6 Week Medical Challenge

What is a six weeks nasal steroid challenge?

This is our medical challenge consisting of regular application od steroid spray to bath nostrils daily, for 6 weeks.

This aims to determine whether or not symptoms can be adequately controlled with first line medical treatment or whether additional medical treatments are required, such as Rhinolight Ⓡ or immunaltheraphy.

If medical treatments fail, the possibility of surgery may need to be revisiled. By performing a six week nasal steroid challenge, we can use objective measurement tools such as rhinomanomelry and naseondoscropic investigations, in combination with your reported symptoms and nasal symptom scales to monitor adassess whether or not the steroid challenge has improved your condition.

Why do I need a six week nasal steroid challenge ?

According to most guidelines, steroid nasal spray is considered a first line medical treatment used to alleviate symptoms of hayfever, non allergic rhinilis, blocked nose mouth breathing, snoring and congestion.

Although some patients may require surgery, our patients (unless there is urgent indication for surgery) will routinely undergo a six week nasal steroid challenge so your Allergy/ENT Doctor and ENT Surgeon can validate your maximum medical improvement before deciding if you are an appropriate surgical candidate.

How to perform the six week nasal steroid challenge:

  • Follow any specific instruction by your doctor.
  • Your doctor may recommend the daily or twice daily application of steroid nasal spray.
Saline rinse prior for maximum results

We recommend prior to inserting the nasal steroid spray, the application of a saline rinse because there is very solid evidence to suggest that applying the steroid after the saline rinse results in better symptom control.

This is due to the swollen tissue and excessive mucous in the nasal passage containing inflammatory materials and pollen, which can decrease the absorption of the steroid spray. Therefore, using the saline rinse, flushes the tissue clear of mucuos, allowing the nasal steroid spray to be more effectively absorbed.

Steroid nasal spray, the right way

Prime the spray device, shake the bottle before use, blow your nose prior to spraying, tilt the head slightly forward, gently insert the nozzle into the nostril, aim the nozzle away from the middle of the nose and direct into the nasal passage, avoid sniffing hard during or after the spray.

Tips for kids: make it fun!

Practice with a saline spray and squirt it in the air for play and get them involved in the treatment.

How quickly do they work?

Unlike decongestants which work immediately, steroid nasal sprays may take a few days to work so this treatment should be used regularly.

Addressing concerns

Steroid nasal spray can be safely used for children and adults. Steroid nasal spray rarely causes side-effects. This is because when applied directly to the nose very little of the medicine is absorbed into the body. Occasionally they cause dryness, crusting and bleeding of the nose. If this occurs stop and make an appointment to see your doctor for an urgent review to consider a change of medication. Steroid sprays are category B in pregnancy and considered safe.

The importance of follow-up after the six week nasal steroid challenge

Please ensure that you return for your follow-up review appointment in six weeks (even if you feel better!) Medical review is extremely important for the creation of your long-term management plan and to involve other therapies or other treatments or even surgery if there is limited improvement.

What about long term use of nasal steroid spray?

After your 6 week review, your doctor will discuss your long term management plan. Although low in risk, long term nasal sterio spray users are managed with eye pressure checks and review of the nasal lining.

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