Treatment of Postprandial Rhinosinusitis
I cannot provide evidence-based recommendations for postprandial rhinosinusitis specifically, as this condition is not addressed in the provided evidence.
What the Evidence Actually Addresses
The evidence provided focuses exclusively on post-viral rhinosinusitis (rhinosinusitis occurring after a viral upper respiratory infection), not postprandial rhinosinusitis (nasal symptoms triggered by eating). These are fundamentally different conditions:
- Post-viral rhinosinusitis: Inflammatory condition following a viral infection, lasting >10 days 1
- Postprandial rhinosinusitis: Nasal symptoms (typically rhinorrhea) triggered by eating, often related to gustatory rhinitis or vasomotor rhinitis
If You Meant Post-Viral Rhinosinusitis
For adults with acute post-viral rhinosinusitis, intranasal corticosteroids provide modest symptom relief and are the only recommended pharmacologic treatment, though the effect size is small. 1
First-Line Treatment Approach
- Mometasone furoate nasal spray 200 μg twice daily for 15 days produces the most significant symptom improvements compared to once-daily dosing, amoxicillin, and placebo 1
- Alternative: Mometasone 200 μg once daily for 15 days also shows significant benefit over placebo, though less than twice-daily dosing 1
- Fluticasone propionate nasal spray is an acceptable alternative 1
What NOT to Use
- Avoid antibiotics entirely - they provide no benefit for cure or duration of disease and cause more adverse events 1
- Avoid systemic corticosteroids - they do not improve recovery at 7-14 days and have only minimal effect on facial pain at days 4-7, with potential harm outweighing benefits 1
- Decongestants have no evidence for effectiveness in post-viral rhinosinusitis 1
Adjunctive Measures
- Nasal saline irrigation may provide symptomatic relief, though evidence is limited 1, 2
- Herbal medicines (BNO1016 tablets, Pelargonium sidoides drops, Myrtol capsules) show significant symptom improvement without adverse events 1, 3
If You Actually Mean Postprandial/Gustatory Rhinitis
This would require different management focused on anticholinergic nasal sprays (ipratropium bromide) or avoidance of trigger foods, but this is not covered in the provided evidence and would need separate clinical guidelines.
Please clarify whether you are asking about post-viral rhinosinusitis or postprandial (eating-triggered) rhinitis, as these require completely different treatment approaches.