Ms Kuchai, having a blocked nose sounds like a very minor problem, but it can affect your
quality of life.
It can actually and it's often something that's lasted for a long time before somebody comes
to see the doctor.
And this is partly because people manage, they just manage day-to-day.
Often when the symptoms get severe enough that means people are finding themselves mouth
breathing for long periods of time.
Maybe even something as severe as snoring at night and finding that they are having
difficulty breathing at night, then they often seek attention.
But the other causes could be seasonal changes so they may find that summertime is particularly
bad, spring time with the pollens.
But when the symptoms are affecting things like catarrh, headaches and affecting the
wider spread of nasal congestion they may want to come and see the specialist.
So is it a good idea to just run to the pharmacy and buy all these nasal sprays or should you
do something else first?
There's a huge variety of sprays available over the counter and to be honest I spend
much of my time weening people off of these.
Even though they are over the counter and people deem them as being safe, the reality
is that they are quite addictive.
Things like Otrivine are readily available and we find that people reach for them and
have been on them for several months.
There is a maximum term for some of these and if you read the small print it says 1
week maximum.
They can help during a cold and they are certainly helpful in the interim period, but if symptoms
last for longer than 4-6 weeks you really should seek attention from your GP first and
then obviously they'll refer you to a specialist.
What they often will start with is a nasal steroid prescribed spray which is readily
available, not a problem to use for at least 4-6 weeks as a trial period and if symptoms
don't abate from that then speciality assessment with an ENT specialist is worth it.
And the main causes for blocked noses?
It is and the thing is it may not actually be affecting both nostrils, it maybe that
1 side is more blocked than the other.
So an ENT specialist will be able to look at the causes of this, whether it's anatomical,
a deviation of the nasal septum, whether it's something as common as polyps, which can happen
due to allergies and even just a nasal blockage from pollution dare I say it.
It's very common.
It affects people in London.
We're finding it increasingly in City life and we're seeing it more and more in younger
people and children as well.
And the range of treatments available allow you to bring back some form of quality of
life and of breathability?
Yes they certainly do and they could be as mild as saline rinses.
So saline rinses are homeopathic and I encourage most people to try this initially even while
they're waiting for a doctor.
They help cleanse the nose and bring things back to some kind of clarity and most patients
really love it and long term it's very helpful as an adjunct.
But we certainly can make a difference with nasal sprays.
They are usually of a steroid basis, which makes few people concerned at the outset,
however I'm always reassuring them that the steroid base is very minimal, they are safe
and they can be used long term.
And the condition could be as simple as allergic rhinitis which is equivalent to asthma of
the nose and this can be treated over a period of a short few weeks and then paused for several
months and then restarted if symptoms come back.
But we have the facility to look inside the nose at a deeper detail with endoscopy, which
helps us to ascertain whether the sinuses are affected, whether there's any ongoing
infection, or anything else in the back of the nose as well particularly in children.
So there's a variety of things that we look at in a 3 dimensional basis and can treat
it specifically depending on the cause.
So don't just reach for the over the counter sprays other than during an acute cold.
Okay.
Thank you very much Ms Kuchai.
Thank you.