Nose & Allergy

Nose & Allergy

“Smell is the Cinderella of the senses, the forgotten faculty. There are no agreed measures of its nature, no societies dedicated to its appreciation or devoted to the care of those who suffer from its loss”

– Lyall Watson


The nose and nasal sinuses control the temperature and humidity warm and humidify air reaching the lungs, give us resonance to our voices and provides a sense of smell and taste.

Normally the nose and sinuses produce a pint and a half of mucus secretions per day. These secretions pass backwards through the nose picking up dust particles, bacteria and other pollutants along the way. This mucus is swept into the back of the throat by millions of tiny hair- like structures called cilia, which line the nasal cavity. The mucus moves into the throat and is swallowed. Most people do not notice this mucus flow because it is a normal bodily function.

Most nasal problems are treated with medicine, occasionally surgery is needed.


Nose bleeds (Epistaxis)

Epistaxis is the medical word for bleeding from the nose.Nosebleeds tend to affect the elderly but are also very common in children. Over half of children aged between 6 and 15 years old have nosebleeds regularly.Most bleeds are relatively minor and can be treated conservatively. Nasendoscopy allows Mr Harris to look for the bleeding point inside your nose and seal it off. This can be a fast and effective treatment for nosebleeds. Recurrent bleeding can often be stopped by cauterising the blood vessels inside the nose during your visit. Occasionally, an operation, such as electrocautery, or SPA ligation, may be required.

You should seek urgent medical attention if you have a severe nosebleed, or a nose bleed that continues for more than 15 minutes.

Blocked nose

The sensation of a blocked nose is often referred to as nasal obstruction, a stuffy nose and nasal congestion. The severity of the nasal obstruction varies from one patient to the next. Some people find even mild nasal blockage quite troublesome, whereas others, with quite severe nasal obstruction, find it does not have a significant impact on their daily activities. Mr Harris will take this into account when developing a plan for your treatment.

Nasal obstruction can be due to problems with the shape of the inside of the nose, or swelling of the lining of the inside of the nose.

Large adenoids are the commonest cause of blocked nose in children. Nasal blockage and congestion can be caused by allergy, nasal polyps, or sinusitis, deviated nasal septum, enlarged turbinates and very rarely tumour.

Nasal congestion

See adenoids and sinusitis.

Nasal discharge

See adenoids and sinusitis.

Itching and sneezing

Usually results from allergy.

Runny nose

May be the result of allergic or non-allergic rhinitis.

Sinus pain and pressure

The pain from sinusitis usually occurs as a result of blockage of the sinus opening as a result of sinusitis. The pain may get worse with movement of the head, strain, or bending down. Sometimes pain in the face is due to other causes such as tension headache, migraine, neuralgia and jaw dysfunction.


Sinus infection occurs in two types. Acute sinusitis gives rise to severe symptoms but is usually short-lived. Acute sinusitis usually occurs following a cold. Typically a green-yellow nasal discharge occurs a week or more after the onset of the cold and this is associated with severe pain around the cheeks, eyes and/or forehead. This may be associated with swelling and a high fever along with toothache.

Chronic sinusitis is sinusitis that continues for many weeks. Chronic sinusitis may be caused by an acute sinus infection which fails to resolve or as a result of an underlying allergy affecting the lining membranes of the nose and sinuses. Common symptoms include nasal obstruction, headache, nasal discharge, reduced sense of smell, facial discomfort and bad breath. Sinusitis may be caused by infections, irritants (e.g. air pollution, smoke and chemical irritants, some sprays), allergies or a structural abnormality.

Chronic sinusitis may need long term treatment. Medical treatment options include antibiotics, decongestants and other treatments to reduce the swelling of the lining such as nasal steroid sprays. Antihistamines will have a place in patients who have an underlying allergy. In the vast majority of cases sinusitis can be managed effectively with medical treatment.

Occasionally symptoms will persist despite ongoing use of medicines in which case surgery may be necessary. The diagnosis of sinusitis will involve the use of a nasal endoscope, which Mr Harris can use to examine the nasal lining and the sinus openings.

Adenoid hypertrophy / adenoiditis

Adenoids are lymphoid tissue (like tonsils) that arise from the ‘nasopharynx’ (the back wall of the throat where it contuse behind the nose). They are frequently enlarged in children and can sometimes block the openings at the back of the nose. They harbour colonies of bacteria that can lead to glue ear. In younger children they are there to fight germs. After the age of about three years, the adenoids are no longer needed. We only remove them (coblation adenoidectomy) when they do more harm than good. Sometimes children have adenoids so big that they have a blocked nose, so that they have to breathe through their mouths. They snore at night, and some children even stop breathing for a few seconds while they are asleep.

Decreased sense of smell and taste

Known as the Cinderella of the senses, you do not appreciate how much you miss your sense of smell and taste until it has gone. Quality of life can be severely negatively impacted. There are a myriad of possible causes including nasal polyps, sinusitis, allergy, hormonal changes and tumours.


There are some patients who experience catarrh with an excess of mucus that actually runs out of their nose. There are other patients, however, who experience the same sensation of an excess of mucus but are unable to clear anything out of their nose or their throat. This can be frustrating for them. It may relate to allergy, or an abnormality of the lining of the throat. Patients may also notice a sensation of nasal congestion,throat discomfort,crackling or dragging sensation in the ears, a sensation of choking or something stuck in the throat, a constant cough or of feeling sick. Nasendoscopy allows Mr Harris to examine the inside of the nose and throat.

Nasal Polyps

A nasal polyp is a grape-like soft inflammatory swelling of the lining of the nose. They cause nasal obstruction and reduced sense of smell and frequently runny nose and sneezing and catarrh. They are frequently associated with asthma, allergy and infection. Most respond to nasal steroid spray or steroid tablets. occasionally sinus surgery is required to improve symptoms.

Turbinate hypertrophy

The nose is lined by a thin mucous membrane which can swell to cause blockage. Folds of the mucous membrane called turbinates are particularly prone to swelling. We all experience this swelling in response to the common cold, in which case the lining swells in response to a viral infection.

Deviated nasal septum

In some people the septum, which is the anatomical partition between the left and right sides of the nose is bent into one or both sides of the nose, blocking it. Sometimes this is because of an injury to the nose, but more frequently it just grows that way. If you have a blocked nose because of the bend in the septum, an operation (septoplasty) will help.

Dry nose

A dry or crusting nose can be the result of ageing, hormonal change, climate change, nose picking, medications, or auto-immune nasal inflammation.


Allergies can cause inflammation inside the nose. Common symptoms of an allergic reaction include nasal stuffiness, runny nose, sneezing and itchy watery eyes. Chronic sinusitis is sometimes associated with asthma. Allergies are responsible for asthma in some patients and may also cause nasal stuffiness making the asthma more difficult to control.


Hayfever is the common name given to cold-like symptoms caused by inhaling plant pollens at certain times of the year. Symptoms of hayfever include itchy nose, with or without itchy ears, throat and eyes, sneezing, watery discharge from the nose and sometimes eyes and blocked nose.

Non-allergic rhinitis (incl vasomotor rhinitis)

Non-allergic rhinitis is inflammation of the inside of the nose that is not caused by an allergy.Symptoms are triggered by hormonal change, imbalance of nerve activity in the nose,  a dry atmosphere, air pollution or medication.

Nasal tumours

Sinonasal tumours are rare and only affect about 10 people in one million a year. They can arise from any structures in the nose (the lining, blood vessels, nerves and even bone or cartilage).Most nasal are benign. Nasal cavity tumours present with one-sided nasal obstruction with or without a mucus nasal discharge, crusting or nosebleeds. Sinus tumours cause inflammation and pressure above, below or in between the eyes, depending which are affected and can affect vision.



Cauterisation of bleeding point


Electro-cauterisation of bleeding point
Reduction of inferior turbinates
Functional Endoscopic Sinus Surgery – FESS
Ligation of artery to stop or prevent bleeding
Nasal polypectomy
Balloon Sinuplasty

Disclaimer: This publication is designed for the information of patients. Whilst every effort has been made to ensure accuracy, the information contained may not be comprehensive and patients should not act upon it without seeking professional advice.