, if present, thinning the mucus, and opening the sinus. Following would be the treatment protocol;

1) Nasal steroid; decrease inflammation and open up obstruction.

2) Oral decongestants such as pseudoephedrine are often helpful.

3) Topical decongestant for short duration.

4) Antihistamines

5) Steam vaporizer

6) Eucalyptus oil may help

7) Nasal saline irrigation

8) Vitamin C

9) Antibiotics; only if nasal culture is positive and there are signs in CT scan.

For treating it naturally; steam inhalation, nasal saline water (salt water) irrigation (can be done by Neti-pot), Vitamin C, Eucalyptus oil inhalation can be done. Following can increase the body immunity so help in overcoming the sinus infection;

1) Omega 3; Fish oil capsule and flaxseed oil capsule.

2) Ginkgo Biloba

3) Zinc 30 mg.

You may also be looked for GERD, which has increasingly been implicated in causing or exacerbating chronic sinusitis. The exact relationships and mechanisms are presently a matter of speculation, though. GERD can not only cause sinusitis but also a condition called as reflux laryngitis. Your voice symptoms point to reflux laryngitis. Following investigations may be able to confirm it;

1) Barium esophagography

2) Ambulatory 24-hour pharyngoesophageal pH monitoring

3) A biopsy of the larynx which may show laryngitis.

Following specialists are needed to work in tandem for treatment;

1) ENT specialist

2) Gastroenterologist,

Following measures are helpful:

1) Small 5-6 meals a day.

2) Last meal should be eaten 3 hours before lying down.

3) Avoid; fried or fatty foods, chocolate, peppermint, alcohol, coffee, carbonated beverages, citrus fruits or juices, tomato sauce, ketchup, mustard, vinegar.

4) Eat slowly so air is not swallowed.

5) Swallowing therapy by a speech-language pathologist.

6) Lose weight if obese or overweight.

7) Elevate the head of the bed by 6 inches.

8) Avoid tight clothing.

9) Stop smoking, if you do.

Please see the resource;

Please feel free for your follow up questions.

I would be happy to assist you further, if you need any more information.

Dr. Arun

Customer: replied 5 years ago.
Relist: Answer quality.
Just didn't seem like it specific enough.
Expert:  Dr. Arun Phophalia replied 5 years ago.

Your sinusitis has specifically two issues associated;

1) Allergic phenomenon
2) Associated with the GERD.

For allergy, avoidance of allergen is the most important. An allergy specialist can identify the allergen and desensitize you, so the reaction is milder or resolve completely. GERD will need management by the various measures, we discussed above. The voice changes are due to the allergen reaction (which is likely due to environmental allergen and thus it is more in out doors) in the throat causing swelling of the vocal cords. The voice changes are also concomitant due to GERD.

It is privilege assisting you.

Dr. Arun
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