For weeks now I have had flu and it doesn’t seem to get better. I have tried everything from actual medicine to remedies like honey and lemon. Nothing seems to work. I really hate going to clinics unless I am seriously ill but this is beginning to really worry me.

I sneeze all the time and my eyes tear. It had made me so weak, I’m now beginning to feel like I have malaria. Plus I sweat a lot in the night even when it is really cold. Anything you can recommend?

Aisha, 27, Kibagabaga

Dear Aisha,

Persistent sneezing is most likely to be due to allergic rhinitis. In this, one gets a running nose, sneezing or blocked nose, any one or more of these symptoms after exposure to something to which the body has allergy. 

There is associated headache, weakness, redness and watering of the eyes, red nose symptoms, among others. It is similar to having bronchial asthma and skin allergy. A person may have either one or even more than one of these conditions. Usually these conditions are hereditary and run in families.

The allergy could be to dust, fumes, smoke, fungal spores, pollens and dampness; anything present in the atmosphere. It could be to something eaten or applied over the body.  There could be one or several factors causing allergy. The symptoms may be intermittent or persistent depending on the type of allergy causing substance and quantum of exposure of the individual to it.

Recurrent cold can become a source of secondary bacterial infection and this infection can spread to cause congestion and inflammation inside the ear (otitis) and or air sinuses (sinusitis) of the brain. Over time, there may be swelling of the inner lining of the nose with a persistent burning sensation. 

This could result in throbbing headache, earache, fever, enlarged lymph nodes around ear. Diagnosis of otitis and sinusitis among others is easily confirmed by clinical features and investigations like complete blood count and an x-ray of the skull. However allergy tests to identify the substance causing allergy are not readily available at present.

Treatment in initial stages consists of using antihistaminic (anti allergy drugs). Nasal sprays are also available to help the patient get relief soon. Non pharmaceutical measures like steam inhalation, using honey and lemon, ginger tea, e.t.c. are useful in early stages. But if the symptoms are persistent or severe then it becomes necessary to take a complete course of a suitable antibiotic along with anti inflammatory drugs. 

If the sickness is very severe as with high fever, severe pain, pus discharge or one or more of these symptoms then a surgical intervention is done to remove the pus and congestion.

Some individuals may have a recurrent cold due to a deviated nasal septum. Here, the nasal bone tends to be deviated towards one side since birth. This deviation encroaches on the breathing space of one nostril and causes a recurrent cold. But this condition can be easily corrected by a minor surgery.

Prevention of allergic rhinitis can be done to keep the nose covered while being exposed to dust while travelling. If possible one can identify other allergy causing substances by stopping their use and then restarting using one by one. A substance which is potential allergen shall aggravate symptoms when used.

Dr. Rachna Pande is a specialist in Internal Medicine at Ruhengeri Hospital