Sunday, August 15, 2010

Stop Dependence On Nasal Spray!‏

Several of my patients have come to me with the fear that they may be addicted to their over-the-counter nasal spray. Their sinuses are chronically blocked and they keep using a nasal spray to clear them! They’re not alone either. In fact, researchers claim that there are 10 million Americans chronically dependent on using nasal sprays!

There was even a funny skit about nasal spray addiction in the TV sitcom, King of Queens. When everyone is gone, the father-in-law takes out a hidden bottle of nasal spray, squirts some into his nostrils and lays back on the couch in an amusing daze, listening to jazz.

There is nothing amusing, though, about the serious medical issues, such as severely inflamed nasal tissues and nasal septum holes that can result from over-use of these chemical nasal sprays.

I’d like to talk to you about using nasal sprays safely and what you can to do stop your dependence on them. Then I’ll tell you about some natural, alternative decongestants that you can use that can both clear congested sinuses, heal inflamed nasal tissues, and stop the swelling.

Nasal Sprays: Over-The Counter vs. Prescription
Even though their labels clearly state they shouldn’t be used more than 3 or 4 days at a time, people enjoy the quick clearing of congestion they afford and continue using nasal sprays far past their deadlines. From this frequent use, natural sinus clearing mechanisms slow way down, or even stop, and using the spray is the only thing that clears the blocked sinuses.

This is called a rebound effect and can occur if you over-use them. The rebound effect is really the addiction to nasal sprays that people experience, as they do not contain any real, addicting chemicals in them.

Two of the most popular OTC nasal decongestants are Afrin and Neo-Synephrine. Both work very well in clearing what is supposed to be, occasional, sinus congestion like that which comes with a bad head cold. Both contain chemicals like xylometazoline, oxymetazoline, and phenylephrine which work fast to clear congestion and are meant to be of self-limiting use.

Rhinostat, RhinoCort, Flonase – are some Rx nasal sprays that doctors prescribe to their patients to wean them off OTC nasal sprays. They contain cortisone which decreases the inflammation and swelling of nasal tissues and do not have the rebound effect of OTC sprays.
Why Are You Using So Much Nasal Spray?
Most people start using nasal sprays for good reason. Like my patients, most sought them out for relief of congested sinuses. However, what many people might not know is that their constant sinus congestion could be due to an allergy and a condition called allergic rhinitis.

When patients tell me that they use nasal sprays for sinus congestion, I first like to find out what’s causing the congestion in the first place. Most often, they either have a seasonal allergy, say to spring or fall airborne pollens or molds; or year-round allergies to dust mite, pet dander, and molds. Treating the allergy first can prevent the abuse of nasal sprays.

In order to determine if an allergy is the cause for the congestion, I refer my patients to a specialist in the field of Allergy and Immunology who deals specifically with people’s allergies. There, they will get a skin test which involves putting about 100 of the most common allergens like dust mite, ragweed, molds, pollens, animal dander on patches to determine the reaction.

If any allergen patches are positive, then you have an allergy to that substance and need to stay away from it to avoid the allergic symptoms. Dust mite, molds, and animal dander are year-round allergens that can cause chronic sinus congestion.

If you have dust, or a pet, in your home, you are constantly breathing in dust mites and pet dander into your nasal airway causing them to become inflamed, swollen and congested. Dust mites are microscopic critters that like to burrow into carpets and bedding and can be everywhere. You likely will have to remove carpets and be sure you wash your bedding regularly. The use of a medical grade HEPA filter air cleaner can collect about 99% of allergens.

Pollens and molds are more seasonal related and blow around outside in the spring and fall. When you breathe these in they irritate your nasal passages. All types of upper respiratory allergens can also lead to chronic inflammation of the lungs and/or asthma if you do not treat or remove the allergen.

Sometimes, nasal polyps or other sinus diseases may be the culprit for your congestion. A visit to an Ear, Nose, & Throat doctor, who can examine your sinuses with a scope, and/or x-rays, can determine if there is a physical obstruction in your sinuses causing the congestion. Less common food allergies can also be to blame for chronic sinus congestion, like a dairy sensitivity, which can cause a lot of sinus phlegm. Even gastric reflux disease can be responsible for constant inflamed and congested sinuses.

As you know, I’m all for natural treatments of ailments whenever possible. Even though your particular dependence on OTC nasal sprays may require a brief weaning off with a prescription nasal spray as mentioned earlier, there are some excellent alternatives which can help you both deal with allergens and keep your sinuses open once you get off the OTC spray.

What Are The Alternatives to OTC Nasal Sprays?
Neti-Pot: Fill with salt water made from 1 tb sea salt and warm water. Tilt your head to the side and pour the solution inside one nostril. The water flows inside your nasal cavity and out the other side. Repeat on the other side. This washes away allergens and breaks up congestion.

External Strips – There are over-the-counter nasal strips that you apply across the bridge of your nose that manually opens the nasal passages to help you breathe better. These can also be used to wean yourself off OTC nasal sprays until you can determine an allergy or what else may be causing the congestion.

Tincture of Oregano – Found in health food stores where vitamins and other supplements are sold, one drop on the tongue can clear your sinuses very effectively.

Aloe Vera and Saline Nasal Spray – Also found in health food stores, this is a small bottle of salt water with aloe vera added to it. It can be used as a nasal spray to wash allergens out of your nasal passages. It is very safe and does not cause the damage that other OTC nasal sprays can.

Sinus Buster – Contains capsaicin (cayenne) which decreases inflammation, swelling, congestion. It too is a very safe, alternative nasal spray which makes use of the natural ingredient in hot peppers to clear your nasal passages.

Fenugreek and Bayberry – An old herbal remedy for sinusitis and congestion, mixed together in a capsule, opens nasal sinuses and decreases inflammation.

Bromelain – An enzyme from the pineapple plant that decreases inflammation in upper respiratory (lungs and sinuses) tract conditions.

Nasal congestion can be very uncomfortable to live with, especially if you find yourself mouth breathing a lot. This can cause a chronically dry mouth and sore throat. You may be tempted to do a few quick fixes with over-the-counter nasal sprays. While these products are okay for very short-term use if you have a bad cold, constant use can create more trouble than they are worth. Try a few of the natural decongestion remedies I’ve listed here and/or visit your doctor if chronic sinus congestion is a problem and get to the bottom of what’s causing it.

Stay well,

Mark Rosenberg, M.D.
Institute For Healthy Aging

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