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Wednesday, June 19, 2013
Complimentary treatments for allegies?
My wife has developed allergies to dust mites and some trees since being pregnant. She had repeated sinus infections (7 in one year). She was referred to an allergist and has for almost 2 years now been receiving immunotherapy. Her propensity for developing sinus infections appears to be continuing, (3 this year already)... she is on rhinocort and Claritin. My question is besides environmental improvements to our home (removal of rugs, washing linens in hot water, all of which we have done) what are some other treatments that she might try. Are their any proven complimentary treatments that she might try...thanks
If she is still symptomatic with recurrent sinus infections, it is important to make sure she doesn`t have a structural problem such as blockage of the opening of her sinuses. This should be evaluated with a CT scan of her paranasal sinuses to exclude osteomeatal complex disease. It is also important to know what symptoms she feels constitutes a sinus infection. Some people think they have a sinus infection if they have increased post nasal drainage which does not indicate a sinus infection. Recurrent infections inspite of aggressive medical treatment should also bring to mind a possible antibody immunodeficiency that would predispose an individual to infections. This can easily be evaluated with blood work. You mentioned environmental control measure for dust mites but the two most important interventions not mentioned are protective bedding over the pillow, mattress and box spring to prevent exposure to the dust mites and dehumidification of the home to reduce growth of dust mites (indoor humidity should stay between 30-45%). Finally, it is important that she has the right diagnosis to begin with as she may have a strong "non-allergic" component of rhinitis to her symptoms. Patients with non-allergic rhinitis have year round nasal congestion with post-nasal drainage that is aggravated by strong odors and irritants in addition to barometric and temperature changes. There are better medications than what your wife is on to treat this disorder. Nasal irrigation with saline solution does also help when used appropriately. It is not the place of this forum to go into specific treatment alternatives. However, it sounds like you should discuss this problem with your allergist. If they are not capable of helping her then I would seek a second opinion from a board-certified allergist who did their residency in Internal Medicine and therefore should have more understanding of the medical management of this problem. To summarize, we see this scenario a lot and more can be done to help your wife. Good Luck.
Jonathan Bernstein, MD
Associate Professor of Medicine
College of Medicine
University of Cincinnati