90% of the time my right nostrilis blocked and left is open - #11713
Main Complaints Persistent nasal blockage (in one Right nostril) with burning head sensation. Morning sneezing fits (5–7). Loose stools (IBS-D like), urgent at times, with mild abdominal discomfort. Excessive thirst, stool urgency worsens with stress medicines. History – Nasal Blockage improves briefly with water/pressure. Triggers: dust, smoke, odors. Relief: nasal irrigation, Mometasone spray (Metaspray).( This spray was prescribed by ent specialist for 6 months , I can't discontinue it due to this suffocation and inflammation problem in right side of head) ENT: Allergic rhinitis (mask advised). CBC (1st Sept 2025): WBC normal (5.0 ×10³/µl) Lymphocytes 47.8% ↑ Monocytes 24.4% ↑ Granulocytes 28.1% ↓ RBC, Hb, platelets – normal ➡ Suggests chronic allergic inflammation, not infection. Pending evaluation: Deviated septum, turbinate hypertrophy, nasal polyps, allergen testing. --- History – Gut Loose stools since post-TB period.( Treatment was done in 2018 , and started from 2016) Triggered by foods; no bleeding/weight loss. Stool: sour/vinegar smell, mostly black; yellow when I consume dal–rice only. Mild fatty liver + occasional low BP. Past scopes (6 yrs ago): Normal.( Colono, endoscopy , gastro all 3 scopes are normal) Concerns: IBS-D root cause – gut dysbiosis, SIBO, bile acid malabsorption, FODMAP sensitivity. --- Past Treatments Nasal: Mometasone spray – partial benefit, stopped after 8 months. Gut: Occasional supplements, no recent antibiotics. Probiotics suggested but not taken. Nexito (escitalopram) → worsened thirst & stool urgency → discontinue after 6 months Key Questions for Doctor 1. Nasal: Is it pure allergic rhinitis or with structural issues (DNS, polyps, hypertrophy)? Which tests are needed (CT PNS, nasal endoscopy, IgE, skin prick)? 2. Gut: Root cause of IBS-D? (gut dysbiosis, SIBO, bile acid malabsorption, FODMAP). What tests, diet, or supplements are recommended? 3. Overall: Safe long-term plan covering both nasal and gut issues together.
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Doctors’ responses
Hello dear See as your clinical history it seems chronic allergy rhinitis only. It will require tests for confirmation Skin prick test Endoscopy if recommended by ent surgeon or pulmonary surgeon Serum ige level Ct scan of recommended For ibs tests are must to know if it is associated with diarrhoea or constipation CBC Endoscopy Celiac serology if recommended by gastroenterologist You can take following precautions Take laxatives Drink plenty of water Include vegetable and fruit in the diet Avoid curd or rice is sensitive to Cold Take citrus fruits for immunity booster Kindly follow these instructions for 1 - 2 months In addition please share the above tests details with both ent surgeon or pulmonary surgeon for better clarification Please donot take any medications without concerned physician Hopefully you recover soon Regards
Hello Abdul, thanks for sharing your concern. I am here to help. Here is my advise -
Nose - You probably have Allergic Rhinitis with a possible structural issue. Here are some tests ti be dine - CT-PNS, Nasal Endoscopy by an ENT doctor, Sr. IgE, Skin Prick Test. For now: Continue Mometasone nasal spray (safe for long-term under ENT guidance). Daily saline nasal irrigation (helps reduce inflammation). Avoid triggers (dust, perfumes, smoke). If obstruction is mostly structural (DNS/polyp) → surgery (septoplasty or polypectomy) may be needed. ENT opinion will be needed.
Gut Issues - You have features of Irritable Bowel Syndrome – Diarrhea type (IBS-D), likely linked to gut dysbiosis after TB treatment. Tests that may help your further treatment: Hydrogen breath test (for SIBO, lactose/fructose intolerance), Fecal calprotectin (to rule out inflammation), Stool routine + occult blood (basic check). Diet - Low FODMAP diet trial, avoid high-fat/oily foods, caffeine, alcohol. Take these medications - Tab. Lactic Acid Bacillus thrice a day Psyllium Husk (Isabgol) for stool regulation. Tab. Drota + Mf for pain.
Also, I suggest you to consider seeing an ENT specialist and a Gastroenterologist for your issues. The gastroenterologist can put you on a trail of gut-directed therapy.
Lastly, general advice -Adequate hydration, avoid unnecessary antibiotics, maintain sleep hygiene.
Feel free to reach out again.
Regards, Dr. Nirav Jain MBBS, DNB D.Fam.Med
Your persistent nasal blockage and morning sneezing suggest chronic allergic rhinitis, but structural issues like deviated septum, turbinate hypertrophy, or polyps need evaluation with CT PNS and nasal endoscopy, along with allergy testing (IgE/skin prick). Your IBS-D–like gut symptoms may be due to gut dysbiosis, SIBO, bile acid malabsorption, or FODMAP sensitivity, and targeted tests (stool studies, SIBO breath test, dietary trials) plus probiotics or diet modification can help. Please consult an ENT specialist for nasal evaluation and a gastroenterologist for IBS-D work-up to create a safe, coordinated long-term management plan covering both systems.
It looks like it has a component of both. Since it was partially benefitted from mometasone. Ctpns and nasal endoscopy both are good at checking for any structural cause but being an invasive procedure endoscopy should be done after consulting a ENT specialist. Skin prick test would be great to check for allergic cause. Considering your gut it is somewhat unclear what is the root cause. IBS -d has many causes some of which might be stress related, organic and even drug related. To understand the etiology like gut dysbiosis, SIBO, bole acid malabsorption. I think following up with a gastroenterologist for some period of time will be a better choice rather than self medication or diagnosing it just by medical history. As I can see you have good knowledge of your symptoms and medical history you should go for it. The best possible plan covering both the things can be You may continue mometasone Saline irrigation for some time. Get a CT pns done for nasal endoscopy you should consult ENT. Low fodmap diet and probiotics should be used as I can see you mentioned that you didn’t use earlier. This is the best to be done for now. I hope it helps you for now.
Hi Dear Abdul, First of all I appreciate for taking time to provide detailed history Regarding Nasal symptoms it looks more of deviated septum Kindly do a CT PNS Plain to look for nasal causes for obstruction Allergic Rhinitis history is associated too Kindly avoid fumes like dust ,agarpathi ,acids Wear masks and shades for eyes to prevent dust entry Avoid anything cold Avoid pets if any for allergy also we can do try surgical measures Kindly follow up with CT PNS Films Kindly donot panic Some people might have allergic changes in GUT Kindly avoid foods which you are allergic Can go for Oral food challenge test Take care
ENT: CT PNS + nasal endoscopy + IgE/skin prick → confirm allergic vs structural contribution. Gastro: Stool tests, SIBO test, FODMAP diet trial → clarify IBS-D cause. Medical therapy: Continue Mometasone spray (short-term), saline irrigation, probiotics, soluble fiber. Lifestyle: Stress reduction, trigger avoidance, hydration, balanced diet. Follow-up: After investigations, ENT + gastro to decide on surgery, dietary, or targeted therapy.
Addressing your nasal and gut concerns involves a multi-pronged approach that considers both structural and functional aspects. For the nasal symptoms, it sounds like there’s both an allergic rhinitis component and potentially structural issues like a deviated septum or turbinate hypertrophy. For a more definitive diagnosis, imaging studies like a CT scan of the paranasal sinuses and a nasal endoscopy can be particularly helpful to identify these structural issues. It’s also worthwhile to pursue allergen testing, through either a skin prick test or serum IgE levels, to pinpoint specific allergens and better tailor your treatment. Continuing with Mometasone can help alleviate inflammation, but if structural issues are confirmed, surgical interventions might be necessary.
On the gut front, the persistent IBS-D symptoms might stem from underlying conditions like gut dysbiosis, SIBO, bile acid malabsorption, or FODMAP sensitivity. A breath test might help diagnose SIBO, while a bile acid sequestrant could be tried empirically if bile acid malabsorption is suspected. Dietary modifications, including a low-FODMAP diet, can sometimes provide relief. Incorporating probiotics can also support gut health and is worth considering as there seems to be a suggestion not yet acted on. Consulting with a gastroenterologist for a tailored diet plan and possible supplementation is advisable.
For your overall health, developing a comprehensive plan that addresses both nasal and gut symptoms is important. Regular follow-ups with your ENT and gastroenterologist will allow for monitoring of symptoms and adjustment of treatments as needed. Lifestyle modifications, such as minimizing exposure to known allergens and managing stress through behavioral strategies or counseling, can also play an important role. Maintaining hydration will help counteract excessive thirst, which might also reduce symptoms of IBS-D especially if exacerbated by stress or stress-related medications. Your condition might benefit from a multidisciplinary approach combining medical, dietary, and possibly surgical interventions.
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