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Dr. P. Jyoti
Dr. P. Jyoti, Consultant MD
Category: Medical
Satisfied Customers: 10103
Experience:  17 yrs experience in treating OPD & Emergency patients.
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I have a sinus question for a doctor, I have sinus issues

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Hi i have a sinus question for a doctor
JA: The Doctor can help. To begin, what are your symptoms? Have you used any medication for this?
Customer: I have sinus issues and have taken a course of antibiotics
JA: Thanks for that. Have you used anything besides the antibiotics for this?
Customer: yes decongestant nasal spray
JA: Thank you so much for your answers. Finally, is there anything else in your medical history the Doctor should know?
Customer: i am currently taking Citalopram
Customer: replied 8 days ago.
I have had a sinus infection which started 4 weeks. I have taken a course of antibiotics. Throughtout the last 4 weeks my sense if smell has been coming and going. The congestion has dramatically improved but I am still getting occassions where it feels like the blood vessels in the top of nose are swelling up. Two days ago i started using nasoxyl which has helped me massively in terms of getting my sense of smell back. However I used it last night and feel slightly more congested this morning. Am unsure of what to do next as the Nasoyxl is giving me relief to smell which is driving me mad but i don't want to make the congestion worse long term. Is it normal for a sinus issue to contiue this long?

Hello, my name is***** thank you for your question. I am a ENT specialist with 18 years’ experience. ​

Please provide some more information so that I can provide you with a better informed answer.

What is your age and sex?

Have you seen an ENT for this?

Any tests done like Xray or CT scan of the sinuses?

Please provide this info and I will help you further with my answer.

You may get a message asking for a phone call which is generated automatically by the website, if you accept this I can help you over phone also.

Customer: replied 8 days ago.
I am female, aged 41. No I haven't seen an ENT nor had any tests or scans done.

Ok, I have your reply. Please hold on while I type out your answer. This can take a few minutes.

Customer: replied 8 days ago.
Thank you

You must not continue the Nasoxyl nasal spray long term.

It is to be used only for short term use.

In the long term, Nasoxyl can cause rebound congestion, ie, congestion becomes more severe once the effect comes down, so you have to use the Nasoxyl again in a vicious cycle till it becomes addictive.

You should show an ENT for this if the sinusitis symptoms persist. Best for you would be a steroid nasal spray which is harmless and can give you complete relief. Your doctor can also do tests like XRay or CT of the sinuses which will give you relief.

TIll then you can try with the following home treatment:

Antihistamines - Alavert 10 mg once daily (OTC)
Decongestants - Sudafed 120 mg once daily(OTC)

Another important home treatment is Menthol steam inhalation - add Menthol salts (available OTC) to a bowl of steaming water and inhale the steam two - three times daily - this will relieve the congestion.

These will give you relief, but if the symptoms persist you should show an ENT.

Take care - wish you good health and a quick recovery. Stay safe.

I hope my answer has helped you gain more knowledge and confidence about your problem and helped you in knowing what to discuss with your doctor if required.

If my answer has helped you, please click on a four or five star rating from the rating bar of stars at the top or bottom of your chatbox. It is only when you give a high rating that I get credit for my work. Bonus and a good feedback is always welcome.

Please note that rating me now does not close your question. We can continue until you are satisfied. If you need more assistance, please use the reply box and let me know, I am sure I can help you further.
With regards,
Dr. P. Jyoti, MD.

Customer: replied 8 days ago.
Thanks. Should I stop the nasoxyl today then? I have tried beconase but i felt like it did nothing. I have bought another nasal spray which i haven't yet tried - nasonex? I understand this can take a while to work? It's so frustrating because the decongestant has given instant relief with being able to smell. When the loss of smell comes over me it triggers a panic attack so I feel like I'm in a cruel circle at the miinute of not feeling any better.
Customer: replied 8 days ago.
Also do you mean a sudafed decongestant? How long am I able to take this for?

Yes stop using Nasoxyl and also dont take Nasonex. They are the same and will have rebound congestion.

Take Tab Sudafed which acts as a decongestant, take it for 10 days.

I hope I’ve provided the information you were seeking. If you are happy with my service, your 5-star rating at this time is most welcome. If you need more help, please let me know so l can continue to assist you.
Thank you and I wish you the best of health - stay safe!
Dr. P. Jyoti

Hello,
I am just checking up on you. Did my answer help you? Do you have any other queries?
Please remember to rate my service with 5 stars from the rating bar of stars at the top or bottom of your chatbox if you have been helped by my answer..

Without a positive rating, this session remains inconclusive.

Of course, you can continue asking as many questions as you like after the rating also.

Thank you.

Dr. P. Jyoti

Customer: replied 8 days ago.
what steroid nasal spray would you reccommend? I thought nasonex was a steroid spray rather than a decongestant?
Customer: replied 8 days ago.
I just have to take my little boy to school so may have some further questions when i return if that's ok? Thanks so much

Yes sorry Nasonex is a steroid spray.

You can use Nasonex then, Nasonex will be useful for you. Use once daily at night regularly for 2 months. This will help to bring down the congestion.

Stop the Naxozyl drops.

Continue the other steps I had advised like Alavert and Sudafed for 10 days.

Continue Menthol nasal spray for a long time, this helps greatly in congestion.

These steps will help control the sinusitis for you.

We have had multiple interactions.
You now need to give a rating if the answer has helped you - you can continue asking questions after the rating also, but it encourages me to continue responding if you give a positive rating..
We are paid only when a positive rating is given.
Thanks.

Dr. P. Jyoti and 4 other Medical Specialists are ready to help you
Customer: replied 8 days ago.
Many thanks. Should the decongestant help with my symptoms of reduced smell? Is it normal for the loss of smell to keep coming and going? Also, is it normal for a sinus infection to continue this long? I had a lot of mucous in the first couple of weeks but now it is just that pressure feeling in my nose.

Yes decongestant will help with the symptoms of reduced smell.

It is the congestion of the mucosa which causes loss of smell.

Sinusitis symptoms can last a long time, thats quite common.

But as you may be aware, decreased or loss of smell is considered as one of the possibilities for corona virus, hence you should discuss with your doctor whether you need a Covid test for this.

Customer: replied 8 days ago.
that had crossed my mind about the covid link, however with the smell coming/going especially with use of decongestant I thought this unlikely but maybe a test should be considered. I have also bought a nasal rinse kit? Is this beneficial?
Customer: replied 8 days ago.
Also, sorry should i not take the nasonex steroid this morning, but rather wait until tonight?

Yes you can use a nasal rinse kit, it will help you.

You should discuss with your doctor about doing the Covid test

Wait until tonight, typical advise is to use the spray at night.

Customer: replied 8 days ago.
Ok many thanks. If this continues what other possibilities are there for treatment?

Surgical treatment is done if medicines cannot cure.

Customer: replied 8 days ago.
Ok thank you. I think that is the end of my questions. In your experience is it likely that this should resolve with the sugesstions you have made? It has improved from where i was two weeks ago but feels like it's taking a long time!!!

Oh yes, it should heal with these treatments.

Customer: replied 8 days ago.
Thank you very much.
Customer: replied 8 days ago.
One more thing - the severe congestion I'm feeling today, presumably maybe from using the naxozyl - should that eventually clear? I've just read some scary stuff about rebound congestion! I have only been using it 2 days
Customer: replied 8 days ago.
Also, i have some sudafed decongestant. When you say take one 120mg tablet what is the normal does of one tablet? It doesn't make it clear on the package. It just says to take one tablet every 4-6 hours

The congestion will clear off with the Sudafed.

There are different forms of Sudafed:

Sudafed Congestion - take 2 tabs 6 hourly

Sudafed 12 hour - take one tab 12 hourly

Sudafed 24 hour - take one tab daily (120 mg)

Customer: replied 8 days ago.
Many thanks. Should the sudafed clear up the congestion permanently??

Hello yes, SUdafed will clear it up permanently in most cases.

Customer: replied 5 days ago.
Hi I just have a follow up question please. I have been taking the sudafed as you suggested which does seem to have cleared a lot of the congestion. For the past 2 days there has been a noticeable improvement in my smell but now it has reduced again even though the congestion seems much better. Is this normal? Could I use a nasal decongestant for occasional use? Thanks

Yes its normal.

No you should not use the nasal decongestant

Customer: replied 5 days ago.
Thank you. Why does it keep coming and going like this even when symptoms are improving? It's so frustrating! Should I continue with the sudafed?

Yes continue with the Sudafed.

You are having a big overlay of health anxiety, you should take anti anxiety pills also.

You are just obsessing about the congestion like I told you before.

Customer: replied 5 days ago.
I am taking some anxiety pills also as I know I am stressing a lot. I just can't help stressing it will never come back. Sorry!

I understand.

Anxiety is not an easy thing to bear.

Dont worry, I am here to help

Customer: replied 5 days ago.
It really is massively affecting me. Its the awful trapped in feeling of not being able to smell anything around me. And I know I probably keep asking the same questions over and over again but am desperate for it to resolve!
Customer: replied 5 days ago.
In terms of taking the sudafed. I have been spacing about 8 hours between doses. I have been waking up in the middle of the night to take a dose but would it be better to take it when I wake in terms of having more of an effect?

You dont have to wake up to take a dose.

You can take the doses at 8am, 3pm and 10 pm.

Customer: replied 5 days ago.
Thank you. I don't have any other symptoms now apart from reduced smell and the occasional pressure feeling in my nose coupled with like a twitching inside at the top of my nose. Is this suggestive that inflammation is still present?

No

Customer: replied 4 days ago.
OK thanks. What is this likely to be then? Even when symptoms reduce can it take a while for sense to recover? Apologies for pestering you.

Its health anxiety

Customer: replied 4 days ago.
I know but having never had a sinus infection before I don't know if these symptoms are normal.

We have had multiple interactions.

A second accept is in order if we are to continue this conversation.

Customer: replied 4 days ago.
Do you mean I have to start a new question thread?

Yes, you can start a new thread, or more simple, give a new accept to this answer which will be equivalent to starting a new thread.

Customer: replied 3 days ago.
I'm not sure how to give a 'new accept'

In that case, please start a new thread asking 'For Dr. P. Jyoti', I will be happy to help you