effect of nasal steroids on asthma

[Montily]

hello all, DS has allergic rhinitis and asthma and we have recently started a new steroid nasal spray (dymista), and have also tried Nasonex. it seems that these are making his asthma symptoms worse. His asthma used to be well controlled with low dose clenil modulate, but since on the spray he has started to cough at night again (we experienced the same thing about a year ago but the doctors then dismissed a link). It's like having to choose between a blocked nose or a night time cough, like we are not able to control both at the same time. Has anyone else experienced this? Thank you!

[Tree20862]

In my experience, night time cough is usually sinus drainage. If I dry it up, cough goes away and asthma settles down.

Is he able to take Saline spray first? My ENT has me rinse with Saline, blow out all the mucous, then take nasal sprays. The nasal sprays work better on your nasal passages than on the mucous.

[elanaoali in reply to Tree20862]

I have just started (day 3 1 puff twice a day) the same nasal spray and use a saline spray to clear my sinus before using it.

[Montily in reply to Tree20862]

Thank you. We tried saline spray but he hates it (he's only 7). I do think it's good and will try to do more of it (especially as we are cutting out the steroid spray for now.)

[Hidden]

Have you checked all the ingredients in the spray as he might have a reaction to one of them, the only other thing is unlikely but corticosteroids ( in clenil and the nose spray) can cause acid reflux

ncbi.nlm.nih.gov/pmc/articl...

acid reflux causes coughing and can cause shortness of breath and these would be worse at night when lying down and these symptoms often dont respond to the normal asthma medications.

[Montily in reply to Hidden]

Thanks very much and thanks for the link - I will definitely look into this.

[Matman]

One gentler way of administering saline to the nostrils is to use an atomiser spray. You can buy these online, but I cleaned out then used one from a pharmacist that originally contained an over the counter nasal spray.

While I sometimes use this myself I do have some reservations over how often to do so. Just as the stomach has it’s own microbiome, so to do other areas of the body like the nasal cavities. The microbes that reside in these areas are often protective ones that fight unwanted infections, so frequently zapping them with saline might not always be the best way to treat them.

[Montily]

Thanks for your reply, had never thought about it like that! will try to find out more. Maybe along with using saline spray it would be beneficial to build up the microbiome somehow...