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Nasal congestion, stuffiness, or obstruction to nasal breathing is one of the oldest and most common human complaints.
Experts have established four main causes of nasal obstruction: infection, structural abnormalities, allergic, and nonallergic (vasomotor) rhinitis. During a viral infection, the nose has poor resistance to bacteria, which is why infections of the nose and sinuses often follow a “cold.” When the nasal mucus turns from clear to yellow or green, it usually means that a bacterial infection has set in.
Chronic sinus infections may or may not cause pain, but usually involve nasal obstruction and offensive nasal or postnasal discharge. These include deformities of the nose and nasal septum; the thin, flat cartilage and bone that divides the two sides of the nose and nostrils.
One of the most common causes of nasal obstruction in children is enlargement of the adenoids.
Hay fever, rose fever, grass fever, and summertime colds are various names for allergic rhinitis.
In addition to allergies and infections, certain circumstances can cause nasal blood vessels to expand, leading to vasomotor rhinitis. Patients who get sleepy from antihistamines should not drive an automobile or operate dangerous equipment after taking them.
Cortisone-like drugs (corticosteriods) are powerful decongestants, administered as nasal sprays to minimize the risk of serious side effects associated with other dosage forms. For some, it may only be a nuisance; for others, nasal congestion can be a source of considerable discomfort. These viral infections occur more often in childhood because immunity strengthens with age. Pain may occur in cheeks and upper teeth, between and behind the eyes, or above the eyes and in the forehead, depending on which sinuses are involved.


Some people develop polyps (fleshy growths in the nose) from sinus infections, and the infection can spread to the lower airways, leading to a chronic cough, bronchitis, or asthma. These deformities are usually the result of an injury, sometimes having occurred in childhood.
Allergy is an exaggerated inflammatory response to a substance which, in the case of a stuffy nose, is usually pollen, mold, animal dander, or some element in house dust. SLIT skin tests and sometimes blood tests are used to make up vials of allergy-inducing substances specific to an individual patient’s profile. During a cold, blood vessels expand, membranes become congested, and the nose becomes stuffy, or blocked.
These include psychological stress, inadequate thyroid function, pregnancy, certain anti-high blood pressure drugs, prolonged overuse of decongesting nasal sprays, and exposure to irritants such as perfumes and tobacco smoke. Decongestants increase pulse rate and elevate blood pressure and therefore should be avoided by those with high blood pressure, irregular heart beat, glaucoma, or difficulty urinating. Patients using steroid nasal sprays should follow instructions carefully, and consult a physician immediately if they develop nasal bleeding, crusting, pain, or vision changes. A cold is caused by one of many different viruses, some of which are airborne, but most are transmitted by hand-to-nose contact. Acute sinus infections generally respond to antibiotic treatment; chronic sinusitis may require surgery. If a foul-smelling discharge is observed draining from one nostril, a physician should be consulted.
Pollen may cause problems during spring, summer, and fall, whereas house dust allergies are often most evident in the winter. Membranes in the nose have an abundant supply of arteries, veins, and capillaries, which have the ability to expand and constrict.


However, if the condition persists, the blood vessels lose their capacity to constrict, much like varicose veins. Once the virus is absorbed by the nose, it causes the body to release histamine, a chemical which dramatically increases blood flow to the nose and causes nasal tissue to swell.
Children who are chronic mouth breathers may develop a sagging face and dental deformities. Once injected, these treatments form blocking antibodies in the patient’s blood stream that interfere with the allergic reaction. When the patient lies down on one side, the lower side becomes congested, which interferes with sleep.
This inflames the nasal membranes which become congested with blood and produce excessive amounts of mucus that “stuffs up” the nasal airway. In the allergic patient, the release of histamine and similar substances results in congestion and excess production of watery nasal mucus. Antihistamines and decongestants help relieve the symptoms of a cold, but no medication can cure it. Adrenaline causes constriction of the nasal membranes so that the air passages open up and the person breathes freely.
Typical antihistamines include Benadryl®, Chlortrimetron®, Claritin®, Teldrin®, Dimetane®, Hismanal®, Nolahist®, PBZ®, Polaramine®, Seldane®, Tavist®, Zyrtec®, Allegra®, and Alavert®, which are often available without a prescription and are available in several generic forms.



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