About nose disorders

Nasal complaints are one of the most common reasons why patients visit the family doctor as well as the ENT (ear, nose and throat) specialist. Common nose conditions include:

  • Blocked nose

  • Runny nose

  • Nose bleeds

Many of these nasal conditions prove to be frustrating at the very least but can be a symptom of more serious health problems.

Although many nasal conditions can be treated by the family doctor, some of these need further evaluation by the ENT specialist with a nasal scope which can easily be done as an in-clinic procedure.

About voice disorders

Our voice is the primary means we use to interact with the people around us. It is essential in our professional, social and family relationships, and yet also something that we often take for granted.

For those of you who use your voice professionally, or who rely heavily on talking in the course of your work (e.g. vocalists, teachers, service professionals, coaches/trainers, healthcare professionals), it is even more essential to take good care of your voice.

Voice complaints include:

  • Roughness

  • Feeling that your voice is not as strong as it used to be

  • Tiring easily when talking for longer periods

These complaints are very common as we grow older, and there are various options such as therapy or small surgical procedures to improve these symptoms.

However, hoarseness may sometimes herald more sinister conditions such as throat cancer, especially when in patients with risk factors such as smoking.

For Oct, we have a special "Ask the Specialist" featuring the Singapore General Hospital (SGH) Department of Otorhinolaryngology.

Be sure to take this chance to ask them any question about nose and voice disorders.

This 'Ask the Specialist' forum has closed. Thank you for your interest and participation.

1. Posted by m*****

I have nasal backflow when I lie down to sleep. I can feel some mucos at the back of the throat and it will block my nose soon after I lie down. I do not having running nose or discharge when I'm upright. This nasal blockage causes dull headaches and affects my sleep. Please advise how I can improve my condition. Thank you.

2. Posted by C*****
My nose always gets blocked whenever I lay down to sleep at night. This started a few month ago only. Why is this happening and what can I do about it? Thanks.

3. Posted by g*******************
10 years old sneezes as soon wakes up in the morning for half an hour every day. It also happens just before sleep at night about 4 times a month. Is it some nose disorder? The condition started from 5 to 6 years back, GPs and paediatric suspect allergy issues. Hope you can advise with your expertise in this area. Thank you.

Answers for all 3 questions answered by Department of Otorhinolaryngology - Head & Neck Surgery, Singapore General Hospital (SGH) :

Bed sheets contain dust mites which can make allergies worse when lying down on the bed/sleeping. In patients with a sensitive nose, also known as Allergic Rhinitis, this causes nasal mucous production, blocked nose and sneezing which may be a possible cause for the symptoms - remember to wash bed sheets at least once a week. You can also see the GP to get nasal steroid sprays as well as oral antihistamines to help with the symptoms. If still not better despite all these, please see an ENT specialist for further evaluation.


4. Posted by g*******************
Hi, my boyfriend is in his 40s and he tends to have nosebleeds once every few months. The blood will flow out of his nose. Is this frequency with amount of blood of a concern? What would constitute a nosebleed condition that is advisable to see a doctor? Thanks.

Answered by Department of Otorhinolaryngology - Head & Neck Surgery, Singapore General Hospital (SGH) :

Frequent nose digging is a common cause of nosebleeds which may resolve after the nose digging is stopped. However for any nosebleed that does not resolve, even if the episodes occur once every few months such as for your boyfriend, please see an ENT specialist immediately for further evaluation with a nasal scope to rule out other causes such as nasal infections or growths.

 

5. Posted by d*******
My nose gets runny most of the time when i am under air-conditioned area, how do i resolve the issue?

Answered by Department of Otorhinolaryngology - Head & Neck Surgery, Singapore General Hospital (SGH) :

Dear d*******,
the condition you describe is also known as Vasomotor Rhinitis, whereby exposure to nasal irritants such as cold air can cause a blocked and runny nose. The simplest method to resolve this would be to avoid air-conditioned areas as reduced exposure to cold air can improve nasal symptoms. You could also obtain nasal steroid sprays and oral antihistamines from your family doctor to help reduce the sensitivity of the nose. If these do not help, please see an ENT specialist for specialised medications and procedures which can help to manage your symptoms.

 

6. Posted by l*******
Hi. I am a 68 years old female.  My throat often feels sore although it doesn't seem like the usual sore throat. Oftentimes when I speak my voice cracks up and I lose my voice which is also hoarse .  I do drink cooling drinks like barley, chrysanthemum etc.    What else should I do other than go to ENT specialist.  Thanks.

Answered by Dr Leong Zhou Hao, Associate Consultant, Department of Otorhinolaryngology - Head & Neck Surgery, Singapore General Hospital (SGH)

The symptoms you have described are suggestive of Laryngopharyngeal Reflux (LPR). This occurs when gastric juices travel up the esophagus (food passage) and reach the throat, causing sensitivity and inflammation.

This may lead to symptoms such as the sore throat and intermittent hoarseness you have described. Other possible symptoms include a sensation that something is stuck in your throat and a sour or bitter taste at the back of your throat (especially in the morning after getting up from bed).

Dietary and lifestyle modifications are important to manage LPR. Avoid taking any food or drink (including water) 3 hours before bed. Spicy, sour and oily foods, as well as caffeinated drinks like coffee and tea can make the condition worse.

In terms of medication, you can try taking some Gaviscon liquid before bed. This is an over-the-counter medication and works by neutralizing gastric acid and forming a protective barrier in your throat.

If these measures do not improve your symptoms, then it may be beneficial to consult a doctor for further evaluation. Of course, if you experience any sinister symptoms like persistent hoarseness that does not resolve, blood streaks in your sputum, difficulty swallowing, or neck swellings, please consult a doctor immediately.


7. Posted by r*******
I have been having a Runny Nose for the past year or so. This becomes runny when I eat spicy, hot food. At times mucus also comes out from the nose.  Sometimes when I yawn a few times the runny nose condition happens.  Kindly advise what could be the reason? What is the medication to overcome this? Thank you.

Answered by Department of Otorhinolaryngology - Head & Neck Surgery, Singapore General Hospital (SGH) :

Runny nose that is worse on eating spicy/hot foods is also known as Gustatory Rhinitis. This is a common problem which can be managed by eating foods that are less spicy/hot. If this does not work or is not an option, you can see your GP to get nasal steroid sprays as well as oral antihistamines to help with the symptoms. If still not better despite all these, please see an ENT specialist for further evaluation.


8. Posted by R*****
Why my Right nose Blocked ( Left nose Clear) when lying on Right side and Left nose Blocked (Right nose Clear) when lying on Left side during sleep in Aircon room?

Answered by Department of Otorhinolaryngology - Head & Neck Surgery, Singapore General Hospital (SGH) : 

Dear R**,

There are many theories as to why you get a blocked nose with affected side depending on which side you lie on. This also known as Positional Nasal Congestion. When you lie on a particular side, nasal mucus tends to flow towards and accumulate towards that side causing blockage of the nasal cavity and associated sinus openings resulting in a blocked nose.

Also, blood tends to accumulate in various nasal structures on the affected side, causing swelling of these structures and a resultant blocked nose.

About Dr Leong Zhou Hao

​Dr Leong Zhou Hao is an Associate Consultant in the Department of Otorhinolaryngology - Head and Neck Surgery at Singapore General Hospital. Dr. Leong received his undergraduate medical degree and his Masters of Medicine (Otorhinolaryngology) from the Yong Loo Lin School of Medicine, National University of Singapore. He then went on to complete his residency training in Otorhinolaryngology in Singapore, where he graduated top of his cohort at the Exit Examinations. His subspecialty interest is in the diagnosis and management of Voice and Swallowing disorders.

Ref: K21