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Question
Posted by: Mom2boys | 2010-11-21

Chronic rhinitis

Dr, my son is 7 yr old...Since he was very young he has been suffering from bad chronic rhinitis with the URI and mild asthma....His general count on the Rast was 270 and then 97. He tested neg on SPT for foods. He has been suffering BADLY the last 3 months, in Aug he had bad URI and viral infection, Sept he had bronchitis, beginning of Nov he had bad sinisitis and some lung infection. He finished his Augmentin last Tuesday....Thursday he cried from ear ache, went to pead AGAIN! The pead checked him(still crying) and emediatly referred him to a very good ENT(who was willing to see us after hours). He was put on 2 antibiotics, with good results for the ear infection. He is on ALL the possible anti allergy meds(Zyrtec, Nasonex) you can think of, plus asthma meds(Flixotide). We are avoiding milk and sweets as far as possible, but even with this last 2 antibiotics(6 in the last 3 months), he STILL has bad post nasal drip and coughing. This was his first introduction to an ENT, can you tell me if we might be on the right track now, is this maybe the answer to maybe getting our son better? I''m not sure what the role of the ENT is in treatment of a chronic rhinitis/ sinisitis/ asthma, allergies? We have been to 2 good proffesors in allergies....still no result. Ps: He started swimming alot the last 2 months, this seemed to worsten his symptoms?

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Our expert says:
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Dear Mom2boys

The role of an ENT is to manage sinusitis, rhinitis and earproblems related to this, but NOT to treat the asthma. It is a fact that uncontrolled nasal symptoms will badly affect the asthma. A child of 7 only has limited developement of the sinusses, as the frontal sinus for instance only developes after this age.
Post nasal drip can never be completely cleared, as a certain amount is necessary for normal functioning of the airways.
It is important in your child's case that there is a close relationship between his ENT and Paed, as he would benefit from a combined approach. Your ENT will advise if surgical intervention is required, as this may alleviate symptoms, but not cure his allergies.
Swimming is generally regarded as a good form of exercise for an asthmatic, so the deterioration in symptoms may be related to chemicals in the water? A salt chlorinator would be much better than chlorine, as chemicals may be to blame for his problems. Saltwater douches is regarded as beneficial for sinus disease, so one would at least expect his symptoms to remain stable. Discuss this with your paediatrician, as a balance is necessary regarding
your sons symptoms and his levels of activity.

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