General measures that allow mucus secretions to pass more easily may be recommended when it is not possible to determine the cause. Many people, especially older persons, need more fluids to thin out secretions. Drinking more water, eliminating caffeine, and avoiding diuretics (medications that increase urination) will help. Mucous-thinning agents such as guaifenesin (Humibid®, Robitussin®) may also thin secretions. Nasal irrigations may alleviate thickened secretions. These can be performed two to four times a day either with a nasal douche device or a Water Pik® with a nasal irrigation nozzle. Warm water with baking soda or salt (½ to 1 tsp. to the pint) or Alkalol®, a nonprescription irrigating solution (full strength or diluted by half warm water), may be helpful. Finally, use of simple saline (salt) nonprescription nasal sprays (., Ocean®, Ayr®, or Nasal®) to moisten the nose is often very beneficial.
Steroid nasal sprays rarely cause side-effects. This is because they are applied directly to the nose and very little of this medicine is absorbed into the body. Therefore, they are much less likely to cause side-effects in other parts of the body. Occasionally, they cause dryness, crusting, and bleeding of the nose. If this occurs, stop it for a few days and then restart. There have been reports of nasal steroids possibly having an effect on behaviour, particularly in children. This is thought to be rare. However, a few people have reported hyperactivity, problems sleeping, anxiety, depression, and aggression.
The mainstay of treatment for allergic rhinitis, or hay fever , is nasal steroids. It is important to note that these are not like body-building, or anabolic, steroids. This type of steroids helps to control inflammation, in this case in the nose. For those with other than very mild and intermittent symptoms, nasal steroids are very helpful. There are two types of nasal steroids, aqueous or wet, and powder or dry.
Nasal steroids take at least several days to become fully effective, so they should be used on a daily basis for the best relief of symptoms. In those with only seasonal allergies, nasal steroids should be started a week or two before the anticipated start of pollen season. For those with perennial, or year-round allergies, nasal steroids should be used year-round. Nasal steroids are also used for nonallergic rhinitis and nasal polyps, and they can help decrease the frequency of sinus infection.
Nasal steroids should be sprayed in the nose and pointed away from the septum, or midline of the nose. Your provider should educate you on proper technique. Potential side effects include dryness, burning, stinging and nosebleeds. If you experience these potential side effects, your doctor may prescribe an alternative nasal steroid for you.