Beer, Ibuprofen Worsen Nasal Issues in a 35-Year-Old With Asthma

Thomas S. Higgins, Jr, MD, MSPH

Disclosures

September 15, 2022

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Background

A 35-year-old man with a history of adult-onset asthma has had nasal obstruction and smelling loss for 4 months. He also reports postnasal drainage, cough, rhinorrhea, and facial pressure. He has no history of asthma or allergies as a child. He also has no history of previous nasal or paranasal sinus surgery. His symptoms worsen after drinking certain beers and also after using ibuprofen or aspirin.

Over the past 4 months, he has been given three courses of antibiotics, including amoxicillin, azithromycin, and amoxicillin-clavulanate with minimal effect on his symptoms. He has used nasal steroid spray one spray twice a day for 2 months, with partial improvement in symptoms of nasal congestion. He has had two courses of methylprednisolone, which had a significant effect on his symptoms; however, the effect was transient.

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