Effect of Intranasal Corticosteroids on Pulmonary Symptoms in Asthmatics With Nasal Congestion
Effect of Intranasal Corticosteroids on Pulmonary Symptoms in Asthmatics With Nasal Congestion
In this study we will investigate the effect of intranasal corticosteroid therapy, which is
 known to reduce mucosal inflammation and nasal blockage, on asthmatic symptoms.
Although up to 95% of asthma patients suffer from blocked nose, the majority of these
 patients do not undergo systematic assessment and treatment for nasal blockage. This is
 unfortunate, as optimal diagnosis and treatment of nasal blockage in asthmatics can reduce
 asthma morbidity and use of anti-asthmatic medication.

 The "Unified Airways" concept considers the upper and lower airways as one unified airway. In
 recent years there has been increasing awareness about the relationship between inflammation
 in the upper and lower airways, with disease in the upper airways affecting the lungs through
 neurological, immunological and mechanical mechanisms, resulting in asthmatic symptoms.

 Conditioning and filtration of the inspired air are important functions of the nose, and oral
 breathing results in inhalation of poorly conditioned and filtered air in to an already
 inflamed lower airway. Together will these mechanisms lead to a worsening of the asthmatic
 disease.

 The aim of this study is to investigate the effect of intranasal corticosteroid therapy,
 which is known to reduce mucosal inflammation and nasal blockage, on asthmatic symptoms. The
 primary outcome variable is improvement in asthma symptomatology. The secondary outcome
 variables are improvement in nasal blockage.
Inclusion Criteria:

 -  asthma (according to British Thoracic Society guideline)

 -  >18 years

 Exclusion Criteria:

 -  pregnancy

 -  systemic disease with nasal manifestations

 -  cancer of the nose

 -  currently receiving cancer therapy

 -  previous nose surgery