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Nasal congestion is the blockage of the nasal passages usually due to membranes lining the nose becoming swollen from inflamed blood vessels. It is also known as nasal blockage, nasal obstruction, blocked nose, stuffy nose, or stuffed up nose.

Nasal congestion has many causes and can range from a mild annoyance to a life-threatening condition. The newborn infant can only breathe through the nose (newborns are "obligate nose breathers"). Nasal congestion in an infant in the first few months of life can interfere with breastfeeding and cause life-threatening respiratory distress. Nasal congestion in older children and adolescents is often just an annoyance but can cause other difficulties.

Nasal congestion can interfere with the ears, hearing, and speech development. Significant congestion may interfere with sleep, cause snoring, and can be associated with sleep apnea. 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.

Nasal congestion can also cause mild facial and head pain, and a degree of discomfort.

Common causes

• Allergic reaction
• Common cold or influenza
• Deviated septum
• Hay fever, allergic reaction to pollen or grass
• Reaction to medication (e.g. Flomax)
• Sinusitis or sinus infection
• If the body is in a position where a lot of blood enters the head (e.g. upside down), the blood vessels in the nasal passage may inflame.
• Many women suffer from nasal congestion during pregnancy due to the increased amount of blood flowing through the body.

Possible link to gastric acid reflux

It has recently been proposed that gastroesophageal reflux disease may be a contributing factor for sinusitis. Studies have shown a significant correlation between individuals suffering from chronic sinusitis and those suffering from acid reflux. Evidence has been found that acid reflux can be severe enough in some cases to reach the nasal or nasopharyngeal area, causing irritation. Additionally, it has been shown that gastroesophageal reflux disease therapy was effective in the treatment of chronic sinusitis. Proton pump inhibitor type medications were shown to improve at least some sinusitis symptoms for most people, and dramatically so in some.^[1]

Treatment

Drinking plenty of fluids, more than usual, aids the body in expelling the irritant and clearing congestion. Water, fruit juice, and teas are recommended by medical experts to resolve congestion, and rest and sleep are also suggested remedies in a case of nasal congestion. Sitting upright and not lying down will relieve some nasal congestion. Avoid substances causing dehydration, for example caffeine.^[2] Increasing air moisture with a humidifier or a steamy bath or shower usually helps relieve the congestion and accompanying discomfort.

Neither influenza nor the common cold can be cured with medication; however, drugs such as acetaminophen, decongestants, nasal sprays or drops, cough remedies and throat lozenges may provide some symptom relief. Furthermore, medications have recently been approved which, when started shortly after the onset of symptoms, may shorten the duration of influenza.

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.

A common household reliever of nasal congestion is cinnamon or peppermint.

If an infant is unable to breathe because of a plugged nose, an adult should immediately use a nasal aspirator to remove the mucus. The mucus might be thick and sticky, making it difficult to expel from the nostril. It can be loosened by putting several drops of saline solution at a rate of 7.04 milligrams of sodium chloride (table salt) per milliliter of filtered or boiled water (7 grams per liter), into each nostril. As home made solutions do not contain preservatives, they should only be kept for a few days in the fridge, and fresh solution made as needed.

Insertion of cotton swabs into a child's nostrils as a remedy is generally discouraged. An alternative solution is for the discharge to be caught outside the nostril on a tissue or swab, be rolled around, and have the discharge pulled out of the nose. Petroleum jelly applied to the nasal openings can assist in providing protection against irritation, though it is important to ensure that the nostrils are not blocked by the jelly.

The ancient use of nasal irrigation, which originated from the Yoga practice of jala neti, is also said to help reduce nasal congestions. It involves rinsing the nasal cavity regularly with salty water 20 times in one day. This remedy may cause further irritation.

References

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