How to treat post nasal drip while pregnant

Rhinitis During Pregnancy Michigan | Allergy & Asthma Center of Rochester

Chronic nasal symptoms occur commonly in pregnant women, adding to the array of health care concerns during this exciting (yet intimidating) time of life.

Some studies indicate that substantial symptoms of rhinitis occur in 30 percent of all pregnant women. Pregnancy-associated hormones have been linked to swelling of the mucosal lining of the nose. These hormones may also indirectly affect the nose through their effect on blood volume during pregnancy. Circulating blood volume increases to 40 percent above non-pregnant levels, which may lead to increased nasal airway resistance during pregnancy.

A physician must evaluate a patient and diagnose what type of rhinitis is causing the nasal symptoms and then great care must be used to formulate a treatment program that will be effective, yet safe for the pregnant woman and the fetus. Routine allergy skin testing during pregnancy cannot be recommended since the potential exists for systemic reactions in very sensitive subjects which could lead to adverse fetal effects.

"Allergic rhinitis is probably the most common overall cause of gestational nasal symptoms," asserts Dr. Ringwald. "It may occur for the first time during pregnancy but it usually has occurred previously." He goes on to explain that allergic rhinitis is characterized by sneezing, runny nose, nasal itching, and perhaps eye itching. It may be seasonal and is frequently triggered by allergens such as house dust, grass, and animals.

Avoidance of any known allergen is especially important during pregnancy. In particular, avoidance of cigarette smoke is significant, not only because of the potential adverse effects on the baby, but because of the effects of smoking on chronic rhinitis/sinusitis. If a patient has been taking allergy injections, these should be continued during pregnancy. A slightly lower maintenance dose may be prescribed to decrease the chance of a systemic reaction. Immunotherapy should not, however, be started during pregnancy.

Bacterial rhinosinusitis is accompanied by sinus pain, postnasal drainage, and a purulent discharge. This type of rhinitis is not allergic in nature. It frequently follows an upper respiratory infection and seems to occur with increased frequency during pregnancy. Symptoms of ear congestion, fullness or stuffiness frequently occur during pregnancy and may be associated with bacterial rhinosinusitis.

Rhinitis medicamentosa is congestion that is brought on by inappropriate use of vasoconstricting nose sprays. Especially during pregnancy, use of any over-the-counter medication should be approved by your physician.

Non-specific post-nasal drainage is post-nasal drainage with clear or white mucus. Nasal congestion in this condition is not a major symptom. If neither allergy nor infection can be documented it may be directly related to the gestational hormone effects on nasal mucosa.

The discomfort caused by all these types of rhinitis may not be tolerated as well by the pregnant woman who is experiencing other physical and psychological stress. Rhinitis can adversely affect pregnancy through an effect on the mother's eating, sleeping, and emotional well-being or by worsening associated conditions such as asthma or sinusitis. The physician must weigh the benefits/risk considerations in the treatment of rhinitis during pregnancy.

In treating rhinitis in a pregnant patient every attempt should be made to use as little medication as possible. Before medication is suggested, non-medical solutions should be tried. For example, a buffered saline nasal spray may be useful for the dryness, bleeding, and vascular congestion associated with rhinitis during pregnancy. Patients with prominent post-nasal drip during pregnancy may benefit from twice daily saline irrigation with a bulb syringe.

The avoidance of allergens and non-specific irritants (aerosols, alcohol, temperature changes, smoke) cannot be stressed enough as a valuable approach to rhinitis symptoms.

Medications should be considered for symptoms which remain uncontrolled by non-pharmacologic measures and which cause substantial maternal discomfort. When alternative medications exist for the treatment of rhinitis the medication choice should be based on consideration of the safety information available for the various medications as well as on the comparative effectiveness of the alternative medication. The patient should be fully informed of the benefits, risks, and alternatives of any medication prescribed.

We encourage all of our allergy patients to notify us when they become pregnant. If problems do arise we can jointly devise a treatment program so that - optimally - rhinitis does not cause distressing physical symptoms during pregnancy.

Contact us today at (248) 651-0606 to set up an allergy treatment program for ensuring a symptom-free pregnancy. Our highly experienced Michigan board-certified doctors are here to help you!

Baby (and tissues!) on board: Tips for managing pregnancy rhinitis | Your Pregnancy Matters

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Your Pregnancy Matters

October 6, 2020

Your Pregnancy Matters

Robyn Horsager-Boehrer, M. D. Obstetrics and Gynecology

Pregnancy-related nasal symptoms are common, affecting up to 20% of women during pregnancy.

When you think of side effects or symptoms brought on by pregnancy, nasal congestion and runny nose are not typically among the first to come to mind.

But maybe they should. Having a stuffy nose, difficulty breathing or sleeping, and snoring when pregnant can be alarming, especially amid the COVID-19 pandemic and the start of flu season.

Pregnancy rhinitis, also called gestational rhinitis, is a common ailment in the second and third trimesters, affecting approximately 20% of women. Characterized by inflammation and swelling of the mucous membranes in the nose, pregnancy rhinitis symptoms include congestion (nasal obstruction), sneezing, postnasal drip, and runny nose. These symptoms can also lead to poor sleep when your growing belly might already be making it difficult to rest.

All these issues can dramatically affect your mood and quality of life. The good news is that, for most patients, pregnancy rhinitis is temporary and there are safe, effective treatments available.

I've invited my colleague, Ashleigh Halderman, M.D., an ear, nose, and throat specialist at UT Southwestern to explain in more detail the causes of pregnancy rhinitis and how patients can manage their symptoms.

What causes pregnancy rhinitis?

Dr. Ashleigh Halderman

The root cause of rhinitis can be allergic (affected by environmental irritants) or non-allergic (caused by infection). However, we are still learning how rhinitis is related to pregnancy.

We know that smoking, as well as having chronic rhinitis before pregnancy, predisposes patients to developing pregnancy rhinitis. Research suggests a few more potential causes:

Having extra fluid in the body: During pregnancy, the body makes more blood and fluids, which can cause swelling, even in unexpected places such as the nasal passages. Blood vessels in the nose can swell with this additional volume, causing stuffiness.
Higher levels of estrogen: Estrogen in older formulations of birth control pills has been associated with a side effect of nasal obstruction. However, in studies of the menstrual cycle, we don't see congestion with fluctuating estrogen levels. So, the connection remains unclear for now.
Creation of human growth hormone: The placenta creates a variant of the human growth hormone (HGH), which has been associated with nasal symptoms in other conditions. For example, tumors that grow on the pituitary glands secrete growth hormones, which can cause severe nasal congestion.

Gestational rhinitis is under-researched. Data to date suggest no known association of rhinitis with pre-existing asthma, maternal age, duration of pregnancy, or the number of times a patient has been pregnant. However, a recent study found that patients carrying female babies were diagnosed significantly more often than patients carrying male babies.

Related reading: How to manage allergies and asthma during pregnancy

How long do symptoms last?

The annoying, uncomfortable symptoms of pregnancy rhinitis typically last six weeks or longer. For most patients, symptoms typically resolve two weeks after delivery.

Approximately a third of patients who had chronic rhinitis before pregnancy will have the same level of symptoms during, and a third will experience worsening of rhinitis symptoms. However, the remaining third will have less severe or no symptoms during pregnancy. I've had many women tell me they've felt the best, sinus-wise, when they were pregnant. However, there's no specific reason why this occurs.

Related reading: 5 weird pregnancy symptoms you might not know about

What treatments are available?

The first step toward relief is a visit with your doctor to rule out infection, such as COVID-19, influenza, or sinusitis. We may also recommend testing for concerns such as sinusitis or pregnancy tumor (pyogenic granuloma) – a non-cancerous growth of blood vessels that may appear during pregnancy.

From there, your doctor and Ob/Gyn may suggest:

Getting regular exercise: Working out has been shown to significantly help relieve nasal congestion and regulate the sleep cycle. All the more reason to bust a move during pregnancy!
Elevating your mattress: Try positioning the mattress so your whole body is situated at a 45-degree angle. While not widely studied, patients have reported that this helps clear the nasal passages enough to sleep.
Using a humidifier: Adding a little moisture to the air can help alleviate nasal irritation. Many patients use them at night to wake up feeling less stuffy.
Trying a sinus wash: Nasal saline sprays or sinus irrigation systems such as a neti pot can help clear the sinuses. Make sure to use distilled or boiled (and cooled) water – using water straight from the tap is not recommended.

Topical decongestants such as Afrin can be incredibly and immediately effective, but there is a risk of dependency. If you use this type of treatment more than once or twice a week, your nose can become "addicted" to it, which can lead to rhinitis medicamentosa – the spray will stop working as well, and your symptoms may get worse. Also, unlike gestational rhinitis, rhinitis medicamentosa won’t resolve after you deliver. It will only resolve when you stop using topical decongestants.

In general, pregnant patients can take decongestants that include pseudoephedrine as directed. However, we always recommend talking with your Ob/Gyn first, especially if you have high blood pressure.

Your Ob/Gyn might also recommend a steroid nasal spray, such as Flonase or Rhinocort, for severe symptoms. If you were using a spray to manage chronic rhinitis prior to pregnancy, your Ob/Gyn might advise you to keep using it during pregnancy. It is generally considered safe to use these products while breastfeeding, under your Ob/Gyn's guidance.

Your body will change in interesting ways during pregnancy. If you have new or unusual symptoms, call your doctor. We'll help you sort out what's normal from what could be a sinus infection or respiratory illness.

To talk with a doctor about nasal symptoms during pregnancy, call 214-645-8300 or request an appointment online.

Prolonged nasal congestion (rhinitis) in pregnant women

Article rating

3. 62 (Votes: 13)

Contents

Causes of prolonged nasal congestion and rhinitis in pregnant women
The frequency of occurrence of rhinitis of pregnant women
What are we afraid of in pregnancy rhinitis?
What to do if you are pregnant and you are suffering from a persistent runny nose and nasal congestion?

One of the most common distressing problems of pregnant women is rhinitis of pregnancy (swelling of the nasal mucosa, accompanied by difficulty in nasal breathing, in some cases with increased mucus production or without it).

Causes of prolonged nasal congestion and rhinitis in pregnant women

Increased hormonal levels of progesterone, estrogen.
Emotional stress (which is pregnancy itself)
An increase in the volume of circulating blood, which increases blood filling, including the lower nasal conchas.
Gastroesophageal reflux - reflux of acidic contents of the stomach into the esophagus and nasopharynx due to an increase in the volume of the uterus (acidity changes cause the development of swelling of the nasal mucosa.)

The incidence of rhinitis in pregnant women more or less pronounced symptoms of prolonged (more than 6 weeks) nasal congestion, which can develop at any period of pregnancy, but most often in the II-III trimesters of pregnancy (from 12 to 38 weeks), which is understandable, based on the listed reasons for its occurrence.

A feature of rhinitis of pregnancy is that its symptoms completely disappear 2 weeks after delivery.

What are we afraid of in pregnancy rhinitis?

Despite the fact that prolonged nasal congestion and rhinitis in pregnant women accompanies a large number of women, unfortunately, if left unattended, these symptoms can lead to serious complications:

First, it is very easy to get naphthyzinum if a woman independently and uncontrollably uses vasoconstrictor drops, and this is highly undesirable during pregnancy, since the part of the drug that enters the bloodstream causes vasoconstriction and the entire vascular system and internal organs, including placental vessels, especially this it is dangerous if a pregnant woman has high blood pressure and a rapid heartbeat, these indicators may worsen while taking drops.
Secondly: against the background of a pronounced prolonged edema and blockage of the fistulas of the paranasal sinuses, with hypothermia or contact with an infection, inflammation in the sinuses may develop: sinusitis, sinusitis, frontal sinusitis, which will entail serious treatment, antibiotic therapy and infectious intoxication of the mother and fetus.
Thirdly: prolonged obstruction of nasal breathing naturally entails the formation of moderate hypoxia (lack of oxygen in the blood) from which both the woman herself suffers (headaches, fatigue, mood depression) and the fetus.

What to do if you are pregnant and you suffer from persistent runny nose and nasal congestion?

Be sure to contact a specialized ENT clinic or an ENT office, an otorhinolaryngologist, who, first of all, will conduct a safe and permitted diagnosis during pregnancy.

For example, in the ENT clinic plus 1, you will have an endoscopy of the ENT organs, including the deep sections of the nose and nasopharynx; to exclude inflammation of the paranasal sinuses, an ultrasound of the paranasal sinuses will be done; if necessary, laboratory diagnostic methods will be carried out. All these methods are absolutely painless, do not require any preparation and have no contraindications at any stage of pregnancy.

After making a diagnosis and prescribing (if necessary) drug therapy, you will be offered methods of hardware treatment, which are also allowed at any stage of pregnancy and are highly effective in removing blockage of nasal breathing: UZOL-therapy, photochromotherapy. These methods give a stable positive result achieved by a course of 8-10 procedures.

Remember that minor symptoms may hide a serious threat to your condition. Contact the experts and they will definitely help you!

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Stuffy nose during pregnancy - what to do and how to quickly remove congestion?

Expecting a child is a wonderful and very responsible period in a woman's life. The body is rebuilt, biochemical parameters change, protective functions weaken. Nasal congestion during pregnancy is a common occurrence. But it must be avoided by all means, since the lack of oxygen negatively affects the health of the woman and the unborn child.

Nasal congestion risk

One of the most common causes of nasal congestion in pregnant women is the common cold. The immune system can not cope with microbes, chronic diseases are exacerbated. The probability of the disease is especially high in the early stages, and this is very dangerous for the fetus. The first thing to do if your nose is stuffy during pregnancy is to see a doctor. Violation of nasal breathing leads to oxygen starvation. This can affect the health of the fetus, provoke hypoxia, which will lead to deviations in the activity of the brain and nervous system.

Causes of edema

The body of the expectant mother is busy supplying herself and the baby with nutrients. This task takes the main forces, so even the simplest infection can easily penetrate the body. Severe nasal congestion occurs precisely for this reason. From the middle of the term, hormonal rhinitis may appear. This is another reason why pregnant women get stuffy nose. During the period of maturation of the placenta, estrogen is actively produced, the walls of the capillaries become highly permeable, and severe edema occurs. At the same time, the nasal passages narrow, the mucous membrane in this case can be very dry. In the 3rd trimester, edema appears that is not associated with a cold. The situation is aggravated if the air in the apartment is too dry. The epithelium of the mucous membrane becomes thinner, and the secret begins to be produced with a vengeance. Therefore, in the later stages, the nose is often stuffy during pregnancy.

Symptoms of disease

Disease caused by infection has the following symptoms:

sneezing;
general weakness;
fever;
copious discharge from nose and eyes;
difficult nasal breathing.

Microbes of any etiology are dangerous for the unborn child. Call the doctor at home to limit contact with other sick people in the clinic. Without taking medication, without getting rid of the source of infection, you will not do better for the child. Rhinitis will turn into sinusitis and purulent processes will begin.

If the nose is blocked during pregnancy due to hormonal changes, the following symptoms occur:

jumps in blood pressure;
difficult to breathe, shortness of breath appeared;
sneezing, tear fluid;
skin rash.

Allergic manifestations are no less harmful than infectious ones. Remember that you are now responsible not only for yourself, but also for the life and health of your child.

How to treat nasal congestion during pregnancy

Aggressive treatments are prohibited during the first trimester. This can cause improper formation of the human skeleton and organs. Even drops from nasal congestion during early pregnancy cannot be used. The vasoconstrictive effect can provoke uterine contraction and miscarriage.

For early pregnancy, it is recommended:

rinse the nasal cavity;
rub into the temples and bridge of the nose balms "Asterisk" or "Doctor Mom";
warm hands under hot water for 5 minutes.

In the second trimester, homemade red beet or carrot drops diluted 1:1 with boiled water can be used. You can do inhalations, pouring a solution of sodium chloride into the nebulizer, 3 times a day.

How to treat nasal congestion during late pregnancy? If it is not possible to get rid of the disease with gentle methods, vasoconstrictors can be used in small doses under the strict supervision of a doctor. Only a specialist should prescribe them to you, do not buy by yourself! Medicines should not enter the bloodstream, they should act only locally. If the inflammation is extensive, the doctor will prescribe several washing sessions in the hospital. When other methods do not save, they puncture the sinus with accumulated pus, clean it with an antiseptic solution.

One of the home remedies for nasal congestion is Aqualor spray. Natural sea water actively fights microbes, removes mucus, making breathing easier. It is indicated for use by pregnant women at all stages. It is used in the treatment of nasal congestion in a child from birth (Aqualor Baby). The drug dilutes thick secretions, brings them out. The patient's condition improves immediately.