Nasal congestion

Nasal congestion

Definition:

Congested nose and sinuses.

Alternative Names:

Obstruction of the nose; Nose congested; Nasal obstruction; Congested nose; Deviated nasal septum; Nose obstruction; Stuffy nose; Rhinitis medicamentosa

Considerations:

A stuffy nose is usually caused by a virus and typically resolves spontaneously within a week.

Nasal congestion has many causes and can range from a mild annoyance to a life-threatening condition. The newborn infant is an obligate nose breather (must breathe through the nose). Nasal congestion in an infant in the first few months of life can interfere with nursing 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 episodes of not breathing during sleep (sleep apnea). In children, nasal congestion from enlarged adenoids has caused chronic sleep apnea with insufficient oxygen levels (hypoxia) and right-sided heart failure. The problem usually resolves after surgery to remove the adenoids and tonsils.

Common Causes:

common cold or influenza
- often accompanied by a clear, watery discharge plus fever, cough, headache, joint aches, muscle aches, or sore throat
hay fever
- often accompanied by a clear, watery discharge, itching eyes, and sneezing
a sinus infection
- often accompanied by thick, cloudy, yellow-green nasal discharge, and pain or tenderness around eyes and cheekbones that worsens when bending the head forward

Home Care:

Drink plenty of fluids, more than usual. Water, fruit juice, teas, and carbonated drinks are recommended. Rest as much as possible. Increase air moisture with a vaporizer or humidifier.

Neither influenza nor the common cold can be cured with medication; however, nonprescription drugs, such as acetaminophen, decongestants, nose drops or sprays, cough remedies (Cough/Cold Combinations - oral), 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 colds caused by influenza.

For a stuffy nose caused by hay fever, avoid exposure to as many allergens (such as pets, foods that cause allergic reaction, and dust) as possible. 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.

For a baby too young to blow his or her nose, use an infant nasal aspirator. If mucus is thick and sticky, loosen it by putting 2 or 3 drops of salt solution (consisting of one-half teaspoon of salt to 1 cup of warm water) into each nostril.

If the air in your home is dry, a humidifier should be used.

Don't insert cotton swabs into a child's nostrils. Instead, catch the discharge outside the nostril on a tissue or swab, roll it around, and pull the discharge out of the nose. Petroleum jelly applied to the nasal openings (be sure not to block them) will help protect against irritation.

Call your health care provider if:

the stuffy nose is accompanied by swelling of the face (forehead, eyes, side of the nose, or cheek) or blurred vision.
there is increased throat pain, or white or yellow spots on the tonsils or other parts of the throat.
there are coughing episodes that last longer that 10 days or if the cough produces yellow-green or gray sputum.
a stuffy nose lasts longer than 2 weeks and impairs lifestyle.

What to expect at your health care provider's office:

The medical history will be obtained and a physical examination performed.

Medical history questions documenting your symptom in detail may include:

time pattern
- When did it develop?
- Is it always present?
- How long has it lasted?
relieving factors
- What have you done to try to relieve the congestion?
- How well has it worked?
other
- What other symptoms are also present?
- Is there nasal drainage?
- Is there a loss of smell?
- Is there difficulty breathing through the nose?
- Are there watery eyes?
- Is there eye burning, itching, or redness?
- Is there sneezing?
- Is there a fever?
- Is there a cough?
- Is there a headache?
- Is there pain in the face?

The physical examination may include an examination of the upper respiratory system, ears, nose, and throat.

Diagnostic tests that may be performed include:

allergy skin tests
blood tests (such as CBC or blood differential)
sputum culture and throat culture
X-rays of the sinuses and chest X-ray

Intervention:
Over-the-counter medications may be recommended (see antihistamines and decongestants). Stronger, prescription medications may be advised. For severe hay fever cases, desensitization injections for known allergens may be administered. Other treatment, including surgery, may be advised depending on the cause.

After seeing your health care provider:
You may want to add a diagnosis related to nasal congestion to your personal medical record.

Review Date: 12/2/2001
Reviewed By: Jonathan Fanaroff, M.D., Department of Pediatrics, Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland, OH. Review provided by VeriMed Healthcare Network.

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