Nasal congestion

Nasal congestion
Classification and external resources
ICD-9	478.19

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

Causes

• Allergic reaction
• Common cold or influenza
• Deviated septum
• Hay fever, allergic reaction to pollen or grass
• Reaction to medication (e.g. Flomax)
• Rhinitis medicamentosa a condition of rebound nasal congestion brought on by extended use of topical decongestants (e.g., oxymetazoline, phenylephrine, xylometazoline, and naphazoline nasal sprays).
• 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.

Gastric reflux

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.^[3]

Treatment

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

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

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.

Alternative medicine

The use of nasal irrigation may help reduce nasal congestion. It involves rinsing the nasal cavity with saline to clear out allergy-causing microscopic particles of dust and pollen that cling to the inner nasal membranes.

References

1. ^ "Nasal congestion". MedlinePlus Medical Encyclopedia. A.D.A.M., Inc. http://www.nlm.nih.gov/medlineplus/ency/article/003049.htm. 
2. ^ Bergeson, PS; Shaw, JC (2001 Oct). "Are infants really obligatory nasal breathers?". Clinical pediatrics 40 (10): 567–9. doi:10.1177/000992280104001006. PMID 11681824. 
3. ^ Study of link between gastric reflux and chronic sinusitis in adults , Ear, Nose, and Throat Journal