Nasal congestion

Nasal congestion is the blockage of the nasal passages usually due to membranes lining the nose becoming swollen from inflamed blood vessels.[1]

This article is about symptomatic nasal congestion. For natural partial congestion, see nasal cycle.

Nasal congestion
Other namesNasal blockage, nasal obstruction, blocked nose, stuffy nose, plugged nose
Medical products for diminution of nasal congestion
SpecialtyOtorhinolaryngology

Nasal decongestants target the discomfort directly. These come as nasal sprays, inhalers, and as oral pills.

Nasal congestion has many causes and can range from a mild annoyance to a life-threatening condition. Most people prefer to breathe through the nose (historically referred to as "obligate nasal breathers").[2] Nasal congestion in an infant in the first few months of life can interfere with breastfeeding and cause life-threatening respiratory distress; in older children and adolescents it is often just an annoyance but can cause other difficulties.

Nasal congestion can interfere with hearing and speech. Significant congestion may interfere with sleep, cause snoring, and can be associated with sleep apnea or upper airway resistance syndrome.[3] In children, nasal congestion from enlarged adenoids has caused chronic sleep apnea with insufficient oxygen levels and hypoxia, as well as right-sided heart failure. The problem usually resolves after surgery to remove the adenoids and tonsils, however the problem often relapses later in life due to craniofacial alterations from chronic nasal congestion.[4]

Nasal congestion can also cause mild facial and head pain, and a degree of discomfort, often from allergies or the common cold.

Causes

Nasal obstruction

Nasal obstruction characterized by insufficient airflow through the nose can be a subjective sensation or the result of objective pathology.[8] It is difficult to quantify by subjective complaints or clinical examinations alone, hence both clinicians and researchers depend both on concurrent subjective assessment and on objective measurement of the nasal airway.[9] Often a doctor's assessment of a perfectly patent nasal airway might differ with a patient's complaint of an obstructed nose.

Prevalence of kyphosis has been linked to nasal obstruction in a study.[10]

Treatment

The treatment of nasal congestion frequently depends on the underlying cause.

Alpha-adrenergic agonists are the first treatment of choice. They relieve congestion by constricting the blood vessels in the nasal cavity, thus resulting in relieved symptoms. Examples include oxymetazoline and phenylephrine.

Both influenza and the common cold are self-limiting conditions that improve with time; however, drugs such as acetaminophen (paracetamol), aspirin, and ibuprofen may help with the discomfort.

A cause of nasal congestion may also be due to an allergic reaction caused by hay fever, so avoiding allergens is a common remedy if this becomes a confirmed diagnosis. Antihistamines and decongestants can provide significant symptom relief although they do not cure hay fever. Antihistamines may be given continuously during pollen season for optimum control of symptoms. Topical decongestants should only be used by patients for a maximum of 3 days in a row, because rebound congestion may occur in the form of rhinitis medicamentosa.

Nasal decongestants target discomfort directly. These come as nasal sprays like naphazoline (Privine), oxymetazoline (Afrin, Dristan, Duramist), as inhalers, or phenylephrine (Neo-Synephrine, Sinex, Rhinall) or as oral pills (Bronkaid, Sudafed, Neo-Synephrine, Sinex, Rhinall). Oral decongestants may be used for up to a week without consulting a doctor, but nasal sprays can also cause "rebound" (Rhinitis medicamentosa) and worsen the congestion if taken for more than a few days. Therefore, you should only take nasal sprays when discomfort cannot be remedied by other methods, and never for more than three days.[11]

If an infant is unable to breathe because of a plugged nose, a nasal aspirator may be useful to remove the mucus. The mucus might be thick and sticky, making it difficult to expel from the nostril.

See also

References
  1. "Nasal congestion". MedlinePlus Medical Encyclopedia. A.D.A.M., Inc.
  2. Bergeson PS, Shaw JC (October 2001). "Are infants really obligatory nasal breathers?". Clinical Pediatrics. 40 (10): 567–9. doi:10.1177/000992280104001006. PMID 11681824.
  3. de Oliveira, Pedro Wey Barbosa; Gregorio, Luciano Lobato; Silva, Rogério Santos; Bittencourt, Lia Rita Azevedo; Tufik, Sergio; Gregório, Luis Carlos (July 2016). "Orofacial-cervical alterations in individuals with upper airway resistance syndrome". Brazilian Journal of Otorhinolaryngology. 82 (4): 377–384. doi:10.1016/j.bjorl.2015.05.015. PMID 26671020.
  4. Buschang PH, Carrillo R, Rossouw PE (March 2011). "Orthopedic correction of growing hyperdivergent, retrognathic patients with miniscrew implants". Journal of Oral and Maxillofacial Surgery. 69 (3): 754–62. doi:10.1016/j.joms.2010.11.013. PMC 3046301. PMID 21236539.
  5. Nasal congestion at MedlinePlus, a service of the U.S. National Library of Medicine, National Institutes of Health. Update Date: 8/2/2011. Updated by: Neil K. Kaneshiro. Also reviewed by David Zieve.
  6. "Blocked Nose, Restricted Air Flow". Aerin Medical. Retrieved 2016-07-12.
  7. Pacheco-Galván A, Hart SP, Morice AH (April 2011). "Relationship between gastro-oesophageal reflux and airway diseases: the airway reflux paradigm". Archivos de Bronconeumologia. 47 (4): 195–203. doi:10.1016/j.arbres.2011.02.001. PMID 21459504.
  8. Wang DY, Raza MT, Gordon BR (June 2004). "Control of nasal obstruction in perennial allergic rhinitis". Current Opinion in Allergy and Clinical Immunology. 4 (3): 165–70. doi:10.1097/00130832-200406000-00005. PMID 15126936.
  9. Wang DY, Raza MT, Goh DY, Lee BW, Chan YH (July 2004). "Acoustic rhinometry in nasal allergen challenge study: which dimensional measures are meaningful?". Clinical and Experimental Allergy. 34 (7): 1093–8. doi:10.1111/j.1365-2222.2004.01988.x. PMID 15248855.
  10. Šidlauskienė M, Smailienė D, Lopatienė K, Čekanauskas E, Pribuišienė R, Šidlauskas M (June 2015). "Relationships between Malocclusion, Body Posture, and Nasopharyngeal Pathology in Pre-Orthodontic Children". Medical Science Monitor. 21: 1765–73. doi:10.12659/MSM.893395. PMC 4484615. PMID 26086193.
  11. Help for Sinus Pain and Pressure WebMd
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