DR FLO: I need to blow my nose, but I can’t. Is this normal?

Dr Flo, in all my 30 years of life I have never blown my nose. When I was young, I was taken to see an ENT specialist and he said that it is normal for some people to not blow their nose. I am asthmatic and I have mild sinusitis.

I also suffer from many respiratory infections for which I have found medical remedies. I always have a cold come rain or shine, but the inability to blow my nose hurts my nostrils. Is it really normal to be unable to blow my nose? Bee

Dear Bee,

Some people do have difficulties blowing their noses due to blockage of the nasal passage caused by a deviated nasal septum (the cartilage between the nostrils) or by nasal polyps (growths in the nose), or enlarged adenoids (growths at the back of the nose) or large turbinates (bony structures in the nose). These can be managed by an ENT specialist, though if the symptoms are severe, you may need surgery.

Try pressing one nostril shut with a finger, then blow gently from the other nostril into a handkerchief or tissue.
You can also loosen the mucus using saline drops/spray or by inhaling steam with eucalyptus oil in it or by applying a warm compress over the nose. Afterwards, squeeze the upper part of the nose on both sides and push down to push the mucus out.

Dr Flo, I had intestinal worms three years ago. I took albendazole and it cleared them, but the symptoms I had before medication – mostly gassy stomach – remained. Could the worms have damaged my internal organs? Gupta

Dear Gupta,

Having a lot of gas in the stomach is called bloating. It makes you feel full and the tummy may appear bigger than usual. It can be caused by overeating, eating too fast, eating fatty foods, drinking through a straw, chewing gum and taking carbonated drinks like soda. Some foods like legumes and cabbage and artificial sweeteners like sorbitol can also cause gassiness. Dairy products can also cause bloating if you are lactose intolerant. Smoking can also cause gas.

The gassiness may also be due to infection e.g. amoebiasis, H. pylori infection; or due to hyperacidity, irritable bowel syndrome, indigestion, poor absorption, food allergy, illnesses that cause inflammation of the lining of the intestines, intestinal obstruction, problems with the movement of the intestinal muscles, problems with other abdominal organs like the kidney, liver or spleen, and in rare occasions, abdominal or pelvic cancers.

See a gastroenterologist and get stool tests and endoscopy tests like oesophagogastroduodenoscopy and colonoscopy, and if necessary, an abdominopelvic ultrasound scan, which will show if you have an infection or other illness.

Beyond medical attention, also eat slowly, take smaller portions of food, and avoid foods that increase gas. You can keep a food diary – record what you eat each day and monitor your symptoms to see which foods may be worsening the symptoms. You can also take simethicone tablets to reduce the gas. Medicine with alpha-D-galactosidase also helps to break down sugars in beans and vegetables and reduce the excess gas.

Dr Flo, a couple of months ago, my fiancée was admitted in hospital with very bad migraines. She also had constant pain in her stomach, and everything she ate came right back up.

Tests indicated that her cerebrospinal fluid (CSF) needed to be drained, as it was causing a lot of pressure in her skull. The fluid was drained over three or so weeks, then medication was prescribed and she was discharged after the migraines and general discomfort had subsided considerably.

My question is, what causes CSF issues? The doctors were not able to pinpoint the cause and I never want to see my woman in so much pain again. Please help. Ngure

Dear Ngure,

It seems that your partner has idiopathic intracranial hypertension. The intracranial pressure (in the skull) rises, causing headaches, blurred and/or double vision and loss of vision.

It has no known cause, though it is associated with hormonal disorders, lupus, kidney disease, too few or too many red blood cells, and use of steroids and antibiotics. It is more common in young obese women.

Some medications e.g. acetazolamide can help lower the pressure. Alternatively, repeated CSF drainage can be done through lumbar puncture or a ventriculoperitoneal shunt can be placed to provide continuous drainage.

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