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Updated 22 May 2015

Nasal congestion

This refers to a blocked nose which usually occurs when an allergic attack develops.

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What is nasal congestion?

Nasal congestion refers to a blocked nose which usually occurs when an allergic attack or a viral condtion, such as a “cold”, develops. The blood vessels expand, the membranes become congested (full of excess blood), and the nose becomes stuffy, or blocked.

Causes
In addition to allergies and infections, other events can also cause nasal blood vessels to expand, leading to nasal congestion, such as

  • irritants such as perfumes and tobacco smoke
  • overuse or prolonged use of decongesting nasal sprays
  • Flu
  • Rhinitis
  • Sinus infection
  • certain anti-high blood pressure drugs

How is it treated?
In the early stages nasal congestion is temporary and reversible, and will improve if the primary cause is corrected. However, if the condition remains unattended for a long enough period of time, blood vessels may lose their capacity to constrict. The vessels fill up when the patient lies down and when he/she lies on one side, the lower side becomes congested. The congestion often interferes with sleep. So, it is helpful for stuffy patients to sleep with the head of the bed elevated two to four inches. Surgery may offer dramatic and long time relief.

Over-the-counter medicines can be used to relieve nasal congestion:

  • Antihistamines reduce the amount of mucus, but should be used with care as drowsiness is a side-effect.
  • Decongestants shrink the blood vessels in the nasal lining, but these medications will only relieve the feeling of stuffiness, not a runny nose or any other symptoms. It is important to only use decongestants for a period of three days because they can worsen the congestion over a longer period of time.

Home treatment:

  • Inhale steam from the show or a humidifier
  • Drink plenty of liquids, such as water, juice or tea, to help thin mucus. Avoid drinks containing caffeine which can cause dehydration and aggravate your symptoms.
  • Chicken soup speeds the movement of mucus through the nasal passages, which helps to relieve the congestion and limits the amount of time viruses are in contact with the nasal lining.
  • Use a gentle over-the-counter nasal saline spray or prepare your own saltwater solution using 1/4 to 1/2 teaspoon of salt mixed with 2 cups of warm water.
  • Breathing strips which will be stocked by your local pharmacy open the nasal passages, allowing you to breathe more freely.


Over-the-counter medicines can be used to relieve nasal congestion:

  • Antihistamines reduce the amount of mucus, but should be used with care as drowsiness is a side-effect.
  • Decongestants shrink the blood vessels in the nasal lining, but these medications will only relieve the feeling of stuffiness, not a runny nose or any other symptoms. It is important to only use decongestants for a period of three days because they can worsen the congestion over a longer period of time. Oral or topical decongestants may have a stimulant effect and raise blood pressure in some people. Children shouldn't use them at all. Gentler options such as steam, nasal rinses and breathing strips are more effective and don't have side effects.

Considerations
Babies suffering from nasal congestion in the first months of life have trouble nursing and can experience breathing problems. If your child is younger than 3 months, call your doctor at the first sign of illness. An older baby's nasal congestion can be treated by giving plenty of fluids, moistening the air in your home, suctioning the baby's nose and using saline nasal drops or a homemade nasal irrigation wash made of 1/4 to 1/2 teaspoon of salt mixed with 2 cups of warm water.

In older children and adults, chronic nasal congestion can interfere with hearing and speech development. Significant congestion may interfere with sleep, can cause snoring and can be associated with sleep apnoea (not breathing during sleep).

When to call your doctor

  • Nasal congestion together with blurred vision
  • Throat pain, or white or yellow spots on the tonsils
  • A cough that produces yellow or gray mucus
  • Nasal congestion along with swelling of the forehead, eyes, side of the nose or cheek
  • A cough that lasts longer than 10 days
  • Nasal congestion that lasts longer than 2 weeks

Prevention
As nasal congestion is a common condition, it is very difficult to prevent. If a specific allergy has been established, then avoidance of the allergen will help.

(Health24, November 2007)

 
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