Do sinus rinses clear stubborn gunk at back of nose and throat?

[Itswonderful]

Just that really. Had several courses of prednisolone and doxycycline over Christmas, January and February after chest infections after catching colds, I used a nasal wash twice a day for weeks but it seemed to miss where the mucus gunk is stuck. If anyone has any experience of this I would be grateful

[Patk1]

I like sterimar( sea salt spray), as easier to use.i find if I do it a cpl of tomes,it really helps I also use a steroid nasal spray,antihistamines and occasionally decongestants

[Itswonderful in reply to Patk1]

Yes I have antihistamines too but still the gunk stays.

[Poobah]

Persistent nasal mucus and congestion is exhausting and affects sufferers more than we realise. There are a plethora of vlogs on YouTube about nasal washes etc and I'm sure you've followed the instructions and despite this and other treatments still are dogged by unwanted symptoms.

If there is persistent mucus, it may be worth trying Carbocisteine, a prescription treatment that can thin mucus, making it easier to expel. Your doctor may also want to prescribe a steroid nasal spray to tackle any ongoing nasal inflammation. This takes a while to see results, but daily use can see good results. Again, there are useful vlogs about how to get the best technique for nasal sprays on YouTube. I find Dr Vik Veer, an NHS ENT consultant, a trusted source on YT. He also warns against the use of over the counter decongestants, as they can cause more problems if used too much.

I find my whole respiratory system hates the winter, with too dry air indoors and not enough fresh air, the mucus membranes can over compensate for the dryness and produce too much mucus. Keeping humidity levels up indoors, to an optimum level (35% to 45% relative humidity) can pay dividends.

Finally, keeping hydrated will help with thinning the mucus and keeping your Vitamin D levels up, especially through winter. I'm probably telling you stuff you already know, but if all this doesn't work, maybe it's time to consider a consultant led resolution, in order to get on top of chest infections etc.

Wishing you well.

[Stewiecat in reply to Poobah]

'My whole respiratory system hates the winter' really strikes a cord with me, great thoughts and ideas specifically on nasal congestion and the dreaded winter gunk over production, thank you as ever for really good advice shared, ditto high dose vitamin d3 has been a benefit to me 😊 x N

[Itswonderful in reply to Stewiecat]

I also take D3 in winter. What dose are you on and do you vitamin K with it?

[Stewiecat in reply to Itswonderful]

I take 4000iu vitamin d3 daily through winter, I don't do vitamin k, carbocisteine is definitely worth a try, I take daily dosage depending on how I feel, and what needs shifting from my chest, it's all part of a tight routine that's developed over time in an attempt at management, in order to live lol it's a never ending cycle for us all I would guess. I hope you find some help in the suggestions, and some relief from the dreaded gunk, lots of good wishes coming your way x N

[Itswonderful in reply to Stewiecat]

Thanks Stewiecat. X

[Itswonderful in reply to Poobah]

Thanks Poobah. Yes I am doing all of those things including humidifiers around the house, but I have never been prescribed carbocisteine. I have thought about asking my consultant about it and also a preventative antibiotic through the winter, like you, as the winter is definitely not my friend. I will have another look at the YouTube video on best use of steroid nasal spays. Last year I had a fungal infection of the vocal cords that had been there well over a year, as it took that long for me to get the ENT appointment. Once I had that I was successfully treated with an antifungal medication but the idea of the steroid nasal spray dripping down the back of my throat concerns me a little. The mucous at the back of my throat causes me to cough until I gag and I know from Speech and Language appointments that the more you cough, the more you cough, so sorting this out would be so helpful Thanks again. 🙏

[Patk1 in reply to Itswonderful]

It's recommended not to sniff steroid spray hard,as u want it to remain & work on nose + sinuses.have u had sample of mucous tested to check for infection? My sister was given mometasone nasal spray for sinusitis with laryngitis and congestion.she was doubtful it would work but it did - its a prescription spray.within few days it was helping.

[Itswonderful in reply to Patk1]

Yes I have prescription steroid nasal spray. I avoid sniffing it because I want to avoid another fungal infection. I have had two samples sent off this winter and both showed I had two bacterial infections going on st the same time so was given doxycycline which worked and when I sent the second sample off I had picked up two more different bacterial infections so was on doxycycline again. It works well but I don't think it completely clears the stubborn infection that's is in the gunk at the back of my nose and throat and behind my ear drum on one side. It's a proper nuisance.

[Patk1 in reply to Itswonderful]

I'd see Yr gp if infections still there.it can take extended course to clear stubborn sinus infection.if u get given antibiotics,if its not gone,get more b4 yr course finishes - maybe worth suggesting an extended course x

[Itswonderful in reply to Patk1]

Thanks Patk1. I think you're right. I have tried just about everything. I have mentioned a few times that I didn't think the infection was totally cleared but because I don't generally spike a fever, I don't usually get anything for it. It's frustrating but I will give it another go.

[Poobah in reply to Itswonderful]

I know what you mean about the steroid spray dripping down the back of your throat, especially if you've had a fungal infection. If you have concerns about that, then I think your idea about a preventative antibiotic may be the answer.

Re vitamin D. I take oil based vitamin D3, oil based Vitamin K2 km7 and magnesium malate. The 3 work together to as vitamin D doesn't work as well if just taken on its own and the two vitamins need fat to be absorbed. I always say get your vitamin D levels checked before you start, as it's important to monitor your levels if supplementing and re-test at periods to ensure a) it's improving your vitD levels and b) you're not over doing it.

[Itswonderful in reply to Poobah]

Thanks Poobar. I have had vitamin D3 oil but at the moment I'm on tablets with K7 and also magnesium. I have had my levels checked and they were to the higher side but within normal range so I know it works. I think I will have to about carbocisteine and a preventative antibiotic.

[Poobah in reply to Itswonderful]

Hope you get a resolution soon.

[Itswonderful in reply to Poobah]

Thank you. It's been a very long term problem but this gagging cough is worse than it ever was.

[Potatocrisp]

I can't use steroid nasal sprays as they cause me dizziness. Although I use antihistamine it doesn't stop it . I find Neilmed Sinus rinse does help but doesn't stop it altogether. Amazon has it . I buy a pack containing several premixed sachets which includes a bottle which you probably know is mixed with warm water from a boiled kettle . The idea being after having squirted most of the mixture up and rinsed you sniff the residue in the nostrils hoping it will reach the sinuses.

[Itswonderful in reply to Potatocrisp]

Thanks for replying. yes I've used a lot but it never gets to the part that I need it to get to. It's a real nuisance.

[T1ggy]

I had tried everything in these comments and had same problem for years. Nothing really works. All the articles say drink more water which I admit I thought would never do any good. Being age 80, it seemed a fad to me to be continually drinking from a bottle! Anyway I started drinking more, about 3/4 litre. To my surprise this does seem to work and my blocked nose and throat are much better. The gunk is still there but much looser and easier to clear. No more choking, touch wood! Still using all the other things, neilmed, nasal spray, steam inhalation too.

[Itswonderful in reply to T1ggy]

Yes drinking lots of water does help. I'm very glad it's helped you.

[peege]

Blocked sinuses the bain of my life. I saw a face scan years ago. It was done by maxofacial consultant for a jaw issue, she sent me next door to the ENT consultant who who showed & explained the scan....there are cavities in the forehead and cheeks, mine were absolutely full of solid gunk and the drainage tube down to nostrils was so inflamed it was like a hair so nothing could escape. (I'd been treated for years with migraine for 10 day severe headache, turned out it wasn't migraine it was the pressure from the blocked sinus cavities). I had to use a steroid nasal spray for a long time to reduce the nasal inflammation & I also had a little op under GA so eventually the solid matter could escape. ENT man had reccomended Sterimar (sterile seawater) too. Its a faff but use it with head hanging off the bed, tilt head to the side so saline reaches where you need it then tilt to the other side to spray. Another thing I learnt at the time was acupressure, pressing in the brow bone & either side of nostrils where nostrils meet the face(look up acupressure for sinus release on youtube) it definitely works for me. Lastly, there's a spot either side of base of skull, if I use gentle pressure there it also releases my sinus. I still use a steroid nasal spray from time to time when I think there's inflammation Plenty of fluids too. P

[Itswonderful in reply to peege]

Thanks for this. I will try the acupressure for sure. I've tried Sterima but like Neilmed, whilst it washes out the nasal cavities it doesn't go right to where I want it to go. You are right, it is the Bain of our lives 🤧😮‍💨😬

[SuziElley]

I’m on antihistamines for long Covid but have been introduced to NeilMed nasal wash. It really is good. Takes a bit of getting used to but once you get the hang of it, it seems to help with that gunk! I’m also on carbocisteine, various inhalers and montelukast for my asthma. Maybe see your asthma nurse

[Itswonderful in reply to SuziElley]

Hi SuziElley. I also use Neilmed and it does clear to a certain degree but it doesn't get to gunk right at the very back of my nose and throat which causes the cough. I have never had carbocisteine. I'm on a biologic and have come off monteleuclast but I can't really notice the difference tbh. I'm under the Brompton and was planning to talk to my consultant this month but my appointment has been changed to December. That's a bit of a wait!

[peege in reply to Itswonderful]

I asked the GP once if Carbocysteine helped moisten the nasal stuff as well as my lungs & she said absolutely not it's only directed at lungs.

[Itswonderful in reply to peege]

Thanks peege.

[Stewiecat in reply to Itswonderful]

Yes, peege your right, thinking about it sensibly, carbocisteine has no access to the nose, sorry itswonderful im not more helpful, I do sympathise totally though, I walk a balance between eosinophilic clogged chest, angry blocked sinuses and left ear problems which ever or all's not happy on a given day, I'm told it's all linked by the internal e-inflammation 🤷‍♀️🤦‍♀️ like many i miss the days of just being able to be 🤦‍♀️🤣 x i do hope you find some relief, hopefully spring and warmer weather helps us all, take care 🤞 for some relief for you very soon x Nicola

[Itswonderful in reply to Stewiecat]

Thank you. Nicola. I just googled it and there has been some research into carbo for sinus problems and it says it does work! So maybe it's worth an ask.

[Stewiecat in reply to Itswonderful]

Ah, might be worth a try then, it's such a merry go round game of trial and error, working out what works, I hope you get your consultant appointment brought forward, that's a very long wait x N

[Itswonderful in reply to Stewiecat]

Thank you. X

[SuziElley in reply to Itswonderful]

That is a long time to have to wait. Maybe ring the consultant’s secretary and ask for an cancellation that comes up

[Itswonderful in reply to SuziElley]

I am definitely going to do that. I can't imagine what's happened to move an appointment forward by 9 months.

[Karenjaninaz]

Retired nurse anesthetist here. I also this since I’m on oxygen 24 seven, and even though it runs through water, my nose gets dry and the normal secretions feel like they’re choking me.

Sinus rinse only works in the front of the nose unless you let it drop down the back of your nose into your throat. This is a technique to wash it down. You do end up swallowing a little salt water, but it won’t hurt. An expectorant, such as guaifenesin also known as Mucinex in the United States, really helps the most. However, you must drink a lot of water with it to work because it mobilizes that water to liquify the mucus. The problem is you end up having to go to the loo a couple of times at night. I also have those saline portable cans that you can spray on the go. Sometimes those will be enough to do it, but you have to let the stuff drip down the back of your throat to wash the dry stuff down.

I feel like I’m an old car that needs constant maintenance.

[Itswonderful in reply to Karenjaninaz]

Thank you Karenjaninaz. I've had the guaifenesin in some over counter medication such as Benylin cold and blocked nose tablets. You definitely need to drink an awful lot of water as it makes mucous membranes very dry if not. I have found I just can't drink enough water when I take these as I already drink lots of water and other fluids. It really dies me out. I can relate to dry nasal passages yet it still runs! I'm going to try somehow letting the Neilmed or the canned salt water nasal rinse go down my throat but not sure of the technique to use to achieve that. Ha ha! I feel like a car that needs continuous maintenance too!

[Patk1 in reply to Itswonderful]

I manage to point the sterimar nozzle towards sinus opening so some goes in.i find it so gd,I keep on bedside table. A can lasts a long time.chronic rhinosinusitis is no fun but very often accompanies asthma& lung disease.mu biologic fasenra helps my asthma but not nose/ sinuses.

[Itswonderful in reply to Patk1]

I will have a go. Yes I agree. I'm on Tezspire and it's helped with the allergic part of the asthma but I'm still prone to respiratory infections and then the asthma kicks in and I really don't think the resulting sinus infections ever really clear. They just hang about sub- clinically and wait for the weather to change in the autumn and then they strike. Vicious cycle.

[Patk1 in reply to Karenjaninaz]

I find the sterimar sea salt sprays helpful.often have to use more than once.i think air bubbles get trapped in mucous in sinuses too.i do occasionally take a decongestant too when bad.ive severe eosinophilliac asthma,among many other lung probs, so chronic inflammation doesn't help.i hope u have something to help with yr nasal dryness - it's worth posting to see what others use x

[Itswonderful in reply to Patk1]

Thank you. 🙏

[RestlessOwl]

I had an asthma exacerbation last May. It has taken until 3 wks ago to get it under control. It started with a sinus infection which wasn't dealt with as docs so reluctant to prescribe antibiotics.Post nasal drip carried on and on despite trying different steroid drops, nasal rinsing, steaming etc. until chest got infected. Then came the asthma.Multiple 5 days courses of Amoxicillin or Doxycycline didn't work. Saw specialist. He put me on Trimbow 172/9/5, Prednisolone, Dymista nasal spray, Fexofenadine, Carbocysteine 2x day, Montelukast at night. Still wheezy despite all those drugs. Saw GP as had already had 2 trips to A&E. She said my chest sounded dreadful i.e infected.

She put me on Azithromycin for 3 days. A game changer. It cleared up the PND I had struggled with for months. Specialist prescribed it 3x a week as a prophylactic to help prevent further infections. I am now wheeze free and mostly PND free. Next problem is weaning off Prednisolone and scary Montelukast. Had anyone had experience of weaning off Montelukast as there's nothing about it online I can find. Only really scary stories about people's personalities changing when they come off it.

[Itswonderful in reply to RestlessOwl]

That is the stir of many of us I fear. Most of us know we are heading for a chest infection but GPs are really reluctant to prescribe antibiotics until the infection is bedded in then it takes multiple courses of antibiotics and steroids to shift it. I'm glad you are feeling better now.

[Itswonderful]

I came off monteleuclast a few months ago with no problems at all.

[Stewiecat]

I'm not sure montelukast makes any difference to my asthma, I've been on it for a year whilst under my consultant, but I don't feel it brings any benefits, my qvar addition on the other hand has been life changing in regards daily management, and nebulising (along side breathing physio) has been a great help. I haven't heard of montelukast being a problem to stop?? Prednisolone, yes, it's a complete pain as it makes me feel amazing, but I have to go through the descending dose to get off it 🤦‍♀️ Restless owl, I'm glad you are feeling better finally, i hope you are able to come off the montelukast without problems 🤞 for you x N

[Itswonderful in reply to Stewiecat]

Same. I was on it for years and years but never thought it did much. What's qvar?

[Stewiecat]

Qvar is another inhaler, I have fostair 100/6 and Qvar (2 puffs each twice daily) it's the one thing my consultant added immediately that had an immediate positive impact, it's a finer mist so gets further in is how understand it 🤷‍♀️ it helps so hurrah 😊 lol x

[Itswonderful in reply to Stewiecat]

Big huge Hurrah! 🥳

[Itswonderful in reply to Stewiecat]

Just seen that you can buy this from Lloyds Pharmacy with on on line consultation. Who knew? £31.00.

[Stewiecat in reply to Itswonderful]

Really!? Wow indeed who knew 🤣 x

[Lysistrata Administrator Community Ambassador in reply to Itswonderful]

Hmm but who is that consultation with? If someone's asthma is complex (or even if it's not), should they be adding extra inhalers in that their GP and/or hospital team don't know about, based on an online consultation with a non-specialist or possibly non-doctor?

[Itswonderful in reply to Lysistrata]

I was surprised that it's available to buy. It's a consultation with a doctor I believe but it's a questionnaire.

[ALUK_Nurses Partner Administrator ALUK Asthma Nurse in reply to Itswonderful]

You should always consult a healthcare professional if considering changing your medication or treatment.

[Itswonderful in reply to ALUK_Nurses]

Thanks Nurses. I understand we should all be very cautious. . I, for one, am not thinking of changing my meds. I was just surprised that Qvar is available to buy, albeit with a consultation with the pharmacy. I hadn't heard of this particular inhaler before and I just googled it and it came up as being available to buy with a consultation. This increasingly the case though. I'm thinking of hydrocortisone cream and something like Gina. I do wonder if the aim is to take the pressure off GPs?

[Stewiecat]

I can see from your profile 😊 you are on tezspire?? Has it helped you?? X Nicola

[Itswonderful in reply to Stewiecat]

Hi Nicola. It has helped with the allergy part of the asthma but not with winter viruses that end up with respiratory infections and asthma flare ups and of course this gunk! This winter I didn't get as unwell as last year so I don't know if that's because of the Tezspire or because of the type of bacteria around this year. X

[Stewiecat in reply to Itswonderful]

Hmm it's so hard to know isn't it, and madly annoying 🙄 I'm really glad to hear it's helped you with the allergy part but the virus part is so huge (at least 6 months of the year 🤦‍♀️) that it's disappointing to know it doesn't lessen this too. I've had less infections this year, again unsure if that's the type of bugs flying around? the fact I had a pneumonia jab in September? Or that I have been more cautious so worn a mask/sanitised more this year?? Despite less infections I've still had pred every 4 weeks ☹️ as my eosinophilic body doesn't like the cold/damp outside air or the dry/central heating indoors air 🤦‍♀️ it gives me a cough, then mucus, then a wheeze, then inhalers not working, so the dreaded pred is my remaining choice 🙄🤣 I have to laugh or I'll give up x I'm taking my first step into tertiary care tomorrow, referred for tezspire, to be honest I'll take anything I can just to get out of the cycle I'm now in. Did i ask if you have you tried doxycyline as an antibiotic option?? It's the one I always ask for, as i find it sorts my gunk on my chest and anything going on in my sinuses, hopefully the coming change in weather will help us all 🤞 x lots of good wishes N

[Itswonderful in reply to Stewiecat]

are we related? 😉. Everything you have written could be about me! I hope the Tezspire helps. It takes a few months to bed in so don't worry if it's not immediate, though occasionally it can be. I partially isolated this winter in an attempt to avoid infections but I didn't do it enough so next winter I will do more. The problem is with that is no social contact except for outside and like you, the cold air doesn't like me. I have humidifiers in my house all winter and I keep the air warm. I think we should be living somewhere warm, don't you? 🌴

[Stewiecat in reply to Itswonderful]

🤣🤣🤣 your post struck a cord with me, we sound like we're walking very similar paths x 5 years 11 months we're mortgage free and off to majorca 🥳 so yes somewhere warm is just over, there 👉🤞😂 you're welcome to visit if we're related 🤭 just like you I isolate every winter, to a point, but with a college age daughter and a building site husband it's kind of pointless, I hide they bring me the bugs, bless them, I had to quit my office job, so clean in the evenings to keep my head sane, it's a way to work but avoid people 🙄 and the exercise is good for me x I wear a mask from Oct to April, sanitise,use nasal blockers etc but still live on pred, so 🤷‍♀️🤦‍♀️ my consultant is hopeful it'll help, I have no allergies, just the Eosinophilic asthma so 🤞🤞 and be patient is all I can do I guess. I hope your sinuses start to clear and ease, I wish I had something helpful to suggest, I know the lovely nurses on the ALUK helpline are raved about, so they might be worth a ring tomorrow, for some suggestions you haven't already had x Nicola

[Itswonderful in reply to Stewiecat]

oh we are definitely related. My husband bought home a hum dinger of a cold this year donated to him from primary school children. Even though we lived in separate parts of the house and wore masks I still picked it up. We have been talking about moving to Spain too. Are you moving lock stock and barrel and buying over there? I have questions about health care and not being able to speak Spanish etc. Why have you chosen that part of Spain? How is the asthma with flying?

[Stewiecat in reply to Itswonderful]

We hide and the germs come to us 🤦‍♀️ I'm actually relieved (sorry!) that it's not just me living this madness 🤣 The Spanish plan is to have no plan 😆 I worry about all those details too, so am trying to look soley at the positives (sun, warmth, consistently better breathing omg how amazing would that be!) we'd like to keep our house here and have a small 'go to and from ' in the sunshine 🌞 but it'll happen how it happens, all in/part in were off 😀 we've been to majorca alot over the years, my asthma journey started suddenly in 2021 so we've only managed to get back to flying last summer as I was too poorly the years before, the flying was fine (helped massively by my fab consultant giving me some extra pred to take with me incase 👍) i took some extra puffs of fostair, more for my nerves than through need and wore my mask cause the regurgitated air on planes fills me with dread, but hey it was fine, i was fine, we had a fantastic time, it reminded me what it's like to actually live like a normal person x N

[Itswonderful in reply to Stewiecat]

The idea of just being able to breathe and live relatively comfortably year round is so luring. We lived abroad for two years in a subtropical country and I wasn't ill once. It was bliss. Came home and it all started up again. Your plan sounds like a good plan to me. I've heard rumours that the Spanish government are trying to deter foreigners from buying second home though that seems to have gone quiet at the moment. I understand completely that it is good to know/ talk to someone else experiencing this. It helps to talk about it and what treatments have been useful. 👍. X

[Stewiecat in reply to Itswonderful]

So you know how much difference the warmth and lifestyle can have 👍 x we can't wait, even if we make it work with living here but holidaying every couple of months, a camper van is a consideration 😊 i can't tell you the difference finding this forum and all you lovely people has made to my previously dwindling sanity 🤪🤣 it's hard going on your head, being 'ill' so much of the time hey, I hope you start to feel better over the coming days, keep in touch, it's been great to find family I didn't know I had 😉😂 x Nicola

[Itswonderful in reply to Stewiecat]

I really do! When I saw GP last month for yet more doxycycline and prednisolone she said "are you going to go and live somewhere warm ?" I told my husband and he's up for it. Camper van sounds good. I th in no just selling up and moving might be a bit scary in case there's problems and no way back. I'm in Norfolk at the moment and I do like it here it's just the winter weather and the winter bugs that spoil it. I was well during lockdown so I know it is colds and other respiratory infections that cause huge problems for me (and you because we are related😉). I'm so glad spring has arrived! Hurrah! Jayne x

[Stewiecat in reply to Itswonderful]

I'm in Cambridge, perhaps we really are related!! 🤭🤣🤣 catchup soon, take care, feel better soon 🤞 x Nicola

[Itswonderful in reply to Stewiecat]

I lived in Cambridge for a few years! Anyway, I'm sure it's time for 💤 😴 so good night x

[Patk1 in reply to Itswonderful]

If I'm among people or at hospital/ drs appointment,I use viral blockers coldzyme throat spray + vicks first defence nasal spray - i think they're quite effective.i also carry handgel everywhere