Hi doctor, I am 33 years. I am facing sneezing and itchy throat. Due to this problem, I am avoiding a few foods like chicken, brinjal, pumpkin. I face this problem in the early morning after I wake up from bad. Also, I start sneezing when I pass through the dusty environment. Also, I start sneezing when I was around any unnatural smell like paint, wooden polish, etc. One doctor prescribed me Montelukast and Cetirizine last year and I am using the medicine whenever I face this issue. It gives temporary relief to me. Is this medicine good for my health? Can I use this continuously for a long time? Please advise. Thank you.
Hello. You seem to be having vasomotor or allergic rhinitis. We need to diagnose it so that the treatment will address the cause. However, temporarily the symptomatic treatment would entail the use of steroid nasal sprays with antihistaminic and Montelukast. The choice of nasal spray and the antihistaminic can be done based on your work and response. Allergy to dust particles, local flora and pollens can be overcome by finding out the offending agent and avoiding it entirely. Such a diagnosis can be made using blood ELISA testing or skin prick testing. Sometimes the offending agent can be food allergen also. Regarding the choice of antihistaminics, there are second-generation antihistaminics with less sleep as a side effect. Some medicines like Cetirizine can produce sleep and dryness of the mouth. Fexofenadine is slightly better that way. Steroidal nasal sprays are generally safe and can be used for a long term. Fluticasone and Mometasone are popular. For further support do revert back to me. In that case please attach your previous consultation papers, any blood investigation reports. If you can click a picture of the throat with open mouth showing the posterior pharyngeal wall, it will be helpful for us to check for any postnasal drip, congestion, follicles, nodes, etc. Hope to see you in good health soon.