Ask the Doctor: allergies, gout and nosebleeds

Dr. Rob Riley joins us each week from the South Bend Clinic. Here are his responses from June 18.

Amanda: Could allergies be causing constant sinus pressure and headaches?

The short answer is yes they can. The sinuses are air pockets in the front part of the skull. Ordinarily, the fluid that’s produced by the lining of the sinuses drains into the nose through little openings. If the lining of those openings swells up, it can obstruct that flow, and the fluid just builds up inside until it causes pressure and pain. The most common things that do that are viral and bacterial infections, but allergies can cause enough irritation to do it, too. One approach is to start with a steroid-containing nasal spray like Flonase or Nasonex you get without a prescription. We also use antihistamines—things like Zyrtec, Claritin, or Allegra, and a whole bunch of others, all of which are also available without a prescription. If you have chronic or severe sinus pressure and pain, though, it’s best to chat with your doctor about the best next step.

Eddie: What can I do to help the pain of gout?

Gout is caused by little crystals of something called uric acid forming in joints. When that happens, the joint becomes red, swollen, and really painful. Since this is an inflammatory response, we use anti-inflammatory medicines. Over the counter medications like Advil, Motrin, and Aleve are effective, but often require higher than the usual doses for gout so talk with your doctor. We also have some medications available by prescription that can help. Prevention of future attacks is really important, not just because of the pain, but repeated gouty attacks can cause damage to the joints. Staying well-hydrated, avoiding excessive intake of alcohol and rich meats, and talking with your doctor about being on a daily medication to reduce the risk of recurrence are important measures to take.

Stephanie: Is having a lot of nosebleeds bad?

For most people, an occasional nose bleed is just a nuisance and doesn’t suggest a serious problem. The blood supply of the nose runs very close to the surface so minimal trauma to the inside of the nose can cause bleeding. We see this more during the winter months when the dry air causes the lining of the nose to dry out and become even thinner than usual. In those cases, gently applying a moisturizer like Vaseline to the lining of the nose helps to restore the lining to normal and reduce the risk of future nosebleeds. But sometimes, frequent nosebleeds are due to a problem with the body’s normal system of forming clots. In those cases, the nosebleeds are often accompanied by other evidence of a clotting problem like easy bruising or cuts that don’t want to stop bleeding. So if these things are present, or if the nosebleeds are particularly frequent or severe, then checking in with your doctor’s a good idea.