Breathing difficulties
May 28, 2009 | 30,00 EUR | answered by Björn Biermann
Dear medical professionals,
For several years now, I have been suffering from an allergy. My nasal and oral mucous membranes are dry, and my nasal mucous membranes swell up so much that I can hardly breathe. Speaking and swallowing (even saliva) is extremely difficult for me. Breathing while lying down is particularly challenging. Sleep is often out of the question for me, as I almost always panic at the thought of suffocating.
X-rays of the airways and nose have shown no abnormalities. Multiple prick tests and extensive skin tests for pollen or other allergens have been negative so far. Blood tests have indicated elevated allergy risk levels, but the trigger has not been identified yet.
These attacks occur regardless of the season, mostly at night or in the evening, and can only be relieved through medical treatment. I have to visit an ear, nose, and throat specialist who applies a decongestant to my nasal mucous membranes. Though uncomfortable, as secretions not only come out of my nose but also my mouth and eyes during decongestion, further treatment usually involves cortisone tablets.
Are there any similar cases? What can I do in an emergency? Can I take tablets preventively at the first sign of symptoms, or should I do something as a prophylactic measure? A friend advised me to take Cetirizine Hexal at the first sign of symptoms, as it has helped him with his allergy (hay fever) and he received the recommendation from another affected individual. Would you also recommend this to me?
I would greatly appreciate a prompt response, as I am currently not feeling well again.
Sincerely, [Your Name]
I would not initially think of an allergy in your case. The various negative allergy tests support this. When I read the description of your symptoms, the first thing that came to mind was the so-called Sjögren's syndrome. This is a chronic inflammation of the tear and salivary glands with the main symptoms of dry eyes and mouth. Those affected often describe complaints due to the drying out of the mouth and other mucous membranes, as in your case with the nasal mucosa. This leads to swelling and makes breathing incredibly difficult. If your treating doctor has not ruled this out yet, you should see him. The diagnosis can be made through various antibodies in the blood. The eye doctor can also confirm the reduced tear secretion through the so-called "Schirmer test." If necessary, the diagnosis must be made by taking a tissue sample from the inside of the lips. Other causes, such as side effects of medication, must of course be ruled out beforehand. The therapy is in any case not quite simple and mainly focused on symptomatic treatment. That means trying to reduce the physical symptoms. Cetirizine is a medication that helps with allergic reactions by suppressing the body's own defenses. Since apparently you do not have an allergy, I doubt its effectiveness. I would personally primarily carry out symptomatic therapy by promoting the secretion stimulus of the salivary glands. I recommend drinking enough, chewing gum if you like and if it helps, using artificial saliva as a spray (e.g. Glandosane), moisture-retaining eye drops, and the use of a corticosteroid nasal spray (Nasonex) - but not for long-term treatment. The mentioned remedies can also be replaced by other preparations with the same active ingredients. I hope that this answers the most urgent questions for now and wish you a happy Pentecost and a speedy recovery.
