Q: I am 26 years old male. I am using Alerid (cetirizine) tablet to treat allergic sneezing, runny nose, etc. The problem started almost four years ago. Now I am working abroad. In India, I underwent a nasal surgery to combat this problem but it didn’t help. Please give me your valuable suggestion regarding the treatment of my frequent nasal symptoms.

A:Nasal block occurs when the mucous membrane inside the nose swells up. Usually, this occurs in common cold, which is due to a viral infection. The treatment for this virus infection includes pain relievers, plenty of water and other hot fluids, steam inhalation and nasal decongestant drops. Most of these medicines are available in several countries without a prescription. This type of cold gets better in a few days. Occasionally, a common cold may turn into a bacterial infection and persist for a longer time. At that time, some antibiotics may have to be given. Some persons have a lot of bends inside the nasal cavities. Obviously, when there is such a bend already inside the nose (deviated nasal septum), even a small swelling of the mucous membrane may lead to a relatively large phlegm or infection can not come out easily and stays for a longer time and troubles the patient. The entire above sequences of disease production can occur with allergy. In patients with structural bends or blocks inside the nasal cavities, several types of surgeries are available to correct the bends inside. This correctional surgery is called a Submucous Resection (SMR) or a Septoplasty. The exact steps of such surgery are decided by the individual surgeon based on his experience and with the aid of an x-ray or a CT scan. If there is any additional block inside the nose or in the adjacent air cavities (these are called sinuses), a newer type of surgery is now available. These newer type of surgeries are called Functional Endoscopic Sinus Surgery (FESS). This is a surgery done inside the sinuses and the nose. Endoscopes are utilised in carrying out the surgery. The aim of the surgery is to restore proper function. Thus, the name says it all. Please remember that such correctional surgeries can only correct the structural abnormalities inside. They cannot protect you from the daily and frequent onslaught of allergy producing substances like dust, diesel smoke, etc. The treatment of allergy is avoidance of the allergy producing substances like dust or offending food items. If this is not possible, antihistamines can be taken. The recent day antihistamines are effective and generally do not have any side effects except drowsiness. The degree of drowsiness produced by these antihistamines is different in different individuals; and also, in the same individual, the same drug may produce a different degree of drowsiness in a different situation. It is impossible to exactly predict which patient will get drowsiness. One common side effect of this group of drugs is drying up of throat. When allergy medicines are used every day for more than a few weeks, some may lose their effectiveness. Simply, changing to another medicines will be helpful. Since about two decades, steroidal nasal sprays are available. These sprays prevent the ill effects of allergy and make your day-to-day activities, very comfortable. Cetirizine, prescribed by your doctor, is a good and effective drug and can be taken as advised by him.