Nasal congestion is swelling of nasal mucosa with discharge which gives an uncomfortable feeling of a stuffy nose. If you have a condition like allergic rhinitis or hay fever you are likely to suffer these symptoms as frequent as daily.
Those of you who are suffering from it may know how annoying life becomes! It may not be life threatening but it won’t let you enjoy your life.
If your child or infant is suffering this condition she/he may feel difficulty in sleeping and also in feeding making you worry as a parent.
Let us discuss what are causes of nasal congestion or stuffy nose and also how to overcome it with some simple remedies.
What are the causes of nasal congestion?
As many of you know you can suffer from nasal congestion when you have allergic rhinitis or common cold.
In simple words there are many causes of nasal congestion but to understand easily them we can group them as:
- Allergies.
- Infections.
- Drug withdrawals.
- Vasomotor rhinitis.
- Inflammation.
- Hypertrophied Nasal papillae.
- Nasal polyps.
Now let us explain these causes one by one:
Allergies
Allergies can be systemic or only with nose like allergic rhinitis. They can be mild or severe in nature.
Allergies are hyperreactive conditions that are triggered by exposure to an allergy inducing agent called allergens.
Allergens can be chemicals, pollens, pollutants, strong smells, hair of pet animals, insects and food or anything that is in your surroundings.
It is famous saying everything under the sun including the sun can cause allergies. Nasal congestion and nasal stuffiness can be a common symptom in such conditions.
Additionally allergies can be occasional that occur on exposure to specific agents and can be seasonal occurring in specific seasons or can be perennial which may last for years.
We have discussed in detail about allergic rhinitis in an earlier post.
Infections
Infections are the next most common cause of stuffy nose or nasal congestion. In a simple world we call it the common cold.
A normal person can experience common cold up to 6 times a year. Most of the time the common cold is caused by viral infections like influenza virus, rhinovirus and coronavirus.
In a few cases, bacterial infections can cause the common cold and lead to symptoms of stuffy nose.
You can unknowingly spread these infections when you sneeze or cough or talk. These infections are also spread by touch and close contact.
Drug withdrawals
If you are taking over the counter nasal decongestant in a wrong way you may get dependent on them. When you don’t use them you may feel the withdrawal effects like nasal congestion and nasal stuffiness.
Specially metazoline nasal decongestants like oxymetazoline and xylometazoline used for more than 5-7 days in a row can cause this effect. This is called ‘rhinitis medicamentosa’.
Vasomotor rhinitis
Typical of vasomotor rhinitis is watery nasal discharge with nasal congestion and multiple sneezing episodes in row.
Usually is triggered in the morning and frequency can be daily. Patient is annoyed by the symptoms and complains wasting 2-5 hours a day due to the symptoms.
Inflammation
Local inflammatory conditions line sinusitis can cause nasal congestion and stuffy nose.
Nasal papillae
Conditions like hypertrophied nasal papillae can cause nasal congestion and stuffiness, These can be on a single side or both the sides. These conditions may need surgical intervention.
Nasal polyps
Nasal polyps can cause a chronic nasal congestion. They can be unilateral and bilateral. They may need medical and surgical intervention.
Deviated nasal septum
Deviated nasal septum can be a cause of nasal block giving you feeling of nasal congestion. It may cause unilateral or bilateral nasal congestion.
How does nasal congestion occur?
Though causes of nasal congestion are many, the mechanism and end result of congestion of the nose can be similar.
The inner layer of the nose is called nasal mucosa. It is richly supplied by blood vessels.
These blood vessels are able to dilate or constrict when they are exposed to various stimuli.
When you are exposed to allergen or infection or inflammation your body produces various chemicals as reactions for example histamine.
These chemicals cause blood vessels to dilate and blood vessels in nasal mucosa dilate.
These chemicals cause blood vessels to become porous and there is leakage of fluids from these vessels.
Additionally These chemicals give you itchy sensations and swelling of mucosa. This swelling obstruct the nasal airway and you get a stuffy nose.
What are associated symptoms with nasal congestion or stuffy nose?
Nasal congestion is itself a symptom, it is not a disease. So, depending on underlying conditions the symptoms associated associated with nasal congestion are:
- Itching sensation in nose, throat and eyes.
- Nasal secretions.
- Watering of eyes.
- Redness of eyes.
- Sneezing.
- Cough.
- Headache.
- Bodyache.
- Sleep disturbance.
- Difficulty in feeding.
- Ear ache.
- Decreased smell sensation.
- Decreased hearing.
- Throat pain.
Whatever may be the theory behind this nasal congestion but we know you get extremely annoyed with it. Let us now discuss the remedies for nasal congestion.
To classify remedies in simple language we can group them as home remedies and medical intervention:
Home remedies
Following are home remedies for nasal congestion that may help you reducing the symptoms:
- Steam inhalation.
- Drinking warm water.
- Drinking warm soup.
- Taking honey.
- Gargles.
- Taking a bath with hot water.
- Having tea.
- Warm compresses.
- Plenty of oral fluids.
- Saline nasal spray.
Steam inhalation
Steam inhalation gives you some relief from stuffy and congested noses. The exact mechanism by which steam inhalation acts is yet poorly understood.
Steam has soothing effects on nasal mucosa. Steam helps to liquify the clogged mucus helps you to remove it.
If the nasal mucosa has become excessively dry the humid steam helps to sooth it.
Warmth and hotness of the steam helps to reduce the itchy sensations in and around the nose. It even relieves itching in the throat and eyes.
It is good to use the steamer which works on electricity as they are less polluting than other steamers which work without electricity. Additionally steamer should be of good quality and it should not spill the hot water or give you electric shock. It should be handled with care.
Drinking warm water
Warm water is one of the harmless home remedies for nasal congestion and in general cough and cold. There is no scientific proof to support this but people experience soothing effects with warm water.
Cold water and cold drink can induce allergic rhinitis and nasal congestion in some patients who have a tendency of hay fever. Warm water may relieve people symptomatically.
Drinking warm soup
Drink warm soup as it has a similar effect and may give some relief to symptoms. Many people like it when they have nasal congestion.
Just take precaution that soup should be homemade from fresh materials and not contain the preservatives and coloring agents. Avoid readymade stuff for this purpose.
Taking honey
Honey is safe to use at age above 1 year old. Below 1 year old avoid honey. Honey may have soothing effects and gives some relief to symptoms associated with nasal congestion.
Gargles
Gargles with warm saline water may give you relief from symptoms associated with nasal congestion like throat irritation.
Simple salt water or specially made gargles can be used for this purpose. Children mostly refuse to gargle in such children so you can give the warm soup they like to drink.
Taking bath or shower with hot water
Exposure to cold water may cause allergic symptoms and worsen the nasal congestion. Taking shower or bath with hot water may give some relief.
The water should not be too hot to tolerate. It should be comfortably warm. It should not give you burns on your skin.
This strategy should be avoided when the environment is too hot as it can cause you heat stroke.
Having a tea
Do you like to have tea on cold rainy days? So does everyone! Tea gives relief to nasal congestion. At least some people get a feeling of relief after a tea.
You can add some ginger to make it better or some lemon grass. Avoid excessive tea if you have sleeping disorder and difficulty in sleeping.
Warm compresses
Warm compresses on the forehead and nose may give you some relief from nasal congestion. You can use a warm cloth or a hot water bag containing warm water for this purpose.
Plenty of oral fluids
Cold, cough and nasal congestion can cause dehydration. You lose some water as water vapour when you breathe. In nasal congestion due to increased breathing efforts you may get dehydrated.
Dehydration can worsen your condition as it increases the symptoms. You should take plenty of oral fluids to stay hydrated during such conditions.
Just make a note, avoid cold drinks and ready made fruit juices which may contain excessive sugar and salt, preservatives and coloring agents. Take homemade juices and soups instead. Avoid adding sugar to juices.
Nasal saline spray
Nasal saline spray is easily available over the counter or you can prepare it home adding some salt to warm water. It is recommended to use commercially available preparations as they are not very costly and home made preparation if contaminated with amoeba species may cause brain abscess.
Nasal saline spray gives a soothing effect to your nasal mucosa and they also liquify the mucus in your nose giving you symptomatic relief from nasal congestion.
For children and infants you can use saline nasal drops in place of spray.
With this saline nasal spray the effect is short lasting and you may need to repeat it every 3-4 hourly.
Medical intervention
Many of the medicines that are used for treating nasal congestion are over the counter medicines and they are available without prescription in many countries.
Used incorrectly these medicines can cause more harm than any benefit to you. So, you should use them after consulting your doctor. If needed you can use them occasionally as over the counter medicine.
Those are grouped as follows:
- Antihistamines.
- Vasoconstrictors like phenylephrine and pseudoephedrine.
- Xylometazoline and oxymetazoline.
- Steroids.
- Anticholinergic like ipratropium bromide.
- Painkillers like paracetamol.
Antihistamines
Antihistamines are used for treatment of nasal congestion for decades. These are generally available as over the counter medicines in many countries.
Some famous antihistamines are hydroxyzine, promethazine, doxinate, chlorpheniramine maleate, loratadine, cetirizine, levocetirizine, fexofenadine.
These can be used as oral drugs that provide relief from allergic symptoms and itching as well as from nasal congestion.
Some antihistamines like azelastine can be used as nasal spray and recommended in allergic rhinitis.
Side effects
- Drowsiness.
- Increased sleeping.
- Loss of concentration.
- Restlessness.
- Loss of balance.
- Feeling of dryness of tongue.
- In some cases cardiac arrhythmias.
Vasoconstrictors like phenylephrine or pseudoephedrine
Phenylephrine and pseudoephedrine are vasoconstrictors. They selectively cause constriction of vessels in nasal mucosa and relieve the nasal congestion.
Many over the counter medicines may contain these two medicines. They are important contents of oral treatment of nasal congestion.
Side effects
- Drowsiness.
- Nausea.
- Increased blood pressure in patients who are diabetic and hypertensive.
- Stroke.
- The side effects are more common in older adults and young children.
Xylometazoline and Oxymetazoline
These are vasoconstrictors too. Many nasal sprays contain these medicines. They give instant relief to nasal congestion. These medicines constriction of vessels in the nose and decrease the congestion.
They are available as instant relief medicine for nasal congestions as over the counter medicines.
Side effects
- Increased blood pressure.
- Drowsiness.
- Stingy itchy sensation in nose.
- Some people may be allergic to them worsening the condition.
- Use for more than 5-7 days in a row, you may become dependent on these medicines.
- Used for a longer period you may get rhinitis medicamentosa.
- Nasal bleeding.
Steroids
Steroids aren’t nasal decongestants in the true sense. They are used to relieve the symptoms of allergy and asthma which also include nasal congestion.
Steroids can be used orally or as nasal spray. Used as nasal spray only a fraction of dose is needed.
You should not use these medicines without medical advice. They are not generally available as over the counter medicines.
Side effects
- Worsening of uncontrolled diabetes mellitus.
- Worsening of hypertension.
- Hyperacidity.
- Abdominal discomfort.
- Gastric ulcer.
- Cataract.
- Osteoporosis and fracture.
- Obesity.
Anticholinergic like ipratropium bromide
Ipratropium bromide is an anticholinergic drug. It reduces nasal congestion when used as nebulizer or nasal spray. It is effective when there is constriction of large airways.
Do not use these medicines without medical advice. Additionally, nebulizers used at home need special care with cleaning the devices.
Side effects
- Drowsiness.
- Stingy sensation is the nose.
- Sneezing.
- Dryness of nose.
Painkillers like paracetamol
Medicines like paracetamol are anti fever medicine with some painkiller effects. It does not relieve nasal congestion but relieves symptoms associated with nasal congestion like headache and body ache.
Combination of medicines
Many medicines available as over the counter medicines contain combinations of one or many of the above. These medicines used longer without may cause more harm than any benefit. You should visit your doctor before taking these medicines.
