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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.



The information provided in this site is designed to be an educational aid only. It is not intended to 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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