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: A chronically stuffy nose may be a sign
of allergies
DEAR DR.PAUL: When my daughter gets a common cold, she
also gets a stuffy nose that seems to last for a long time. It
usually turns into a sinus infection or something requiring antibiotics.
Isn't there something that she can take that will curb the stuffiness
and help clear things up? Thank you.
PEDIATRICIAN DR.PAUL Answers: A stuffy nose is very
common in young children. The most usual reason for this is
that the nasal passages are quite small in children, and it
doesn't take very much to block them.
However, in situations where this is recurrent, like in your
daughter, one has to consider allergies. Allergens (something
that causes an allergy) such as dust mites, cat or other animal
dander, can irritate the nose resulting in chronic nasal congestion,
and sometimes a chronically runny nose. This is referred to
as "allergic rhinitis". Typically, the symptoms are worse during
the winter months when everyone tends to spend more time indoors.
Additionally, there is usually a history of allergies in the
family.
Another typical feature of the allergy symptoms which you describe
in your daughter, is that colds may last longer than usual and
often turn into sinus infections. This happens because the normal
drainage of the sinuses into the nose is blocked by the nasal
irritation. This leads to a build-up of fluid in the sinuses
which then get infected.
To treat allergic rhinitis in children we focus primarily on
identifying the specific allergen. We do this by performing
an allergy test. Once we have identified what is causing the
allergy, we can proceed to allergic precautions.
Dust mites, which are microscopic insects that live in dust,
are commonly identified allergens. They like humidity and can
be found in upholstered furniture and bedding. Dust mite precautions
include: removing the carpet and stuffed toys from the child's
room, washing the bed sheets weekly in hot water, covering the
mattress and pillow with specially-made dust-mite covers and
maintaining the humidity level at 40%.
If a pet, such as a dog or (especially) a cat is causing the
allergy, then we usually recommend removing that pet from the
household. Of course, second-hand smoke is a major risk factor
for all children.
Smoking should be avoided in the home and in the car at all
times.
In terms of medications, inhaled nasal (steroid) treatments
are available. These work by decreasing the nasal irritation,
which in turn decreases the symptoms. However, medications should
not replace the most basic treatment in these situations - the
identification and subsequent removal of any indoor allergens
or irritants in the environment that may be causing the problem
or making it worse.
Although an allergy is an important cause of a chronically stuffy
nose in children, it is not the only cause. Chronic nasal congestion
can also be caused by enlarged adenoids, the treatment of which
is different than that of allergic rhinitis. I'll deal with
that in an upcoming column.
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replace the advice and care of your child's physician, nor is
it intended to be used for medical diagnosis or treatment. If
you suspect that your child has a medical condition, always
consult a physician.
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